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on Health Economics |
| By: | Nitya Mittal and J V Meenakshi (Centre for Development Economics, Delhi School of Economics, University of Delhi, India) |
| Abstract: | The study analyses a rural household’s decision to participate in a public pre-school intervention called the Integrated Child Development Scheme (ICDS), and evaluates its impact on anthropometric outcomes of children in three Indian states, namely Bihar, Jharkhand and Orissa in the year 2012. Using multinomial logistic models, we find that access costs, defined both in physical (distance) and social (caste) terms, are the main drivers of ICDS utilization. We also estimate the impact of utilization of one or more of the multiple services offered by the ICDS on anthropometric outcomes, by using matching methods. Our results suggest that conditional on utilization, compared to singleton services, utilization of multiple services translates into larger increase in weight-for-age z-scores. Participation in all the services of the ICDS program leads to a 13 percentage points lower prevalence of underweight children. Given the evidence that relatively greater emphasis is placed on the supplementary nutrition component of the program, these results are not surprising. |
| Date: | 2015–10 |
| URL: | http://d.repec.org/n?u=RePEc:cde:cdewps:247&r=hea |
| By: | Sinne Smed (Department of Food and Resource Economics, University of Copenhagen); Lars Gårn Hansen (Department of Food and Resource Economics, University of Copenhagen) |
| Abstract: | Numerous studies find that education and the healthiness of diets are highly correlated. One possible explanation is that the most highly educated consumers are better at understanding and appreciating the health implications of their diet than consumers with less lower education. In this study, we estimate a hedonic model of consumers’ valuation of food characteristics that allows nutrients to influence utility both through their perceived effects on health and through their effects on the taste and consumption experience. We find that the most highly educated have the same or lower revealed preferences for health compared to the least educated, and we find that it is differences in taste preferences, not differences in health preferences, that explain why the most highly educated have a healthier diet. |
| Keywords: | hedonic model, taste, health, food consumption |
| JEL: | D12 I12 |
| Date: | 2016–01 |
| URL: | http://d.repec.org/n?u=RePEc:foi:wpaper:2016_01&r=hea |
| By: | Dana M. Petersen; Joseph Zickafoose; Mynti Hossain; Henry Ireys |
| Abstract: | Patient-centered medical home recognition can be valuable to practices as public acknowledgement to payers and patients that certain processes are in place, and can also catalyze new and continued transformation. |
| Keywords: | patient-centered medical home, child health, primary care, practice transformation, medical home recognition |
| JEL: | I |
| Date: | 2015–12–16 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:a5e5e46f11fd47099ce43bdef1610946&r=hea |
| By: | Jennifer Perloff; Catherine M. DesRoches; Peter Buerhaus |
| Abstract: | This study provides new evidence of the lower cost of care for beneficiaries managed by nurse practitioners, as compared to those managed by primary care physicians across inpatient and office-based settings. |
| Keywords: | Medicare Beneficiaries, Primary Care Nurse Practitioners and Physicians |
| JEL: | I |
| Date: | 2015–12–27 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:afadd8863f3c4d24afbea022db0f0b1b&r=hea |
| By: | Nuhu, Ahmed Salim |
| Abstract: | In this paper, we explore a unique exogenous instrument to examine how the intra-familial position of women influence health outcomes of their children using micro data from Ghana. Using the 2SLS-IV estimation technique,we build a model of household bargaining and child health development with perceptions of women regarding wife-beating and marital rape in the existence of domestic violence laws, in Ghana. Even though the initial OLS estimates suggest that women’s participation in decisions regarding purchases of household consumption goods help to improve child health outcomes, the IV estimates reveal that the presence of endogeneity underestimates the impact of women’s bargaining power on child health outcomes. Our test for endogeneity also confirms that child-health investment decisions is mediated through domestic violence laws, which protect women from physical and sexual abuse in the household. Our instrument is also robust to rural residency and father characteristics controls. |
| Keywords: | Keywords: Household Bargaining, Women Empowerment, Child Health Investment, Instrumental Variables, Domestic Violence |
| JEL: | J12 J13 J16 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:68630&r=hea |
| By: | Hu, Zihan; Li, Teng |
| Abstract: | Exposure to high temperatures during pregnancy is generally associated with low birth weight---a proxy for endowment. But whether such early life shock is further related to welfare losses in adulthood is still unknown. Utilizing random temperature fluctuations across 123 counties in China, we examine the relationships between high temperatures during pregnancy and birth weight and later outcomes. One standard deviation of high temperature days during pregnancy triggers about 0.17 kilograms loss of birth weight, and further in adulthood 1.63 cm decrease in height and 0.86 years less of schooling. Health and intelligence outcomes are adversely affected as well. The impacts are concentrated in the first and third trimesters. Such effects should become part of the calculations of the costs of global warming. Back-of-the-envelope predictions suggest that at the end of the 21st century newborns on average weigh 54.36-210.44 grams less. And the losses in height and education years are 0.52-2.02 centimeters and 0.26-1.01 years, respectively. We also argue these patterns are more likely consistent with physiological effects than with income effects, because total precipitation and high temperatures in the growing season of one year before birth have no significant effects. |
