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on Health Economics |
| By: | Richard J. Manski; John F. Moeller; Haiyan Chen; Jody Schimmel Hyde; John V. Pepper; Patricia A. St. Clair |
| Abstract: | The authors analyze correlates of the direction and magnitude of changes in out-of-pocket (OOP) payments for dental care by older Americans over a recent 4-year period. |
| Keywords: | dental insurance, coverage, dental use, self-payments |
| JEL: | I |
| Date: | 2015–08–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:230eee5ffdd847f48db5688b21ccc413&r=hea |
| By: | Richard D. Kim; Vishesh K. Kapur; Julie Redline-Bruch; Michael Rueschman; Dennis H. Auckley; Ruth M. Benca; Nancy R. Foldvary-Schafer; Conrad Iber; Phyllis C. Zee; Carol L. Rosen; Susan Redline; Scott D. Ramsey |
| Abstract: | For payers, a home-based diagnostic pathway for obstructive sleep apnea with robust patient support incurs fewer costs than a laboratory-based pathway. For providers, costs are comparable if not higher, resulting in a negative operating margin. |
| Keywords: | sleep apnea |
| JEL: | I |
| Date: | 2015–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:56b383ab573d426087b7ad90ced5309b&r=hea |
| By: | Anna L. Kratz; Edmund Chadd; Mark P. Jensen; Matthew Kehn; Thilo Kroll |
| Abstract: | The authors examined the psychometric properties of the Community Integration Questionnaire (CIQ) in large samples of individuals with spinal cord injury (SCI). |
| Keywords: | Spinal cord injury, Community Integration Questionnaire, Factor analysis, Validity, Reliability |
| JEL: | I |
| Date: | 2015–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:928cc1df1cf84a65827bfca0f5a940ad&r=hea |
| By: | Kevin Denny |
| Abstract: | Numerous papers have documented a positive association between height and good physical health and also with good economic outcomes such as earnings. A smaller number have argued for an association with well-being. In this paper, cross-country data from Europe is used to analyse whether individuals’ height is associated with higher or lower levels of life-satisfaction. In simple models there is a positive but concave relationship between height and life satisfaction. However it is shown that the results are quite sensitive to the inclusion of controls reflecting demographics, human capital and health status. Where effects do exist, it is predominantly at low to medium levels of height. There is also evidence of heterogeneity across countries. |
| Keywords: | Height; Stature; Well-being; Life satisfaction; Health |
| JEL: | I31 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:ucn:wpaper:201530&r=hea |
| By: | Chowdhury, Shyamal; Krause, Annabelle; Zimmermann, Klaus F |
| Abstract: | This paper investigates the effect of drinking arsenic contaminated water on mental health. Drinking water with an unsafe arsenic level for a prolonged period can lead to arsenicosis, which includes symptoms such as black spots on the skin and subsequent illnesses such as various cancers. We collected household survey data from Bangladesh, a country with wide arsenic contamination of groundwater to construct several measures for arsenic contamination that include the actual arsenic level in the respondent’s tubewell (TW) and past institutional arsenic test results, as well as collected household members’ arsenicosis symptoms and their physical and mental health. We find that suffering from an arsenicosis symptom is strongly negatively related to mental health, even more so than from other illnesses. Furthermore, individuals drinking from an untested TW have lower mental health and having to walk a longer distance to a TW also decreases mental health. Calculations of the costs of arsenic contamination reveal that the average individual would need to be compensated for suffering from an arsenicosis symptom by an amount as high as the average annual household income. |
| Keywords: | arsenic; Bangladesh; environment; mental health; subjective well-being; water pollution |
| JEL: | I10 I31 Q53 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:10978&r=hea |
| By: | Bijlsma, M.; Boone, Jan (Tilburg University, TILEC); Zwart, G.T.J. (Tilburg University, TILEC) |
| Abstract: | We analyze the role of community rating in the optimal design of a risk adjustment scheme in competitive health insurance markets when insurers have better information on their customers’ risk profiles than the sponsor of health insurance. The sponsor offers insurers a menu of risk adjustment schemes to elicit this information. The optimal scheme includes a voluntary reinsurance option. Additionally, the scheme should sometimes be complemented by a community rating requirement. The resulting inefficient coverage of low-cost types lowers the sponsor’s cost of separating different insurer types. This allows the sponsor to redistribute more rents from low-cost to high-cost consumers. |
