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on Health Economics |
| By: | Alexander Ahammer; Analisa Packham; Jonathan Smith |
| Abstract: | We estimate the role of firms in worker health care utilization. Using linked administrative data on Austrian workers from 1998-2018, we exploit mobility between firms to estimate how much a firm contributes to worker-level differences in utilization in a setting with non-employer provided universal health care. We find that firms are responsible for nearly 30 percent of the variation in across-worker health care expenditures. Effects are not driven by changes in geography or industry. We then estimate a measure of relative firm-specific utilization and explore existing correlates to help explain these effects. |
| JEL: | H51 I1 |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:32011&r=hea |
| By: | Breno Braga; Gaurav Khanna; Sarah Turner |
| Abstract: | In the United States, rural and low-income communities have difficulty attracting and retaining physicians, potentially adversely impacting health outcomes. With a limited supply of physicians completing medical school at US universities, foreign-born and educated physicians provide a potential source of supply in underserved areas. For international medical school graduates (IMGs) the terms of the commonly used J-1 visa require a return to the home country for two years following employment in medical residency. Our analysis examines the extent to which the Conrad 30 Visa Waiver impacts the supply of physicians at state and local levels, particularly in areas designated as medically underserved. Changes in the federal limit on the number of waivers per state, combined with variation in the state-level restrictions on eligible specialties, and geographies in which physicians can work, provide evidence on the role of visa restrictions in limiting the supply of doctors. Expansion of the cap on visa waivers increased the supply of IMGs, particularly in states that did not limit waiver recipients to primary care physicians or particular places of employment. There is little evidence of reductions in US-trained doctors in states where IMG increases were the largest, suggesting little evidence for crowding out. |
| JEL: | I20 J6 J68 |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:32005&r=hea |
| By: | Mareen Bastiaans; Robert Dur; Anne C. Gielen |
| Abstract: | In many Western countries, a sizeable group of people live on welfare benefits for a long time. Many of them suffer from mental health issues. This paper studies the labor market and mental health effects of an activation program targeting these long-term inactive people. We exploit the staggered implementation of the program in a difference-in-differences design. We find that the activation program hardly affects labor market outcomes. However, for those on mental health medication prior to the start of the program, the use of mental health medication substantially drops in the years following the start of the program. This effect is particularly pronounced and statistically significant for men. We also study spillover effects on the children of those targeted by the program, finding some tentative evidence for improved learning and mental health outcomes. |
| Keywords: | activation program, long-term inactive, welfare beneficiaries, mental health, intergenerational spillovers |
| JEL: | H53 I19 I38 J68 |
| Date: | 2023 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_10830&r=hea |
| By: | Costa-Font, Joan; Cowell, Frank; Shi, Xuezhu |
| Abstract: | We study inequality in the distribution of self-assessed health (SAH) in the United States and China, two large countries that have expanded their insurance provisions in recent decades, but that lack universal coverage and differ in other social determinants of health. Using comparable health survey data from China and the United States, we compare health inequality trends throughout the period covering the public health insurance coverage expansions in the two countries. We find that whether SAH inequality is greater in the US or in China depends on the concept of status and the inequality-sensitivity parameter used; however, the regional pattern of SAH inequality is clearly associated with health-insurance coverage expansions in the US but not significant in China. |
| Keywords: | health inequality; self-assessed health; health insurance coverage; social determinants of health |
| JEL: | D63 I18 I30 |
| Date: | 2023–12–16 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121099&r=hea |
| By: | Tamilina, Larysa; Hohol, Oleksandra; Ihnatenko, Yaroslava |
| Abstract: | This study examines the mental health of students from Kyiv universities, considering the context of 21 months of war in Ukraine. Our primary dataset is derived from an online survey. Employing Ordinary Least Squares (OLS) regression, we analyze two key facets of mental health: anxiety levels and safety perception. Our findings reveal that anxiety levels among students are primarily shaped by the frequency of contemplation regarding the ongoing war and their emotional responses to war-related news. Similarly, obsessive thoughts about the war negatively impact safety perception, a trend that, however, tends to diminish for students studying abroad during the conflict. Conversely, for students who remain in Ukraine, the absence of psychological support from the university exacerbates the situation, contributing to a significant decrease in the sense of safety. |