| Keywords: | High temperatures during pregnancy, birth weight, adult welfare outcomes, global warming |
| JEL: | I12 I21 Q51 Q54 |
| Date: | 2016–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:68631&r=hea |
| By: | Enami, Ali |
| Abstract: | Current literature is ambiguous regarding the significance of public health expenditure in reducing mortality rate among children in cross country studies. In fact, several previous studies found the relationship between these two variables to be insignificant. Such findings indicate the existence of a huge inefficiency in public sector of struggling countries and discourage supports provided by donating entities. This study addresses the disagreement in the literature by pointing out how results are sensitive to the use of non-stationary variables that are used often in the literature. Using a Panel Vector Autoregressive model, no empirical evidence for the role of public health expenditure in reducing child mortality is found when non-stationary variables are used. However, results are significantly different as soon as stationary variables are substituted in the same model. In fact, the elasticity of under five mortality rate with respect to per capita public health expenditure is about -0.22 for African countries in the sample. |
| Keywords: | Under five mortality rate, public health expenditure, female education, panel vector autoregressive, impulse-response analysis. |
| JEL: | C33 H51 I18 |
| Date: | 2016–01–05 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:68671&r=hea |
| By: | Enami, Ali |
| Abstract: | The “fetal origin hypothesis” predicts that the exposure to unfavorable environments early in life negatively affects future health and non-health (e.g. income) outcomes. This paper evaluates this theory by examining the effect of in utero exposure to influenza pandemic of 1957-58, the 2nd biggest of the 20th century, on the future earnings of exposed cohort. Using data from National Longitudinal Survey of Youth 1979 (NLSY79), a difference-in-differences model is estimated for four demographic groups: white and non-white males and females. While the effect of this exposure on earnings of white individuals is statistically insignificant, the effect is both (economically and statistically) significant and contradictory for non-whites. Non-white females experienced a $6100 loss in their yearly wage while the wage of non-white males increased by about $11900. |
| Keywords: | Fetal origin hypothesis; Earnings, Asian flu, NLSY79 |
| JEL: | I12 I19 N32 |
| Date: | 2016–01–05 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:68673&r=hea |
| By: | Fidel Gonzalez (Department of Economics and International Business, Sam Houston State University); Santosh Kumar (Department of Economics and International Business, Sam Houston State University) |
| Abstract: | We estimate the marginal impact of prenatal care on birth outcomes using a nationally representative data on about 14 million births in Mexico. Given the self-selection into prenatal care, we identify the causal impact of prenatal care on birth outcomes by estimating an instrumental variable model. We find positive impacts of increased prenatal visits on birthweight, length, and APGAR score of the newborn. The impacts of prenatal care on birth outcomes differ by mother's education, municipality's development level, and birthweight distribution. We find suggestive evidence that prenatal visit affects birth outcomes through reduction in pre-term births. |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:shs:wpaper:1505&r=hea |
| By: | Quan-Hoang Vuong |
| Abstract: | This paper communicates results from a statistical investigation into questions of relationships between sources of health-care information, data sufficiency, and final outcomes of Vietnamese patients' choice of health-care provider. The study employs a data set of 1459 observations collected from a survey in Hanoi in the fourth quarter of 2015. Significant relationships among these factors are identified following categorical data modeling employing the baselinecategory logit (BCL) method. Among the significant results reported, sources ofinformation, cost, and amount of time for seeking information are found to have significant influences on data sufficiency. The quality of information and health professionals’ credibility are critical factors in helping patients choose a healthcare provider In addition, empirical probabilities for different conditions patients face are provided together with insights and policy implications. Final suggestionsemphasize an upgrade of the knowledge base and an increase in public access to information with Internet-based innovations such as smartphone apps and data storage with the participation of healthcare providers and the Ministry of Health's ICT units. The underutilized 115 Emergency Service could also be transformed to function as a call center that helps coordinate and channel requests forinformation across a broad network of health-care professionals for better public use. |