| Keywords: | health insurance; cherry picking; risk adjustment; mechanism design |
| JEL: | D02 I3 |
| Date: | 2015 |
| URL: | http://d.repec.org/n?u=RePEc:tiu:tiutil:43ea34f9-763a-451a-9f12-5761deb6a710&r=hea |
| By: | Anthony J Culyer (Emeritus Professor, Centre for Health Economics, University of York, UK. Adjunct Professor, University of Toronto, Canada) |
| Abstract: | There is misunderstanding about both the meaning and the role of cost-effectiveness thresholds in policy decision making. This article dissects the main issues by use of a bookshelf metaphor. Its main conclusions are these -  It must be possible to compare interventions in terms of their impact on a common measure of health.  Mere effectiveness is not a persuasive case for inclusion in public insurance plans.  Public health advocates need to address issues of relative effectiveness.  A ‘first best’ benchmark or threshold ratio of health gain to expenditure identifies the least effective intervention that should be included in a public insurance plan.  The reciprocal of this ratio – the ‘first best’ cost-effectiveness threshold – will rise or fall as the health budget rises or falls (ceteris paribus).  Setting thresholds too high or too low costs lives.  Failure to set any cost-effectiveness threshold at all also involves avertable deaths and morbidity.  The threshold cannot be set independently of the health budget.  The threshold can be approached from either the demand-side or the supply side – the two are equivalent only in a health-maximising equilibrium.  The supply-side approach generates an estimate of a ‘second best’ cost-effectiveness threshold that is higher than the ‘first best’.  The second best threshold is the one generally to be preferred in decisions about adding or subtracting interventions in an established public insurance package.  Multiple thresholds are implied by systems having distinct and separable health budgets.  Disinvestment involves eliminating effective technologies from the insured bundle.  Differential (positive) weighting of beneficiaries’ health gains may increase the threshold.  Anonymity and identity are factors that may affect the interpretation of the threshold.  The true opportunity cost of health care in a community, where the effectiveness of interventions is determined by their impact on health, is not to be measured in money – but in health itself |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:chy:respap:121cherp&r=hea |
| By: | Emmanuel CHABERT; Antoine MONS; Bruno PEIRERA; Martine AUDIBERT (Centre d'Etudes et de Recherches sur le Développement International(CERDI)); Nadia YAKHELEF |
| Abstract: | Purpose: To evaluate the cost-utility of Vertebroplasty versus conservative therapy (Thoracolumbosacral orthosis) for treatment of post-traumatic non-osteoporotic and/or non-neoplastic fractures. Materials and Methods: A prospective, randomized, non-blinded, single-center study was carried out between 2010 and 2013. The study included 99 patients, aged from 18 years to 70 years, suffering from acute non-osteoporotic vertebral fracture. We compared costs and Quality-Adjusted Life Years and assessed the Incremental Cost-Effectiveness Ratio for the two arm groups. Health insurance, patient and societal perspectives are considered. Results: For health insurance perspective, total cost was €7,267 for the brace group versus €7,365 for the vertebroplasty group (mean difference €75.3; p <0.9). For patient perspective, total cost was €5,303 for the brace group and €3,435 for the vertebroplasty group (mean difference €-1,900.7; p<0.02). For societal perspective, total cost was €13,071 for the brace group and €14,289 for the vertebroplasty group (mean difference €1,165, p <0.36). Differences between groups in QALY were non-significant: 0.01 (95% CI -0.01; 0.04 p=0.5). The Incremental Cost-Effectiveness Ratio was €-12,200 for the health insurance perspective, €159,200 for the patient perspective and €119,466 for societal perspective. Conclusion: The difference in QALYs does not differ between the two groups, but the vertebroplasty technique results in significantly lower costs from a patient perspective. From societal and health insurance perspectives, we are unable to conclude if the vertebroplasty was more cost-effective than Thoracolumbosacral orthosis. |
| Keywords: | Health economic assessment ; Cost-utility ; QALY ; SF-36 ; SF-6D ; Vertebroplasty ; TLSO ; Clinical |
| JEL: | O33 I19 I18 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:cdi:wpaper:1768&r=hea |
| By: | David (David Patrick) Madden |
