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on Health Economics |
| By: | O'Nwachukwu, Chinedu Increase; Anani, Makafui |
| Abstract: | Given the adverse effects of air pollution on human health, a lot of studies have empirically investigated the causal effect of air pollution on health. However, no study has considered how fine particulate matter interacts with GDP per capita to affect cancer mortality. This study therefore uses data for 20 OECD countries to estimate the conditional effect of air pollution on cancer mortality. To this end, a fixed effect panel regression model which takes both country and time fixed effects into consideration is estimated. The conditional causal effect of fine particulate matter was found to be negative 0.22 and significant at 1% level. |
| Keywords: | Fine Particulate Matter; Conditional Effect; Pollution; Cancer Mortality |
| JEL: | Q5 Q51 Q52 Q53 |
| Date: | 2017–06–26 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:81123&r=hea |
| By: | Argys, Laura (University of Colorado Denver); Friedson, Andrew (University of Colorado Denver); Pitts, M. Melinda (Federal Reserve Bank of Atlanta); Tello-Trillo, D. Sebastian (University of Virginia) |
| Abstract: | A main goal of health insurance is to smooth out the financial risk that comes with health shocks and health care. Nevertheless, there has been relatively sparse evidence on how health insurance affects financial outcomes. The few studies that exist focus on the effect of gaining health insurance. This paper explores the effect of losing public health insurance on measures of individual financial well-being. In 2005, the state of Tennessee dropped about 170,000 individuals from Medicaid, resulting in a plausibly exogenous shock to health insurance status. Both across- and within-county variation in the size of the disenrollment is linked with individual-level credit risk score and debt data to identify the effects. The results suggest that the disenrollment resulted in a 1.73 point decline in credit risk scores for the median individual in Tennessee. There is also evidence of increases in the amount and share of delinquent debt (90 days past due or more) and of increases in bankruptcy risk. These findings are mostly concentrated among individuals who were in relatively worse financial status before the disenrollment and suggest that there are significant negative consequences to current recipients that would need to be considered in the cost and benefit calculations around rollbacks of recent Medicaid expansions. |
| Keywords: | Medicaid; public assistance; household finance; debt; bankruptcy |
| JEL: | D14 H75 I13 |
| Date: | 2017–08–01 |
| URL: | http://d.repec.org/n?u=RePEc:fip:fedawp:2017-06&r=hea |
| By: | Cronin, C.J.; Forsstrom, M.P.; Papageorge, N.W.; |
| Abstract: | There are two primary treatment alternatives available to those with mild to moderate depression or anxiety: psychotherapy and medication. The medical literature and our analysis suggests that in many cases psychotherapy, or a combination of therapy and medication, is more curative than medication alone. However, few individuals choose to use psychotherapy. We develop and estimate a dynamic model in which individuals make sequential medical treatment and labor supply decisions while jointly managing mental health and human capital. The results shed light on the relative importance of several drawbacks to psychotherapy that explain patients’ reluctance to use it: (1) therapy has high time costs, which vary with an individual’s opportunity cost of time and flexibility of the work schedule; (2) therapy is less standardized than medication, which results in uncertainty about its productivity for a given individual; and (3) therapy is expensive. The estimated model is used to simulate the impacts of counterfactual policies that alter the costs associated with psychotherapy. |
| Keywords: | Mental Health; Demand for Medical Care; Labor Supply; Structural Models; |
| JEL: | I10 I12 J22 J24 |
| Date: | 2017–08 |
| URL: | http://d.repec.org/n?u=RePEc:yor:hectdg:17/25&r=hea |
| By: | Zura Kakushadze; Rakesh Raghubanshi; Willie Yu |
| Abstract: | We estimate treatment cost-savings from early cancer diagnosis. For breast, lung, prostate and colorectal cancers and melanoma, which account for more than 50% of new incidences projected in 2017, we combine published cancer treatment cost estimates by stage with incidence rates by stage at diagnosis. We extrapolate to other cancer sites by using estimated national expenditures and incidence rates. A rough estimate for the U.S. national annual treatment cost-savings from early cancer diagnosis is in 11 digits. Using this estimate and cost-neutrality, we also estimate a rough upper bound on the cost of a routine early cancer screening test. |
| Date: | 2017–08 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:1709.01484&r=hea |