| Keywords: | health-care provider; quality of information; data sufficiency; Vietnam; consumer behavior |
| JEL: | D83 I12 D12 |
| Date: | 2016–01–04 |
| URL: | http://d.repec.org/n?u=RePEc:sol:wpaper:2013/222896&r=hea |
| By: | Jason J Madan; Knut Lonnroth; Samia Laokri; Stephen Bertel SB Squire |
| Abstract: | Tuberculosis (TB) is a major global public health problem which affects poorest individuals the worst. A high proportion of patients incur 'catastrophic costs' which have been shown to result in severe financial hardship and adverse health outcomes. Data on catastrophic cost incidence is not routinely collected, and current definitions of this indicator involve several practical and conceptual barriers to doing so. We analysed data from TB programmes in India (Bangalore), Bangladesh and Tanzania to determine whether dissaving (the sale of assets or uptake of loans) is a useful indicator of financial hardship. |
| Keywords: | Catastrophic health expenditure, Tuberculosis, Financial protection for health, Innovative measurements, coping strategies |
| Date: | 2015 |
| URL: | http://d.repec.org/n?u=RePEc:ulb:ulbeco:2013/223014&r=hea |
| By: | Yaa Akosa Antwi (Indiana University - Purdue University Indianapolis); John R. Bowblis (Miami University) |
| Abstract: | We estimate the causal effect of nurse turnover on mortality and the quality of nursing home care with a fixed effect instrumental variable estimation that uses the unemployment rate as an instrument for nursing turnover. We find that ignoring endogeneity leads to a systematic underestimation of the effect of nursing turnover on mortality and quality of care in a sample of California nursing homes. Specifically, 10 percentage point increase in nurse turnover results in a facility receiving 2.2 additional deficiencies per annual regulatory survey, reflecting a 19.3 percent increase. Not accounting for endogeneity of turnover leads to results that suggest only a 1 percent increase in deficiencies. We also find suggestive evidence that turnover results in lower quality in other dimensions and may increase mortality. An implication of our mortality results is that turnover may be a mechanism for the procyclicality of mortality rates. |
| Keywords: | Employee turnover, unemployment rate, quality of care, nursing home |
| JEL: | I11 J21 E24 |
| Date: | 2016–01 |
| URL: | http://d.repec.org/n?u=RePEc:upj:weupjo:16-249&r=hea |
| By: | Bénédicte H. Apouey (Paris School of Economics); Gabriel Picone (Department of Economics, University of South Florida); Joshua Wilde (Department of Economics, University of South Florida); Joseph Coleman (Department of Economics, University of South Florida); Robyn Kibler (Department of Economics, University of South Florida) |
| Abstract: | This article explores the impact of antimalarial campaigns, and in particular of the scale up in the distribution of mosquito nets, on anemia for children under 5 in sub-Saharan Africa. It uses individual-level data on more than 150,000 children and their families, combined with regionallevel data on malaria intensity before the antimalarial campaigns, for 16 countries between 2000 and 2014. Using a differences-in-differences estimation strategy, the paper tests whether the impact of the campaigns on anemia is larger in regions where the intensity of malaria was greater prior to the campaigns. The results indicate that the scale up has a negligible or small effect on moderate or severe anemia, whereas the other campaigns do not have any significant impact. |
| Keywords: | Anemia, Malaria, Bed Nets, Africa, Child Health |
| JEL: | I12 I15 I18 O55 |
| URL: | http://d.repec.org/n?u=RePEc:usf:wpaper:0116&r=hea |
| By: | Miriam Schneidman; Joanne Jeffers; Kalina Duncan |
| Abstract: | Worldwide, deaths from cancer exceed those caused by human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), tuberculosis, and malaria combined. Seventy percent of deaths due to cancer occur in low-and middle-income countries, which are often poorly prepared to deal with the growing burden of chronic disease. Over a period of 18 months, the cancer care and control South-South knowledge exchange brought together a group of stakeholders from five countries in Africa - Botswana, Kenya, Rwanda, Uganda, and Zambia to share experiences, lessons, and good practices through a set of video conferences and a site visit to Zambia. All five countries have demonstrated commitment, initiated various cancer control and cancer screening programs, and expressed interest in sharing their experiences. The knowledge exchange on cancer care and control aimed to raise awareness, increase knowledge of effective strategies, and strengthen regional collaboration in cancer control planning and expanding equitable access to cancer treatment. This paper presents highlights of the country experiences shared, common challenges discussed, and innovative solutions explored during the knowledge exchange. Topics addressed include population-based surveillance and data collection to better document the burden of cancer; strategies for designing and implementing successful national cancer care and control programs; innovative approaches for strengthening cancer prevention efforts such as human papilloma virus (HPV) vaccination programs; task sharing and other strategies to build capacity and increase access to services; analytical tools for understanding the costs of programs; financing models, including public private partnerships, to increase cancer prevention and care; policy reforms needed to improve access to palliative care; and opportunities for regional collaboration. |