| Abstract: | An association between health and education has been well-established empirically. It is not clear however whether this represents a causal effect and, if so, in which direction. Recent research has attempted to unravel this by using educational reforms, such as compulsory schooling laws, as exogenous sources of variation in education and examining their long-run effects on a variety of health outcomes. When proper account is taken of age, cohort, and state specific effects, it is difficult to establish a credible causal link from educational reforms which affect the quantity of education to health. Thus the balance of research so far suggests that it would be imprudent to assign a causal effect from educational reforms to long-run health. |
| Keywords: | Returns to education; Schooling reforms; Long-run health |
| JEL: | I12 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:ucn:wpaper:201531&r=hea |
| By: | Cheng,T.C.;; Costa-i-Font, J.;; Powdthavee, N.; |
| Abstract: | We exploit lottery wins to investigate the eects of exogenous changes to individuals' income on health care demand in the United Kingdom. This strategy allows us to estimate lottery income elasticities for a range of health care services that are publicly and privately provided. The results indicate that lottery winners with larger wins are more likely to choose private health services than public health services from the National Health Service. The positive eect of wins on the choice of private care is driven largely by winners with medium to large winnings (win category > $500 (or US$750); mean = $1922:5 (US$2,893.5), median = $1058:2 (US$1592.7)). For privately-insured individuals, larger winners are more likely to obtain private care for dental services and for eye, blood pressure, and cervical examinations. For individuals without private insurance, lottery wins have no effect on the choice of public or private care. We find that medium to big winners are more likely to have private medical insurance. Large winners are also more likely to drop coverage earlier, possibly after their winnings have been exhausted. The elasticities with respect to lottery wins are comparable in magnitude to the elasticities of household income from fixed effect models. |
| Keywords: | lottery wins, health care; income elasticity; public-private |
| JEL: | H42 I11 D1 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:yor:hectdg:15/30&r=hea |
| By: | Kerris Cooper; Kitty Stewart |
| Abstract: | There is ample evidence that adults with lower incomes tend to have worse outcomes including worse health, lower life expectancy and lower subjective wellbeing than individuals with more. But is money in adulthood itself important? Or are these relationships driven by other factors such as higher levels of education, underlying personality traits or the long-term impact of childhood circumstances? This study reviews the evidence, focusing on research that tested whether the relationship between money and outcomes in adulthood is causal. |
| Keywords: | money, poverty, health, adult, wellbeing |
| JEL: | I30 I31 I32 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:cep:sticar:case/96&r=hea |
| By: | Apergis, Nicholas; Ben Jebli, Mehdi |
| Abstract: | This paper employs a number of panel methodological approaches to explore the link between per capita carbon dioxide emissions, per capita real income, renewable energy consumption and health expenditures for a panel of 42 sub-Saharan African countries, spanning the period 1995-2011. The empirical findings provide supportive of a long-run relationship among the variables. Granger causality reveals the presence of a short-run unidirectional causality running from real GDP to CO2 emissions, a bidirectional causality between renewable energy consumption and CO2 emissions, a unidirectional causality running from real GDP to renewable energy consumption, and a unidirectional causality running from real GDP to heath expenditure, while long-run estimates document that both renewable energy consumption and health expenditures contribute to the reduction of carbon emissions, while real GDP leads to the increase of emissions in these countries. The results are expected to be of high importance for policymakers in the region. Both renewable energy consumption and expansionary health expenditures are the major drivers of pollution declines. In that sense the findings imply that a substantial part of the state budget in relevance to health expenditures would be a good path to combat global warming in these countries. |
| Keywords: | carbon emissions; renewable energy consumption; health expenditures; panel data; Sub-Saharan countries. |
| JEL: | C1 I15 |
| Date: | 2015–08–01 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:68294&r=hea |
| By: | Cavalieri, M.;; Guccio, C.;; Lisi, D.;; Pignataro, G.; |