| By: | Christian Murray (University of Houston); Frederick Lipfert |
| Abstract: | Perhaps the clearest indications of adverse environmental health effects have been responses to short-term excursions in ambient air quality or temperature as deduced from time-series analyses of exposed populations. However, current analyses cannot characterize the prior health status of affected individuals. We used data on daily elderly death counts, ambient air quality indicators, and temperature in Philadelphia, Chicago, and Atlanta to estimate the daily numbers of frail elderly at-risk of premature mortality, their remaining life expectancies, and environmental effects on life expectancy. These unobserved frail populations at-risk were estimated using the Kalman filter. Frail life expectancies range from 13-16 days. Despite substantial differences in demography and environmental conditions in the three cities, frail life expectancies and contributions of ambient conditions are remarkably similar. The loss in frail life expectancy is approximately 12 hours. Conventional time-series analyses of air pollution effects report similar increases in daily mortality associated with air pollution, but our new model shows that such acute environmental risks are limited to a small fraction of the elderly population whose deaths were imminent in any event. This paradigm shift offered by the Kalman filter provides context to previous estimates of acute associations of air pollution with mortality . |
| Keywords: | life expectancy, daily mortality, frailty, temperature, particulate matter, ozone, time series |
| JEL: | C18 Q51 Q53 |
| Date: | 2017–09–03 |
| URL: | http://d.repec.org/n?u=RePEc:hou:wpaper:2017-247-29&r=hea |
| By: | Brilli, Ylenia (Department of Economics, School of Business, Economics and Law, Göteborg University); Restrepo, Brandon J. (Economic Research Service, U.S.Department of Agriculture (USDA)) |
| Abstract: | Using a regression discontinuity design, this study estimates the effect of extra medical care on the short-run health of babies born at the high end of the birth weight distribution. Consistent with the notion that neonatal treatment decisions are guided by a rule of thumb when assigning medical care to macrosomic newborns, we find evidence of a large discontinuous jump in the likelihood of being admitted to a neonatal intensive care unit (NICU) as the 5000-gram cuto_ is crossed from below. The resulting plausibly exogenous variation in medical care in the vicinity of the 5000-gram cutoff identifies the health effect of additional medical care. Parametric and non-parametric regressions reveal that being born above the 5000-gram cutoff increases the probability of NICU admission by about 30% and decreases the risk of infant mortality by about 130% relative to sample means below the 5000-gram cutoff. The importance of the substantial health gains associated with extra medical care in the macrosomic patient population is likely to grow over time since maternal obesity, a major risk factor for macrosomia, is on the rise. |
| Keywords: | medical intervention; birthweight; mortality. |
| JEL: | I12 I14 |
| Date: | 2017–09 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:gunwpe:0705&r=hea |
| By: | Kate Ho (Columbia University); Robin Lee (Harvard University Department of Economics) |
| Abstract: | Why do insurers choose to exclude medical providers, and when would this be socially desirable? We examine network design from the perspective of a profit-maximizing insurer and a social planner to evaluate the welfare effects of narrow networks and restrictions on their use. An insurer may engage in exclusion to steer patients to less expensive providers, cream-skim enrollees, and negotiate lower reimbursement rates. Private incentives for exclusion may diverge from social incentives: in addition to the standard quality distortion arising from market power, there is a “pecuniary” distortion introduced when insurers commit to restricted networks in order to negotiate lower rates. We introduce a new bargaining solution concept for bilateral oligopoly, Nash-in-Nash with Threat of Replacement, that captures such bargaining incentives and rationalizes observed levels of exclusion. Pairing our framework with hospital and insurance demand estimates from Ho and Lee (2017), we compare social, consumer, and insurer-optimal hospital networks for the largest non-integrated HMO carrier in California across several geographic markets. We find that both an insurer and consumers prefer narrower networks than the social planner in most markets. The insurer benefits from lower negotiated reimbursement rates (up to 30% in some markets), and consumers benefit when savings are passed along in the form of lower premiums. A social planner may prefer a broader network if it encourages the utilization of more efficient insurers or providers. We predict that, on average, network regulation prohibiting exclusion has no significant effect on social surplus but increases hospital prices and premiums and lowers consumer surplus. However, there are distributional effects, and regulation may prevent harm to consumers living close to excluded hospitals. |