| Keywords: | health care providers, psychosocial support, emergency plan, social mobilization, caregivers, risks, reproductive health, economic growth, counselors, urbanization, ministries ... See More + of health, vaccination, national resources, young girls, informed decisions, pharmacists, prevention, family support, laws, cervical cancer screening, equitable access, premature death, morbidity, health education, international organizations, community health, discrimination, health insurance, health research, health care, drugs, cervical cancer, aging populations, legal status, patient education, health, holistic approach, health workers, breast cancer, publications, prevention efforts, rural population, information systems, civil society organizations, community participation, hospital, public health, radiation, knowledge, cost effectiveness, public policy, healthy lifestyles, rural populations, national plans, ministry of health, diseases, aids relief, training, immunization, infectious diseases, patients, patient, smoking, intervention, leukemia, health systems, aging, hospices, nurses, coverage of population, observation, health management, dissemination, medical school, marriage, essential health care, levels of knowledge, tuberculosis, gynecology, screening, service delivery, sustainable population, global health, gross domestic product, mortality, political support, social support, palliative care, cancer, progress, quality care, medical research, workers, surgery, policies, physiotherapy, national strategy, quality of care, chronic disease, hiv, surveillance, policy makers, health policy, health outcomes, occupational safety, hygiene, workshop, hepatitis b, family planning, medical personnel, decision making, chemotherapy, nutrition, populations, workshops, malaria, security policy, quality control, policy, infant health, quality of life, world health organization, lifestyles, internet, risk factors, health system, ministers of health, vaccines, physicians, communicable diseases, government agencies, children, alcoholic, liver cancer, clinics, generic drugs, lack of awareness, health providers, rural areas, general practitioners, disability, addiction, referral systems, national leaders, population, bereavement, research program, early detection, quality assurance, strategy, epidemiology, registration, families, women, medicines, referral system, hospitals, health interventions, aids, illnesses, urban population, secondary education, behavior change, health services, implementation, demand for services, nursing, national health systems, service providers, pharmaceutical companies |
| Date: | 2015–11 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:hnpdps:100898&r=hea |
| By: | Anne M. Pierre-Louis; Nesha Harman; Montserrat Meiro-Lorenzo; Martin Lutalo; Brian Pascual; Maggie Davies |
| Abstract: | The KP aims to support the Bank in adopting a significantly more systematic approach to multisectoral action in countries to maximize investment in other sectors for health results, in line with its comparative advantage. It will help to meet the Bank?s twin goals and add value to its work in countries, by providing task teams with data on the burden of disease and risks and their upstream determinants, which multisectoral action could address, toward the goal of reducing poverty. It will assist in demonstrating the links between upstream determinants, such as poverty and inequality, and health outcomes. KP will identify proven and cost-effective multisectoral solutions from international best practice that have the potential for transferability to local contexts. It will then help understand the drivers, opportunities and constraints of work across practices and sectors on a common agenda to meet the Bank?s goals. Finally, contributing to the effective delivery of existing Bank work across sectors within countries, and provide foresight and priorities for future action. |
| Keywords: | sanitation, waste, risks, treatment, peer education, vaccination, personal development, stroke, vitamins, antenatal care, laws, prevention, transport infrastructure, ... See More + ehicles, morbidity, health education, needs assessment, sexual health, community health, infrastructure development, health care, sexually transmitted infections, cervical cancer, health, traffic, road infrastructure, tax, airports, crime, smokers, hypertension, environmental health, air, life expectancy, public health, drivers, knowledge, cost effectiveness, vehicle, diabetes, diets, community development, road, crashes, costs, iron, air pollution, ventilation, training, immunization, patients, physical development, social exclusion, transport, smoking, intervention, food preparation, health indicators, sexuality, traffic safety, child development, migration, health management, observation, violence, marketing, true, pollution, disasters, road safety programs, folic acid, genital mutilation, lone parents, interview, mental health, traffic accidents, mortality, subsidies, health promotion, traffic crashes, infrastructure, taxes, childbirth, initiatives, driving, older people, transportation, workers, traffic injuries, climate change, policies, transparency, social services, police, surveillance, immunodeficiency, postnatal care, road safety, lifestyle, health policy, smoking policies, social policy, health outcomes, accessibility, hepatitis c, hygiene, wounds, hepatitis b, nutrition education, stress, excise tax, child nutrition, measurement, road traffic accidents, nutrition, injuries, adolescents, quality control, safety agency, internet, roads, risk factors, drunk driving, health care professionals, weight, communicable diseases, pregnant women, obesity, children, clinics, working conditions, accidents, fatalities, road safety agency, fuel, traffic accident, household fuel, investments, safety issues, financial risk, strategy, epidemiology, canteens, families, safety, transport v v v v • policy, health services, implementation, pregnancy, road traffic, breastfeeding |