| Abstract: | Recently increasing public pressure to contain costs in the healthcare sector has led many national governments to introduce some type of prospective payment system and reduce the scope of global budgeting. This study investigates the extent to which the reimbursement systems of the Italian hospital sector have an impact on hospitals’ technical efficiency. Because of high variation in the financing and provision of healthcare servicesamong regions and hospitals, Italy represents an interesting case study to test these effects. A two-stage Data Envelopment Analysis was employed, in which the efficiency scores of all Italian hospitals were first calculated and then regressed on different environmental variables to capture the role of reimbursement systems. The results found a significant impact of the use of Diagnostic-Related Group-based prospective payment systems on hospitals’ efficiency. |
| Keywords: | hospital efficiency; Data Envelopment Analysis; prospective payment systems; hospital ownership type; |
| JEL: | C14 I11 I18 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:yor:hectdg:15/29&r=hea |
| By: | Duijzer, E.; van Jaarsveld, W.L.; Wallinga, J.; Dekker, R. |
| Abstract: | For a large number of infectious diseases, vaccination is the most effective way to prevent an epidemic. However, the vaccine stockpile is hardly ever sufficient to treat the entire population, which brings about the challenge of vaccine allocation. To aid decision makers facing this challenge, we provide insights into the structure of this problem. We first investigate the dependence of health benefit on the fraction of people that receive vaccination, where we define health benefit as the total number of people that escape infection. We start with the seminal SIR compartmental model. Using implicit function analysis, we prove the existence of a unique vaccination fraction that maxi- mizes the health benefit per dose of vaccine, and that the health benefit per dose of vaccine decreases monotonically when moving away from this fraction in either direc- tion. Surprisingly, this fraction does not coincide with the so-called critical vaccination coverage that has been advocated in literature. We extend these insights to other compartmental models such as the SEIR model. These results allow us to provide new insights into vaccine allocation to multiple non-interacting or weakly interacting populations. We explain the counter-intuitive switching behavior of optimal allocation. We show that allocations that maximize health benefits are rarely equitable, while equitable allocations may be significantly non-optimal. |
| Keywords: | resource allocation, optimization, vaccination, disease modelling, infectious diseases |
| Date: | 2015–10–29 |
| URL: | http://d.repec.org/n?u=RePEc:ems:eureir:79212&r=hea |
| By: | Joshua C. Hall (West Virginia University, Department of Economics); Brad R. Humphreys (West Virginia University, Department of Economics); Jane E. Ruseski (West Virginia University, Department of Economics) |
| Abstract: | The social determinants of health include the communities in which people reside. Associated with geographic areas are public policies that influence a variety of economic and social outcomes. The group of public policies associated with economic freedom have been found to be positively related to a number of economic and social outcomes. In this paper, we investigate the impact of economic freedom on self-reported health and racial health disparities. We use propensity score matching to construct a control group of whites who can be compared to blacks in the 2011 BRFSS. After accounting for confounding variables and possible selection, we find evidence that economic freedom is associated with lower levels of self reported health for the population overall. After allowing for the effects of economic freedom to differ by race, we find that higher levels of economic freedom mitigate the observed gap in health status. |
| Keywords: | economic freedom, health disparities |
| JEL: | I12 I18 J22 R5 |
| Date: | 2015–10 |
| URL: | http://d.repec.org/n?u=RePEc:wvu:wpaper:15-43&r=hea |
| By: | Anthony J Culyer (Emeritus Professor, Centre for Health Economics, University of York, UK. Adjunct Professor, University of Toronto, Canada) |