| Keywords: | health insurance, narrow networks, selective contracting, hospital prices, bargaining, bilateral oligopoly |
| JEL: | C78 I11 L13 |
| Date: | 2017–09 |
| URL: | http://d.repec.org/n?u=RePEc:hka:wpaper:2017-067&r=hea |
| By: | Benoît Lalloué (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, IGR - Institut Gustave Roussy); Shu Jiang (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, IGR - Institut Gustave Roussy); Anne Girault (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP]); Marie Ferrua (IGR - Institut Gustave Roussy); Philippe Loirat (IGR - Institut Gustave Roussy, EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité); Etienne Minvielle (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP], IGR - Institut Gustave Roussy) |
| Abstract: | Objective Most studies showed no or little effect of pay-for-performance (P4P) programs on different outcomes. In France, the P4P program IFAQ was generalized to all acute care hospitals in 2016. A pilot study was launched in 2012 to design, implement and assess this program. This article aims to assess the immediate impact of the 2012–14 pilot study. Design and setting From nine process quality indicators (QIs), an aggregated score was constructed as the weighted average, taking into account both achievement and improvement. Among 426 eligible volunteer hospitals, 222 were selected to participate. Eligibility depended on documentation of QIs and results of hospital accreditation. Hospitals with scores above the median received a financial reward based on their ranking and budget. Several characteristics known to have an influence on P4P results (patient age, socioeconomic status, hospital activity, casemix and location) were used to adjust the models. Intervention To assess the effect of the program, comparison between the 185 eligible selected hospitals and the 192 eligible not selected volunteers were done using the difference-in-differences method. Results Whereas all hospitals improved from 2012 to 2014, the difference-in-differences effect was positive but not significant both in the crude (2.89, P = 0.29) and adjusted models (4.07, P = 0.12). Conclusion These results could be explained by several reasons: low level of financial incentives, unattainable goals, too short study period. However, the lack of impact for the first year should not undermine the implementation of other P4P programs. Indeed, the pilot study helped to improve the final model used for generalization. |
| Keywords: | hospital,pay-for-performance, quality indicators, financial incentives, impact evaluation |
| Date: | 2017–08–30 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-01579386&r=hea |
| By: | Esther Duflo; Michael Greenstone; Rema Hanna (Center for International Development at Harvard University) |
| Abstract: | It is conventional wisdom that it is possible to reduce exposure to indoor air pollution, improve health outcomes, and decrease greenhouse gas emissions in rural areas of developing countries through the adoption of improved cooking stoves. This is largely supported by observational field studies and engineering or laboratory experiments. However, we provide new evidence, from a randomized control trial conducted in rural Orissa, India (one of the poorest places in India) on the benefits of a commonly used improved stove that laboratory tests showed to reduce indoor air pollution and require less fuel. We track households for up to four years after they received the stove. While we find a meaningful reduction in smoke inhalation in the first year, there is no effect over longer time horizons. We find no evidence of improvements in lung functioning or health and there is no change in fuel consumption (and presumably greenhouse gas emissions). The difference between the laboratory and field findings appears to result from households’ revealed low valuation of the stoves. Households failed to use the stoves regularly or appropriately, did not make the necessary investments to maintain them properly, and usage rates ultimately declined further over time. More broadly, this study underscores the need to test environmental and health technologies in real-world settings where behavior may temper impacts, and to test them over a long enough horizon to understand how this behavioral effect evolves over time. |
| Keywords: | indoor air pollution, human health, climate change, technology adoption |
| JEL: | O10 O13 O12 Q0 Q23 Q3 Q51 Q53 Q56 I15 I18 |
| Date: | 2017–08 |