| Keywords: | Anxiety, safety perception, mental health, wartime, Ukraine |
| JEL: | I00 I12 |
| Date: | 2023–12–01 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:119435&r=hea |
| By: | Pierre van der Eng |
| Abstract: | This paper examines the human toll of the 1944-1945 famine in Java, Indonesia’s main island. It estimates birth and death rates for the Indonesian population in Java during 1941-1951. Using the net population loss method, the paper approximates a net loss of 3.4 million people during the 1942-1945 Japanese occupation period, including 1.9 million excess deaths; 0.7 million during 1944 and 1.2 million during 1945. The residual 1.5 million were missing births in 1944 and 1945, associated with the malnutrition of women of childbearing ages and the physical separation of wives from husbands recruited by Japanese authorities for forced labour. |
| Keywords: | famine, malnutrition, Java, Indonesia, Japanese occupation |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:auu:hpaper:117&r=hea |
| By: | Faradilla Rahma Sari (Master of Science and Doctorate, Faculty of Economics and Business, Universitas Gadjah Mada); Diyah Putriani (Department of Economics, Faculty of Economics and Business, Universitas Gadjah Mada); Wisnu Setiadi Nugroho (Department of Economics, Faculty of Economics and Business, Universitas Gadjah Mada) |
| Abstract: | This study aims to estimate the impact of program cessation on the behavior of Program Keluarga Harapan (PKH) beneficiaries. We utilize the Propensity Score Matching (PSM) and Difference-in-Differences (DID) models to overcome potential bias in the estimation results. We use household longitudinal data from the PKH implementation pilot study. The results show that program cessation has a significant positive impact on the share of expenditure on food and the probability of children not attending school, as well as reducing the share of expenditure on education. On the other hand, program cessation has no impact on the utilization of health services, the share of expenditure on health, and the share of expenditure on milk and eggs. These findings indicate that the impact of PKH on behavior related to health tends to continue, while for behavior related to education it does not. |
| Keywords: | Intergenerational Transfer, Transfers, Welfare, Poverty, Health, Education |
| JEL: | D15 I38 |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:gme:wpaper:202312011&r=hea |
| By: | Orbeta, Aniceto Jr. C.; Araos, Nina Victoria V.; Melad, Kris Ann M. |
| Abstract: | The Pantawid Pamilyang Pilipino Program is the government’s primary social protection strategy to break intergenerational poverty by supporting poor households and investing in children’s health and education. Previous impact evaluations demonstrated the program’s success in keeping children healthy and in school. This third impact evaluation seeks to reevaluate the program’s impact on short-term and intermediate outcomes related to health, education, household welfare, and other sociobehavioral domains. The evaluation employs regression discontinuity design to compare the program’s impact on treatment households (Pantawid beneficiaries) and comparison households (non-Pantawid beneficiaries) within specific bandwidths of distance from the poverty threshold that determines program eligibility. Results indicate that the program still positively impacts most of the target education and health outcomes of children and pregnant women. In addition, the program positively impacts household welfare, community participation, awareness of basic means to mitigate vulnerabilities, and children’s grit or determination. However, some results are inconsistent with previous evaluations, such as the negative impact on some nutrition outcomes, maternal healthcare service usage variations, and an insignificant reduction in child labor incidence. The study recommends improving program monitoring, strengthening enforcement of health conditions, and further researching the factors driving some of the unexpected results. It also suggests adjusting program policies or incentives, particularly in terms of reevaluating the cash grant value and using the program’s positive impacts on the behavior of children and adults as a model for other interventions. |
| Keywords: | Pantawid Pamilya;4Ps;cash transfers;human capital;Regression Discontinuity;impact evaluation |
| Date: | 2023 |
| URL: | http://d.repec.org/n?u=RePEc:phd:rpseri:rps_2023-06&r=hea |
| By: | Xudong An; Stuart A. Gabriel; Nitzan Tzur-Ilan |