| Abstract: | Three common “Es†have high ethical and political content for health policy: efficiency, equity and equality. This article examines the links between the three, with especial attention given to (a) the claimed conflict between efficiency and equity, (b) the equity of inequalities and (c) the conflict between six equity principles: equal health, equal health gain, equal value of additional health, maintaining existing distributions, allocation according to need and equal per capita resources. Conclusions include -  Efficiency and equity do not inherently conflict  an inefficient allocation can be equitable  an efficient allocation can be inequitable  an inefficient allocation can become more efficient without increasing inequity  what is equitable often requires inequality in health and inequality in resource distribution per capita  equality in health requires inequality in resource allocation  equality in resource allocation typically leads to inequality in health  allocation according to need typically leads to inequality in health |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:chy:respap:120cherp&r=hea |
| By: | Blum, Matthias; Rei, Claudia |
| Abstract: | The large-scale persecution of Jews during World War II generated massive refugee movements. Using data from 20,441 predominantly Jewish passengers from 19 countries traveling from Lisbon to New York between 1940 and 1942, we analyze the last wave of refugees escaping the Holocaust and verify the validity of height as a proxy for human and health capital. We further show this episode of European migration displays well-known features of migrant self-selection: early migrants were taller than late migrants; a large migrant stock reduces migrant selectivity; and economic barriers to migration apply. Our findings show that Europe experienced substantial losses in human and health capital while the US benefitted from the immigration of European refugees. |
| Keywords: | migration,refugees,World War II,Holocaust,Germany,New York |
| JEL: | N32 N34 N42 N44 F22 J24 O15 |
| Date: | 2015 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:qucehw:1508&r=hea |
| By: | Schünemann, Johannes; Strulik, Holger; Trimborn, Timo |
| Abstract: | Aging humans adapt to their worsening state of health and old people are usually happier than estimated by young individuals. In this paper we investigate how adaptation to a deteriorating state of health affects health spending, life expectancy, and the value of life. We set up a a life cycle model in which individuals are subject to physiological aging, calibrate it with data from gerontology, and compare behavior and outcomes of adapting and non-adapting individuals. While adaptation generally increases the value of life (by about 2 to 5 percent), its impact on health behavior and longevity depends crucially on whether individuals are aware of their adaptive behavior. |
| Keywords: | health,adaption,aging,longevity,health care demand |
| JEL: | D91 J17 J26 I12 |
| Date: | 2015 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:cegedp:268&r=hea |
| By: | José A. Tapia Granados; Javier M. Rodriguez |
| Abstract: | Reports have attributed a public health tragedy in Greece to the Great Recession and the subsequent application of austerity programs. |
| Keywords: | Population health, Health service performance, Greece, Iceland, Finland |
| JEL: | I |
| Date: | 2015–07–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:1cdbac6dc6c548e3877b7b1809cc5629&r=hea |
| By: | Kazumi Shimizu (Department of Political Science and Economics, Waseda University); Daisuke Udagawa (Faculty of Economics, Hannan University) |
| Abstract: | The “peanuts effect,” which states that people are more willing to gamble when playing for "peanuts" (a small outcome), has been stably observed in the context of a small monetary stake. We conducted 2 experiments to verify whether the peanuts effect still occurred when the type of stakes changed. Our results showed that people tend to gamble more for a qualitatively smaller value when the stake is material in nature, but are less willing to take a risk for a smaller value when the stake is a human life. This risk attitude change may support the contingent weighting model. |
| Keywords: | peanuts effect, life-or-death decision, contingent weighting model, risk attitude, disappointment, monetary stakes |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:wap:wpaper:1518&r=hea |
| By: | Ambel,Alemayehu A.; Andrews,Colin; Bakilana,Anne Margreth; Foster,Elizabeth; Khan,Qaiser M.; Wang,Huihui |
| Abstract: | Recent surveys show considerable progress in maternal and child health in Ethiopia. The improvement has been in health outcomes and health services coverage. The study examines how different groups have fared in this progress. It tracked 11 health outcome indicators and health interventions related to Millennium Development Goals 1, 4, and 5. These are stunting, underweight, wasting, neonatal mortality, infant mortality, under-five mortality, measles vaccination, full immunization, modern contraceptive use by currently married women, antenatal care visits, and skilled birth attendance. The study explores trends in inequalities by household wealth status, mothers? education, and place of residence. It is based on four Demographic and Health Surveys implemented in 2000, 2005, 2011, and 2014. Trends in rate differences and rate ratios are analyzed. The study also investigates the dynamics of inequalities, using concentration curves for different years. In addition, a decomposition analysis is conducted to identify the role of proximate determinants. The study finds substantial improvements in health outcomes and health services. Although there still exists a considerable gap between the rich and the poor, the study finds some reductions in inequalities of health services. However, some of the improvements in selected health outcomes appear to be pro-rich. |