| URL: | http://d.repec.org/n?u=RePEc:cid:wpfacu:241&r=hea |
| By: | Danielle H. Sandler; Lisa Schulkind |
| Abstract: | We examine the long-term outcomes for a population of teenage mothers who give birth to their children around the end of their high school year. We compare the mothers whose high school education was interrupted by childbirth, because the child was born before her expected graduation date to mothers who did not experience the same disruption to their education. We find that mothers who give birth during the school year are seven percent less likely to graduate from high school, are less likely to be married, and have more children than their counterparts who gave birth just a few months later. The labor market outcomes for these two sets of teenage mothers are not statistically different, but with a lower likelihood of marriage and more children, the households of the treated mothers are more likely to fall below the poverty threshold. While differences in educational attainment have narrowed over time, the differences in labor market outcomes and family structure have remained stable. |
| JEL: | J13 |
| Date: | 2016–01 |
| URL: | http://d.repec.org/n?u=RePEc:cen:wpaper:16-39r&r=hea |
| By: | Jeffrey Clemens; Benedic Ippolito |
| Abstract: | Hospital payment regulation has historically been introduced to meet multiple policy objectives. The primary objective of "all-payer" rate setting regimes was to control costs through consistent, centrally regulated payments. These regimes were often linked, however, to an ancillary goal of financing care for the uninsured. We show that this secondary objective made states' all-payer regimes economically and legally unstable. Their economic instability reflected a feedback loop from surcharge rates to insurance coverage rates and back to the quantities of uncompensated care in need of being financed. The erosion of all-payer regimes' surcharge bases was particularly pronounced when health maintenance organizations were exempted from surcharge collections, creating a regulatory arbitrage opportunity. The economic and legal instability we highlight could largely have been avoided by financing the cost of uncompensated care provision through taxation of income or other standard revenue bases. These developments thus illustrate the wisdom of the Tinbergen Rule, which recommends that independent policy objectives be met with independent policy instruments. |
| JEL: | H2 I11 I13 I18 |
| Date: | 2017–08 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23758&r=hea |
| By: | Felipe A. Dunsch; David K. Evans; Ezinne Eze-Ajoku; Mario Macis |
| Abstract: | If health service delivery is poorly managed, then increases in inputs or ability may not translate into gains in quality. However, little is known about how to increase managerial capital to generate persistent improvements in quality. We present results from a randomized field experiment in 80 primary health care centers (PHCs) in Nigeria to evaluate the effects of a health care management consulting intervention. One set of PHCs received a detailed improvement plan and nine months of implementation support (full intervention), another set received only a general training session, an overall assessment and a report with improvement advice (light intervention), and a third set of facilities served as a control group. In the short term, the full intervention had large and significant effects on the adoption of several practices under the direct control of the PHC staff, as well as some intermediate outcomes. Virtually no effects remained one year after the intervention concluded. The light intervention showed no consistent effects at either point. We conclude that sustained supervision is crucial for achieving persistent improvements in contexts where the lack of external competition fails to create incentives for the adoption of effective managerial practices. |
| JEL: | I15 M10 O15 |
| Date: | 2017–08 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23749&r=hea |
| By: | Jeffrey C. Schiman; Robert Kaestner; Anthony T. Lo Sasso |
| Abstract: | A growing literature argues that early environments affecting childhood health may influence significantly later-life health and financial wellbeing. We present new evidence on the relationship between child health and later-life outcomes using variation in infant mortality in England and Wales at the onset of World War II. Using data from the British Household Panel Survey, we exploit the variation in infant mortality across birth cohorts and region to estimate the associations between infant mortality and adult outcomes such as disability and employment. Our findings suggest that higher infant mortality is significantly associated with higher likelihood of disability, a lower probability of employment, and less earned income. |
| JEL: | I15 N3 |