| Abstract: | We link detailed wildfire burn, satellite smoke plume, and ground-level pollution data to estimate the effects of extreme wildfire and related smoke and air pollution events on housing and consumer financial outcomes. Findings provide novel evidence of elevated spending, indebtedness, and loan delinquencies among households distant from the burn perimeter but exposed to high levels of wildfire-attributed air pollution. Results also show higher levels of financial distress among renters in the burn zone, particularly those with lower credit scores. Financial distress among homeowners within the fire perimeter is less prevalent, likely owing to insurance payout. Findings also show out-migration and declines in house values in wildfire burn areas. The adverse smoke and pollution effects are salient to a substantial geographically dispersed population and add appreciably to the household financial impacts of extreme wildfires. |
| Keywords: | Wildfires; Air Pollution; Consumer Credit; Financial Distress; Spending |
| JEL: | R23 Q53 Q54 D12 |
| Date: | 2024–01–03 |
| URL: | http://d.repec.org/n?u=RePEc:fip:fedpwp:97535&r=hea |
| By: | Zahra Ghasemi Kooktapeh; Hakimeh Dustmohammadloo; Hooman Mehrdoost; Farivar Fatehi |
| Abstract: | Using a systematic review and meta-analysis, this study investigates the impact of the COVID-19 pandemic on job burnout among nurses. We review healthcare articles following the PRISMA 2020 guidelines and identify the main aspects and factors of burnout among nurses during the pandemic. Using the Maslach Burnout questionnaire, we searched PubMed, ScienceDirect, and Google Scholar, three open-access databases, for relevant sources measuring emotional burnout, personal failure, and nurse depersonalization. Two reviewers extract and screen data from the sources and evaluate the risk of bias. The analysis reveals that 2.75% of nurses experienced job burnout during the pandemic, with a 95% confidence interval and rates varying from 1.87% to 7.75%. These findings emphasize the need for interventions to address the pandemic's effect on job burnout among nurses and enhance their well-being and healthcare quality. We recommend considering individual, organizational, and contextual factors influencing healthcare workers' burnout. Future research should focus on identifying effective interventions to lower burnout in nurses and other healthcare professionals during pandemics and high-stress situations. |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2312.14853&r=hea |
| By: | de Mello-Sampayo, F.; |
| Abstract: | Uncertainty significantly influences healthcare policy decisions, especially regarding lockdown exits amid pandemics. This paper examines different uncertainties affecting stayat-home and essential workers concerning COVID-19 exposure. Using an epidemiological real options model, we assess how uncertainty impacts the decision to end lockdown without causing disease resurgence. Results indicate higher policy-change value lengthens the lockdown delay. Greater shock correlation between stay-at-home and mask-only populations reduces this value, leading to earlier lockdown exits. The findings bridge discrepancies between public health recommendations and policymakers' actions. Integrating options theory enables more informed decision-making by considering uncertain risks and outcomes. |
| Keywords: | public health strategy; uncertainty; real options; mitigation measures; lockdown; |
| JEL: | C61 H12 I18 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:yor:hectdg:24/01&r=hea |
| By: | Nalini Prasad (UNSW Sydney); Christian Gillitzer (The University of Sydney) |
| Abstract: | Pandemic school closures were widespread but occurred together with COVID-19 health effects. Australia’s successful COVID-19 elimination policies provide a unique setting to studythe effect of school closures on learning loss absent significant health effects. We exploit variation in the duration of school closures across Australian regions of 9-157 school days and student-level test score data from a national standardized test with high participation to estimate learning loss. Learning loss was substantially smaller than comparable estimates from the literature, including for disadvantaged socioeconomic groups. |
| Keywords: | student test scores, COVID-19, NAPLAN, pandemic |
| JEL: | I20 I21 |
| Date: | 2023–09 |
| URL: | http://d.repec.org/n?u=RePEc:swe:wpaper:2023-13&r=hea |
| By: | Taisuke Nakata; Daisuke Fujii; Asako Chiba; Yuta Maeda; Masataka Mori; Kenichi Nagasawa; Wataru Okamoto |
| Abstract: | We present a series of quantitative analyses conducted from mid-May of 2021 to mid-June of 2021 that examined the effects of hosting the Tokyo 2020 Olympic and Paralympic Games on the spread of COVID-19 in Tokyo. Our ex-ante quantitative analyses pointed out that (i) the direct effects on the spread of COVID-19 of welcoming Games-related foreign visitors to Japan or allowing spectators in competition venues would be either limited or manageable, but (ii) a festive mood generated by the Games could greatly contribute to the spread of COVID-19 if it led to a decline in people¡Çs willingness to take preventive actions against infection. Ex-post, the key results of our ex-ante analyses are broadly in line with available circumstantial evidence as well as ex-post consensus by public-health experts on how the Games affected the spread of COVID-19 in Tokyo. |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:tcr:wpaper:e194&r=hea |