| Keywords: | Health Systems Development&Reform,Health Monitoring&Evaluation,Population Policies,Early Child and Children's Health,Early Child and Children',Adolescent Health |
| Date: | 2015–12–09 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wbrwps:7508&r=hea |
| By: | Jean-Claude Berthélemy (Centre d'Economie de la Sorbonne); Victor Doubliez (Centre d'Economie de la Sorbonne); Josselin Thuilliez (Centre d'Economie de la Sorbonne) |
| Abstract: | This article estimates the effect of the introduction of an effective treatment on prevention behaviors in the case of malaria. We rely on microeconomic data and build up a difference-in-differences analysis of individuals prevention behaviors following the introduction of Artemisinin Combination Therapies (ACTs) in Angola. We exploit differences in terms of treatment intensity across geographic areas and differences in individuals exposure to the introduction of ACTs. Our results suggest that the increase in access to treatment for malaria in Angola may have had a negative impact on the use of Insecticide Treated Nets even though the two were jointly promoted over the period |
| Keywords: | Malaria; Treatment; Prevention |
| JEL: | O12 I15 I25 |
| Date: | 2015–10 |
| URL: | http://d.repec.org/n?u=RePEc:mse:cesdoc:15089&r=hea |
| By: | R. Verzulli; G. Fiorentini; M. Lippi Bruni; C. Ugolini |
| Abstract: | This paper examines the behaviour of public hospitals in response to the average payment incentives created by price changes for patients classified in different Diagnosis Related Groups (DRGs). Using panel data on public hospitals located within the Italian region of Emilia-Romagna, we test whether a one-year increase in DRG prices induced public hospitals to increase their volume of activity, and whether a potential response is associated with changes in waiting times and/or length of stay. We find that public hospitals reacted to the policy change by increasing the number of patients with surgical treatments. This effect was smaller in the two years after the policy change than in later years, and for providers with a lower excess capacity in the pre-policy period, whereas it did not vary significantly across hospitals according to their degree of financial and administrative autonomy. For patients with medical DRGs, instead, there appeared to be no effect on inpatient volumes. Our estimates also suggest that an increase in DRG prices either decreased or had no impact on the proportion of patients waiting more than six months. Finally, we find no evidence of a significant effect on patients’ average length of stay. |
| JEL: | I11 I12 I18 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:bol:bodewp:wp1041&r=hea |
| By: | Kevin P. Collins; Sean D. Cleary |
| Abstract: | Economics, family status, non-English language in the home, and neighborhood safety factors differentially impacted diagnosed ADHD across racial/ethnic groups. |
| Keywords: | Racial Ethnic Disparities, ADHD, Survey , Children's Health |
| JEL: | I |
| Date: | 2015–11–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b058db857503494eb1ca293fa48caa2d&r=hea |
| By: | Kristin L. Reiter; Kristin Andrews Lemos; Charlotte E. Williams; Dominick Esposito; Sandra B. Greene |
| Abstract: | To measure the return on investment (ROI) for a pediatric asthma pay-for-reporting intervention initiated by a Medicaid managed care plan in New York State. |
| Keywords: | Medicaid, asthma, pay-for-reporting, audit and feedback, business case, return on investment |
| JEL: | I |
| Date: | 2015–06–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:4b890380251a415ab7ed76666cf91dc4&r=hea |
| By: | Milesh M. Patel; Jonathan D. Brown; Sarah Croake; Rita Lewis; Junqing Liu; Lisa Patton; D. E. B. Potter; Sarah Hudson Scholle |
| Abstract: | This review examined the extent to which existing behavioral health quality measures address the priority areas of the National Behavioral Health Quality Framework (NBHQF) as well as the extent to which the measures have received National Quality Forum endorsement and are used in major reporting programs. |
| Keywords: | behavioral health, quality measures |
| JEL: | I |