| Date: | 2017–08 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23763&r=hea |
| By: | Johanna Catherine Maclean; Benjamin L. Cook; Nicholas Carson; Michael F. Pesko |
| Abstract: | Mental illnesses are prevalent in the United States and globally, and cost is a critical barrier to treatment receipt for many afflicted individuals. Affordable insurance coverage can permit access to effective healthcare services and treatment of mental illnesses. We study the effects of recent and major eligibility expansions within Medicaid, a pubic insurance system in the U.S. that finances healthcare services for the poor, on psychotropic medications prescribed in outpatient settings. To this end, we estimate differences-in-differences models using administrative data on medications prescribed in outpatient settings for which Medicaid was a third-party payer between 2011 and 2016. Our findings suggest that these expansions increased psychotropic prescriptions by 22% with substantial heterogeneity across psychotropic class and state characteristics that proxy for patient need, expansion scope, and system capacity. We provide further evidence that Medicaid, and not patients, primarily financed these prescriptions. These findings suggest that public insurance expansions have the potential to improve access to evidence-based treatments among low-income populations suffering from mental illnesses. |
| JEL: | I1 I13 I18 |
| Date: | 2017–08 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23760&r=hea |
| By: | Zack Cooper; Amanda E Kowalski; Eleanor N Powell; Jennifer Wu |
| Abstract: | This paper examines the link between legislative politics, hospital behavior, and health care spending. When trying to pass sweeping legislation, congressional leaders can attract votes by adding targeted provisions that steer money toward the districts of reluctant legislators. This targeted spending provides tangible local benefits that legislators can highlight when fundraising or running for reelection. We study a provision - Section 508 – that was added to the 2003 Medicare Modernization Act (MMA). Section 508 created a pathway for hospitals to apply to get their Medicare payment rates increased. We find that hospitals represented by members of the House of Representatives who voted ‘Yea’ on the MMA were significantly more likely to receive a 508 waiver than hospitals represented by members who voted ‘Nay.’ Following the payment increase generated by the 508 program, recipient hospitals treated more patients, increased payroll, hired nurses, added new technology, raised CEO pay, and ultimately increased their spending by over $100 million annually. Section 508 recipient hospitals formed the Section 508 Hospital Coalition, which spent millions of dollars lobbying Congress to extend the program. After the vote on the MMA and before the vote to reauthorize the 508 program, members of Congress with a 508 hospital in their district received a 22% increase in total campaign contributions and a 65% increase in contributions from individuals working in the health care industry in the members’ home states. Our work demonstrates a pathway through which the link between politics and Medicare policy can dramatically affect US health spending. |
| JEL: | D72 H51 I10 I18 P16 |
| Date: | 2017–08 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:23748&r=hea |
| By: | Radka Prichystalova (ISCC - Institut des Sciences de la Communication du CNRS - UPMC - Université Pierre et Marie Curie - Paris 6 - UP4 - Université Paris-Sorbonne - CNRS - Centre National de la Recherche Scientifique); Jean-Baptiste Fini (ERE - Evolution des régulations endocriniennes - MNHN - Muséum National d'Histoire Naturelle - CNRS - Centre National de la Recherche Scientifique); Leonardo Trasande (NYU - New York University School of Medicine - New York University School of Medicine); Martine Bellanger (Santé Publique EA7348 - USPC - Université Sorbonne Paris Cité); Barbara Demeneix (ERE - Evolution des régulations endocriniennes - MNHN - Muséum National d'Histoire Naturelle - CNRS - Centre National de la Recherche Scientifique); Laura Maxim (ISCC - Institut des Sciences de la Communication du CNRS - UPMC - Université Pierre et Marie Curie - Paris 6 - UP4 - Université Paris-Sorbonne - CNRS - Centre National de la Recherche Scientifique) |
