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on Health Economics |
| By: | De Nardi, M.; French, E.; Bailey Jones, J.; McGee, R. |
| Abstract: | We estimate a model of savings for retired couples and singles who face longevity and medical expense risks, and in which couples can leave bequests both when the first and last spouse dies. We show that saving motives vary by marital status, permanent income, and age. We find that most households save more for medical expenses than for bequests, but that richer households and couples, who hold most of the wealth, save more for bequests. As a result, bequest motives are a key determinant of aggregate retirement wealth. |
| Date: | 2023–11–28 |
| URL: | http://d.repec.org/n?u=RePEc:cam:camdae:2377&r=hea |
| By: | Gerard J. van den Berg (University of Groningen, University Medical Center Groningen, IFAU Uppsala, ZEW, IZA, CEPR); Hanno Foerster (Boston College, IZA); Arne Uhlendorf (CNRS and CREST, IAB Nuremberg, DIW, IZA) |
| Abstract: | This paper provides a structural analysis of the role of job vacancy referrals (VRs) by public employment agencies in the job search behavior of unemployed individuals, incorporating institutional features of the monitoring of search behavior by the agencies. Notably, rejections of VRs may lead to sanctions (temporary benefits reductions) while workers may report sick to avoid those. We estimate models using German administrative data from social security records linked with caseworker recorded data on VRs, sick reporting and sanctions. The analysis highlights the influence of aspects of the health care system on unemployment durations. We estimate that for around 25% of unemployed workers, removing the channel that enables strategic sick reporting reduces the mean unemployment duration by 4 days. |
| Keywords: | unemployment, wage, sanctions, moral hazard, sickness absence, physician, structural estimation, counterfactual policy evaluation, unemployment duration |
| JEL: | J64 J65 C51 C54 |
| Date: | 2023–09–17 |
| URL: | http://d.repec.org/n?u=RePEc:crs:wpaper:2023-10&r=hea |
| By: | Bruce D. Meyer; Angela Wyse; Ilina Logani |
| Abstract: | This paper examines the relationship between extreme socioeconomic disadvantage and poor health by providing the first detailed and accurate picture of mortality patterns among people experiencing homelessness in the U.S. Our analyses center on 140, 000 people who were sheltered or unsheltered homeless during the 2010 Census, by far the largest sample ever used to study this population and the only sample designed to be nationally representative. These individuals, along with housed comparison groups, are linked to Social Security Administration data on all-cause mortality from 2010-2022 to estimate the magnitude of health disparities associated with homelessness. We find that non-elderly people experiencing homelessness have 3.5 times the mortality risk of those who are housed, accounting for differences in demographic characteristics and geography, and that a 40-year-old homeless person faces a similar mortality risk to a housed person nearly twenty years older. Our results reveal notable patterns in relative mortality risk by age, race, gender, and Hispanic ethnicity and suggest that within the homeless population, employment, higher incomes, and more extensive observed family connections are associated with lower mortality. The mortality hazard of homeless individuals rose by 33 percent during the COVID-19 pandemic, an increase that, while similar in proportional terms to the increase for the housed population, affected a much larger share of the homeless population due to their substantially elevated baseline mortality rate. These findings elucidate the persistent hardships associated with homelessness and show that the well-documented gradient between health and poverty persists into the extreme lower tail of socioeconomic disadvantage. |
| JEL: | I0 J0 R0 |
| Date: | 2023–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:31843&r=hea |
| By: | Yazan Alnsour (UWO - University of Wisconsin Oshkosh); Marina Johnson (MSU - Montclair State University [USA]); Abdullah Albizri (MSU - Montclair State University [USA]); Antoine Harfouche Harfouche (UPN - Université Paris Nanterre) |
| Abstract: | Artificial intelligence (AI) significantly revolutionizes and transforms the global healthcare industry by improving outcomes, increasing efficiency, and enhancing resource utilization. The applications of AI impact every aspect of healthcare operation, particularly resource allocation and capacity planning. This study proposes a multi-step AI-based framework and applies it to a real dataset to predict the length of stay (LOS) for hospitalized patients. The results show that the proposed framework can predict the LOS categories with an AUC of 0.85 and their actual LOS with a mean absolute error of 0.85 days. This framework can support decision-makers in healthcare facilities providing inpatient care to make better front-end operational decisions, such as resource capacity planning and scheduling decisions. Predicting LOS is pivotal in today's healthcare supply chain (HSC) systems where resources are scarce, and demand is abundant due to various global crises and pandemics. Thus, this research's findings have practical and theoretical implications in AI and HSC management. |
| Keywords: | Artificial Intelligence, Predictive Analytics, Length of Stay, Healthcare Supply Chain, Clinical Decision Support |
| Date: | 2023–01 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-04263512&r=hea |