| Date: | 2015–08–01 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:58ad9003b9b34f65aeb8424214765b3b&r=hea |
| By: | Daniel Grossman (West Virginia University, Department of Economics) |
| Abstract: | I estimate the health impacts of the Empowerment Zone (EZ) program - a federal program that gave sizeable grants and tax breaks to certain high-poverty census tracts in selected cities. Using difference-in-differences methods, I find that the EZ program decreased fertility rates by 11 percent and improved birth outcomes. This increase in infant health was not driven by changes in the composition of births. Synthetic control methods and estimates using an alternate control group support these findings. Recent research on the later-life impacts of low birth weight suggest that the health impacts of this program may have substantial long-term benefits. |
| Keywords: | urban empowerment zones, fertility, health, chicago, new york, philadelphia |
| Date: | 2015–10 |
| URL: | http://d.repec.org/n?u=RePEc:wvu:wpaper:15-44&r=hea |
| By: | Ho, Katherine; Hogan, Joseph; Scott Morton, Fiona |
| Abstract: | Medicare Part D presents a novel privatized structure for a government pharmaceutical benefit. Incentives for firms to provide low prices and high quality are generated by consumers who choose among multiple insurance plans in each market. To date the literature has primarily focused on consumers, and has calculated how much could be saved if they chose better plans. In this paper we take the next analytical step and consider how plans will adjust prices as consumer search behavior improves. We use detailed data on enrollees in New Jersey to demonstrate that consumers switch plans infrequently and imperfectly. We estimate a model of consumer plan choice with inattentive consumers. We then turn to the supply side and examine insurer responses to this behavior. We show that high premiums are consistent with insurers profiting from consumer inertia. We use the demand model and a model of firm pricing to calculate how much lower Part D program costs would be if consumer inattention were removed and plans re-priced in response. Our estimates indicate that consumers would save $601 each over three years when firms’ choice of markup is taken into account. Cost growth would also fall: by the last year of our sample government savings would amount to $224 million per year or 4.1% of the cost of subsidizing the relevant enrollees. |
| Keywords: | consumer inattention; firm pricing; health insurance |
| JEL: | I11 L1 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:10976&r=hea |
| By: | Huijie Yan (Aix-Marseille University (Aix-Marseille School of Economics), CNRS & EHESS) |
| Abstract: | The goal of sustainable development is far from being achieved in China. In this context, this paper aims to provide an overview of China’s energy, environment and health policies over the past 30 years and discuss whether the previous policies have fully integrated the energy, environment and health issues in its sustainable development agenda. From the overview, we observe that the energy policies accelerating energy industrial upgrading, stimulating development of new energy sources, deregulating energy pricing mechanism, promoting energy saving and seizing the opportunity of green growth are conducive to an improvement of environmental conditions and public health in China. However, the environmental policies are not effectively implemented and subsequently they could not succeed in reducing environmental risks on public health and putting pressure on enterprises to efficiently use energy. The health policies have not taken real actions to focus with any specificity on energy-induced or pollution-induced health problems. |
| Keywords: | Energy, Environment, Health, China |
| JEL: | Q48 Q53 Q58 I18 |
| Date: | 2015–11–10 |
| URL: | http://d.repec.org/n?u=RePEc:aim:wpaimx:1548&r=hea |
| By: | Zack Cooper; Stuart Craig; Martin Gaynor; John Van Reenen |
| Abstract: | We use insurance claims data for 27.6 percent of individuals with private employer-sponsored insurance in the US between 2007 and 2011 to examine the variation in health spending and in hospitals' transaction prices. We document the variation in hospital prices within and across geographic areas, examine how hospital prices influence the variation in health spending on the privately insured, and analyze the factors associated with hospital price variation. Four key findings emerge. First, health care spending per privately insured beneficiary varies by a factor of three across the 306 Hospital Referral Regions (HRRs) in the US. Moreover, the correlation between total spending per privately insured beneficiary and total spending per Medicare beneficiary across HRRs is only 0.14. Second, variation in providers' transaction