| Date: | 2014–06 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:hnpdps:89391v1&r=hea |
| By: | Kavi Bhalla; Jesse B. Bump; Laura Frost; Amanda Glassman; Kate McQueston; Beth Anne Pratt; Anne M. Pierre-Louis; Nesha Harman; Montserrat Meiro-Lorenzo |
| Abstract: | The KP aims to support the Bank in adopting a significantly more systematic approach to multisectoral action in countries to maximize investment in other sectors for health results, in line with its comparative advantage. It will help to meet the Bank?s twin goals and add value to its work in countries, by providing task teams with data on the burden of disease and risks and their upstream determinants, which multisectoral action could address, toward the goal of reducing poverty. It will assist in demonstrating the links between upstream determinants, such as poverty and inequality, and health outcomes. KP will identify proven and cost-effective multisectoral solutions from international best practice that have the potential for transferability to local contexts. It will then help understand the drivers, opportunities and constraints of work across practices and sectors on a common agenda to meet the Bank?s goals. Finally, contributing to the effective delivery of existing Bank work across sectors within countries, and provide foresight and priorities for future action. |
| Keywords: | sanitation, risks, automobile, transport sector, public utilities, sex workers, personality, vaccination, stroke, antenatal care, psychology, laws, prevention, calories ... See More + vehicles, road building, morbidity, sexually transmitted diseases, trend, emissions, health care, death, sexually transmitted infections, death rate, health, back pain, depression, toll, traffic, road infrastructure, tax, crime, smokers, air, life expectancy, public health, traffic volume, drivers, knowledge, public security, vehicle, diabetes, workplace, road safety education, road, tolls, crashes, costs, air pollution, training, immunization, infectious diseases, patient, patients, transport, smoking, intervention, vehicle emissions, aging, road users, traffic deaths, international transport, medical anthropology, migration, nurses, road injuries, health management, marketing, pollution, road safety programs, screening, interview, mental health, traffic accidents, mortality, subsidies, injury, health promotion, traffic crashes, risk groups, infrastructure, taxes, unemployment, initiatives, young adults, workers, traffic injuries, fatigue, climate change, policies, social services, police, surveillance, immunodeficiency, road safety, health policy, health effects, social policy, road death toll, health outcomes, motor vehicle, victims, nutrition education, excise tax, motor vehicles, decision making, measurement, road traffic accidents, drug users, nutrition, injuries, public works, workshops, adolescents, quality control, primary health care, quality of life, safety agency, internet, roads, risk factors, walking, weight, communicable diseases, physicians, pregnant women, cardiovascular diseases, obesity, children, injury prevention, clinics, accidents, safety education, isolation, railroads, road safety agency, traffic accident, transport system, investments, motor vehicle emissions, financial risk, strategy, transport impacts, families, medicines, hospitals, health interventions, road transport, intermediaries, safety, implementation, health services, mental, pregnancy, condoms, road traffic, breastfeeding |
| Date: | 2014–06 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:hnpdps:89391v2&r=hea |
| By: | Francesco Longo; Luigi Siciliani; Andrew Street |
| Abstract: | Prospective payment systems fund hospitals based on a fixed-price regime that does not directly distinguish between specialist and general hospitals. We investigate whether current prospective payments in England compensate for differences in costs between specialist orthopaedic hospitals and trauma and orthopaedics (T&O) departments in general hospitals. We employ reference cost data for a sample of hospitals providing services in the trauma and orthopaedics specialty. Our regression results suggest that specialist orthopaedic hospitals have on average 13.5% lower profit margins. Under the assumption of break-even for the average trauma and orthopaedics department, two of the three specialist orthopaedic hospitals appear to make a loss on their activity. The same holds true for almost 34% of departments in our sample. Variations in the salary of doctors, scale economies, other hospital status (e.g. foundation trust, teaching hospital), and quality of care explain only a small proportion of such differences. |
| Keywords: | specialist hospitals, orthopaedics, hospital costs, HRG, tariff, reference costs |
| JEL: | I18 H51 D24 |
| Date: | 2015–12 |
| URL: | http://d.repec.org/n?u=RePEc:yor:yorken:15/30&r=hea |