| By: | Gihleb, Rania (University of Pittsburgh); Giuntella, Osea (University of Pittsburgh); Tan, Jian Qi (University of Pittsburgh) |
| Abstract: | Unions play a crucial role in determining wages and employment outcomes. However, union bargaining power may also have important effects on non-pecuniary working conditions. We study the effects of right-to-work laws, which removed agency shop protection and weakened union powers on long hours and non-standard work schedules that may adversely affect workers' health and safety. We exploit variation in the timing of enactment across US states and compare workers in bordering counties across adopting states and states that did not adopt the laws yet. Using the stacked approach to difference-in-differences estimates proposed by Cengiz et al. (2019), we find evidence that right-to-work laws increased the share of workers working long hours by 6%, while there is little evidence of an impact on hourly wages. The effects on long hours are larger in more unionized sectors (i.e. construction, manufacturing, and transportation). While the likelihood of working non-standard hours increases for particular sectors (education and public administration), there is no evidence of a significant increase in the overall sample. |
| Keywords: | unions, working conditions, workers' health |
| JEL: | J50 I10 |
| Date: | 2023–11 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16588&r=hea |
| By: | Johannes Geyer; Axel H. Börsch-Supan; Peter Haan; Elsa Perdrix |
| Abstract: | This chapter provides an overview of the German long-term care insurance. We document care needs and wellbeing of the elderly population. Moreover, we provide a detailed description of the German long-term care institutions (sources of finance and types of benefits), the professional care work force, and informal caregivers. Finally, we document expenditures on long-term care and estimate the value of informal care. The cost of long-term care for the elderly (65+), including both cost of nursing home and home health agency, reached 61 billion euro in 2019. Half of these spending are for nursing homes while only about 22.5% of beneficiaries use these institutions. Out-of-pocket spending differs greatly between modes of care. Out-of-pocket expenditures make up only about 7% of total expenditures for home care. In nursing homes, 41% of expenditures are out-of-pocket payment. Most of the expenditures are covered by the long-term care insurance. The share of other governmental schemes in expenditures for inpatient care is relatively high. This is explained by a high rate of benefit recipients who cannot afford co-payments for nursing homes: about one-third of all nursing home residents receive means- and wealth-tested social assistance. If we add the costs of informal care the share of privately financed care amounts to nearly 60% of total expenditures. |
| JEL: | H51 I13 I18 |
| Date: | 2023–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:31870&r=hea |
| By: | Ghazarian, Avenia (Mistra Center for Sustainable Markets (Misum)); Khan, Akib (Uppsala University) |
| Abstract: | How does human capital investment respond to local economic opportunities? Income gains can increase the demand for schooling while new jobs raise the opportunity costs. We investigate this question in the context of rapid growth in artisanal gold mining in sub-Saharan Africa. We compile 45 waves of Demographic and Health Surveys covering 1.3 million individuals from 14 countries in this region. Identification comes from two sources of variation: one in the global gold price and the other in the exposure of households to places that are geologically suitable for artisanal gold mining. We find that a near-tripling of the global gold price – reflecting changes between 2005 and 2010 – leads to a decline in school attendance: by 3.1 pp for 11 to 15-year-olds and by 2.3 pp for 16 to 20-year-olds who live near gold-suitable areas. These reductions are higher for boys. Taken together, these results highlight the potential costs of economic development driven by natural resources. |
| Keywords: | Human capital investment; Economic opportunities; Artisanal mining; Gold; Africa |
| JEL: | J24 O15 Q32 |
| Date: | 2023–11–27 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:hamisu:2023_014&r=hea |
| By: | María Laura Alzua (CEDLAS-IIE-FCE-UNLP, CONICET & Partnership for Economic Policy); Natalia Cantet (Department of Economics and Finance, Universidad EAFIT); Ana C. Dammert (Economics and International Affairs, Carleton University); Damilola Olajide (Initiative for Evidence-Based Development and Empowerment) |
| Abstract: | Many countries in the developing world have implemented old-age pensions. Evidence of the impact of such policies on the elderly in sub-Saharan Africa, however, is scarce. We provide evidence from a randomized evaluation of an unconditional old-age pension targeted at the elderly in Ekiti State, Nigeria. Our findings show that treated beneficiaries self-report better quality of life and a more stable mental health. We also provide evidence of spillover effects on the labor outcomes of other household members and of household savings patterns as well as support for interventions aimed at improving the welfare of elderly poor citizens and other household members. |
| JEL: | C21 C93 H31 H55 H75 I38 |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:dls:wpaper:0322&r=hea |
| By: | Claudia Allende; Juan Pablo Atal; Rodrigo Carril; José Ignacio Cuesta; Andres Gonzalez-Lira |