prices across HRRs is the primary driver of spending variation for the privately insured, whereas variation in the quantity of care provided across HRRs is the primary driver of Medicare spending variation. Consequently, extrapolating lessons on health spending from Medicare to the privately insured must be done with caution. Third, we document large dispersion in overall inpatient hospital prices and in prices for seven relatively homogenous procedures. For example, hospital prices for lower-limb MRIs vary by a factor of twelve across the nation and, on average, two-fold within HRRs. Finally, hospital prices are positively associated with indicators of hospital market power. Even after conditioning on many demand and cost factors, hospital prices in monopoly markets are 15.3 percent higher than those in markets with four or more hospitals. |
| Keywords: | healthcare, health spending, hospitals, prices, price dispersion, competition, market structure |
| JEL: | L10 L11 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:cep:cepdps:dp1395&r=hea |
| By: | Catherine M. DesRoches; Kirsten A. Barrett; Bonnie E. Harvey; Rachel Kogan; James D. Reschovsky; Bruce E. Landon; Lawrence P. Casalino; Stephen M. Shortell; Eugene C. Rich |
| Abstract: | Databases of practicing physicians are important for studies that require sampling physicians or counting the physician population in a given area. However, little is known about how the three main sampling frames differ from each other. |
| Keywords: | sample, frame, physician, surveys |
| JEL: | I |
| Date: | 2015–08–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:dd9415f7585d4e4687e20b71c9ef87da&r=hea |
| By: | Billings, Stephen B.; Schnepel, Kevin |
| Abstract: | The presence of lead paint significantly impairs cognitive and behavioral development, yet little is known about how this residence-specific environmental health risk affects property values. In this paper, we estimate the benefits of lead-paint remediation on housing prices. Using data on all homes that applied to a HUD-funded program in Charlotte, North Carolina, we adopt a difference-in-differences estimator that compares values among remediated properties with those for which an inspection does not identify a lead paint hazard. Results indicate that remediation has large benefits—a typical investment of $7,291 is associated with a capitalized benefit of $20,323 as well as a reduction in residential turnover. |
| Keywords: | lead exposure; lead paint; lead hazard control, environmental quality; urban environmental health; difference-in-differences |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:syd:wpaper:2015-23&r=hea |
| By: | Hannes Schwandt; Amelie Wuppermann |
| Abstract: | Attention Deficit/Hyperactivity Disorder (ADHD) is a leading diagnosed health condition among children in many developed countries but the causes underlying these high levels of ADHD remain highly controversial. Recent research for the U.S., Canada and some European countries shows that children who enter school relatively young have higher ADHD rates than their older peers, suggesting that ADHD may be misdiagnosed in the younger children due to their relative immaturity. Using rich administrative health insurance claims data from Germany we study the effects of relative school entry age on ADHD risk in Europe's largest country and relate the effects for Germany to the international evidence. We further analyze different mechanisms that may drive these effects, focusing on physician supply side and demand side factors stemming from the production of education. We find robust evidence for school-entry age related misdiagnosis of ADHD in Germany. Within Germany and internationally, a higher share of misdiagnoses are related to a higher overall ADHD level, suggesting that misdiagnoses may be a driving factor of high ADHD levels. Furthermore, the effects in Germany seem to be driven by teachers and parents in an attempt to facilitate and improve the production of education. |
| Keywords: | ADHD, misdiagnosis, age cut-off, education |
| JEL: | I1 I2 J1 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:cep:cepdps:dp1394&r=hea |
| By: | Marian Jarlenski; Julia Baller; Sonya Borrero; Wendy L. Bennett |
| Abstract: | Some disparities in access to care related to family immigration status have lessened over time among children in low-income families, although large disparities still exist. |
| Keywords: | access to care, disparities, health insurance, immigrant |
| JEL: | I |
| Date: | 2015–08–29 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:66a19f6cc3ad45f49bda518ea783f27b&r=hea |
| By: | Vasilev, Aleksandar |
| Keywords: | RBC,health |
| JEL: | D91 |
| Date: | 2015 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:esrepo:124187&r=hea |