| Abstract: | Background: Socioeconomic analysis is currently used in the Europe Union as part of the regulatory process in Regulation Registration, Evaluation and Authorisation of Chemicals (REACH), with the aim of assessing and managing risks from dangerous chemicals. The political impact of the socio-economic analysis is potentially high in the authorisation and restriction procedures, however, current socio-economic analysis dossiers submitted under REACH are very heterogeneous in terms of methodology used and quality. Furthermore, the economic literature is not very helpful for regulatory purposes, as most published calculations of health costs associated with chemical exposures use epidemiological studies as input data, but such studies are rarely available for most substances. The quasi-totality of the data used in the REACH dossiers comes from toxicological studies. Methods: This paper assesses the use of the integrated probabilistic risk assessment, based on toxicological data, for the calculation of health costs associated with endocrine disrupting effects of triclosan. The results are compared with those obtained using the population attributable fraction, based on epidemiological data. Results: The results based on the integrated probabilistic risk assessment indicated that 4894 men could have reproductive deficits based on the decreased vas deferens weights observed in rats, 0 cases of changed T3 levels, and 0 cases of girls with early pubertal development. The results obtained with the Population Attributable Fraction method showed 7,199,228 cases of obesity per year, 281,923 girls per year with early pubertal development and 88,957 to 303,759 cases per year with increased total T3 hormone levels. The economic costs associated with increased BMI due to TCS exposure could be calculated. Direct health costs were estimated at €5.8 billion per year. Conclusions:The two methods give very different results for the same effects. The choice of a toxicological-based or an epidemiological-based method in the socio-economic analysis will therefore significantly impact the estimated health costs and consequently the political risk management decision. Additional work should be done for understanding the reasons of these significant differences. |
| Keywords: | Endocrine disruptor,Triclosan,Health costs,REACH regulation,Socio-economic analysis,Chemical risk,Attributable fraction,Probabilistic risk assessment |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-01547024&r=hea |
| By: | Bérangère Legendre (IREGE - Institut de Recherche en Gestion et en Economie - USMB [Université de Savoie] [Université de Chambéry] - Université Savoie Mont Blanc); Mareva Sabatier (IREGE - Institut de Recherche en Gestion et en Economie - USMB [Université de Savoie] [Université de Chambéry] - Université Savoie Mont Blanc) |
| Abstract: | This article investigates the extent to which the distance to retirement affects low employment rates among European older workers, taking into account a key but often neglected determinant: health status. To begin, the study amends McCall's job search model, in which the job search behavior is treated as age dependent. Agents are heterogeneous according to two attributes: distance to retirement and health. This model leads to clear predictions, such that the closer the retirement, the greater the reservation wage and the lower people's search effort. Older workers also exhibit lower exit rates from unemployment , an effect that gets enhanced by health problems. This empirical work, based on a French survey, confirms the existence of a distance effect but also puts the greater impact of health status into perspective. The distance effect explains only part of the puzzle of older workers' employment. |
| Keywords: | distance to retirement,older workers' employment,health |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-01522749&r=hea |
| By: | Samira Alaani (Fallujah General Hospital); Florent Pirot (GATE Lyon Saint-Étienne - Groupe d'analyse et de théorie économique - ENS Lyon - École normale supérieure - Lyon - UL2 - Université Lumière - Lyon 2 - UCBL - Université Claude Bernard Lyon 1 - UJM - Université Jean Monnet [Saint-Etienne] - Université de Lyon - CNRS - Centre National de la Recherche Scientifique) |
| Abstract: | It is possible to observe a very clear correlation between the presence of uranium near the surface of the ground and several illnesses for which the link with radioactivity had not been established before (autism, schizophrenia). It is also possible to confirm the link between radioactivity and Down Syndrome that had been already established by Kochupillai et al. 1976, Bound, Francis et Harvey 1995, Schmitz-Feuerhake et al. 2009, and Robert-Gnansia et al. 2007. |
| Abstract: | On observe une corrélation très intéressante entre la présence d’uranium dans la couche superficielle du sol et diverses maladies pour lesquelles le lien avec la radioactivité n’avait pas encore été établi (autisme, schizophrénie). Il est également possible de confirmer le lien radioactivité – trisomie 21 qui avait déjà été établi par Kochupillai et al 1976, Bound, Francis et Harvey 1995, Schmitz-Feuerhake et al. 2009, et Robert-Gnansia et al. 2007. |
| Keywords: | autisme, schizophrénie, trisomie 21, uranium, radioactivité, cancer |
| Date: | 2017 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:halshs-01528351&r=hea |