| Abstract: | This paper examines the determinants of public procurement prices using comprehensive data on pharmaceutical purchases by the Chilean public sector. We start by estimating the extent to which different public agencies pay different prices for the same product. These buyer effects are sizable, and the difference between average prices paid by buyers at the 10th and 90th percentiles is 16%. Our main set of results is related to the role of market structure. The variation in market structure explains three times more variation in procurement prices than buyer effects. Moreover, using exogenous variation from patent expirations, we estimate that the entry of an additional vendor decreases average procurement prices by 11.7%, which is 72% of the gap between average prices paid by buyers at the 10th and 90th percentiles of the distribution of buyer effects. These results suggest that supply-side factors are key determinants of public procurement prices and that their quantitative importance may exceed that of demand-side factors previously emphasized in the literature. |
| Keywords: | Procurement, Bureaucracy, competition, pharmaceutical drugs |
| JEL: | D44 D73 H57 |
| Date: | 2023–11 |
| URL: | http://d.repec.org/n?u=RePEc:bge:wpaper:1413&r=hea |
| By: | Dahl, Christian M. (University of Southern Denmark); Hansen, Casper W. (University of Copenhagen); Jensen, Peter S. (Linnaeus University); Karlsson, Martin (University of Duisburg-Essen); Kühnle, Daniel (University of Duisburg-Essen) |
| Abstract: | This study examines the impact of primary-school closures during the 1918 Pandemic in Sweden on mortality and long-term outcomes of school children. Using the universe of death certificates from 1914-1920 and newly-collected data on school closures across 2, 100 districts, we conduct high-frequency event studies at both weekly and daily intervals to show that schools closed in response to local surges in influenza deaths. Faster implementation of school closures significantly reduced peak mortality rates among primary-aged individuals. However, our long-run analysis of approximately 100, 000 affected children per grade shows precisely estimated, minor and mostly insignificant effects on longevity, employment, and income. |
| Keywords: | short- and long-run effects, human capital, mortality, 1918 Pandemic, school closures |
| JEL: | J10 N34 I10 |
| Date: | 2023–11 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16592&r=hea |
| By: | Enza Simeone (Universitat de Girona) |
| Abstract: | Using the Understanding Society data (UKHLS and COVID-19 surveys), first this work uses the models that preserve the ordinal nature of data to measure in England and Scotland the overall health inequality in the pandemic context, and second it adopts the parametric approach to measure the portion of inequalities due to circumstances.The findings show that within UK regions, overall health inequalities decrease during the pandemic, while the absolute measure of the inequality of health opportunities remains stable in both regions. Between UK regions, the overall health inequality is greater in England than in Scotland during the pandemic (except in November 2020), while inequalities of health opportunities are greater in Scotland than in England in both periods, especially in November 2020.Considering these different results within and between regions, this work also aims at assessing whether the trends in health inequalities could be related with the different national implementation of the second lockdown policy of “Stay-at-home†, also looking at the heterogeneous effect by gender. The findings show that with the second lockdown policy the probability of being in the highest health status categories decreases in England by 10 percentage points, and the impact of the lockdown policy is higher for women than men. |
| Keywords: | health inequality, inequality of opportunity in health, self-assessed health status, COVID-19, policy evaluation |
| JEL: | C1 D63 I12 I14 I18 |
| Date: | 2023–11 |
| URL: | http://d.repec.org/n?u=RePEc:inq:inqwps:ecineq2023-661&r=hea |
| By: | Soares, Sergei,; Berg, Janine, |
| Abstract: | This paper builds on the existing literature on the effect of unionization on OSH by providing an analysis of unionization’s effects on COVID-19 mortality. It combines data from the NVSS with the CPS into a unique dataset. It finds that a 10 percentage-point increase in unionization is associated with a reduction in mortality from 26 per 100, 000 workers to 24 per 100, 000 workers. This means that if the United States had the union density of 35 percent that it had in 1954 instead of today’s rate of 10 percent, the COVID-19 mortality rate for working people would have fallen from 26 to 19 per 100, 000.. |
| Keywords: | mortality, COVID-19, occupational safety and health, methodology |
| Date: | 2023 |
| URL: | http://d.repec.org/n?u=RePEc:ilo:ilowps:995331191502676&r=hea |
| By: | Eiji Yamamura; Yoshiro Tsutsui; Fumio Ohtake |
| Abstract: | Some people did not get the COVID-19 vaccine even though it was offered at no cost. A monetary incentive might lead people to vaccinate, although existing studies have provided different findings about this effect. We investigate how monetary incentives differ according to individual characteristics. Using panel data with online experiments, we found that (1) subsidies reduced vaccine intention but increased it after controlling heterogeneity; (2) the stronger the social image against the vaccination, the lower the monetary incentive; and (3) persistently unvaccinated people would intend to be vaccinated only if a large subsidy was provided. |
| Date: | 2023–11 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2311.11828&r=hea |