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on Health Economics |
By: | Darden, Michael E. (The Johns Hopkins Carey Business School); Macis, Mario (The Johns Hopkins Carey Business School) |
Abstract: | We present results from a nationally representative survey of American adults, guided by a simple theoretical model expressing health care-seeking behavior as a function of economic and behavioral fundamentals and highlighting the role of trust. We report several findings. First, we document a strong association between higher levels of trust in the health care system and reported care-seeking behavior, both retrospective and anticipated. This relationship holds across several care scenarios, from routine check-ups to vaccinations. Second, the impact of trust on health care utilization is similar in magnitude to that of factors such as income and education, long recognized as crucial in the existing literature. Third, the relationship between trust and care-seeking behavior appears to be mediated by key mechanisms from our theoretical framework, notably individuals' beliefs about the system's effectiveness in managing their health and their personal disutility tied to medical visits. Fourth, we ask respondents about trust in specific health care system sectors, and we find important heterogeneity in the associations between trust and care-seeking behavior, notably between trust in the Centers for Disease Control and Prevention and the likelihood to receive flu and COVID-19 vaccinations. Finally, we find no differential relationship between trust and care-seeking for Black respondents, but we find important differences by age and political affiliation. Our findings hold significant implications for policy, particularly given that trust in medical and, more broadly, scientific expertise is increasingly difficult to establish. |
Keywords: | trust, health care, disparities |
JEL: | I11 I12 I14 I18 |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16720&r=hea |
By: | Carozzi, Felipe; Pinchbeck, Edward William; Repetto, Luca |
Abstract: | What drives soldiers to risk their life in combat? We show that the legacy of war creates lasting conditions that encourage younger generations to take greater risks when fighting for their country. Using individual-level data from over 4 million British war records, we show that WWI deaths deeply affected local communities and the behaviour of the next generation of soldiers. Servicemen from localities that suffered heavier losses in WWI were more likely to die or to be awarded military honours for bravery in WW2. To explain these findings, we document that WWI deaths promoted civic capital in the inter-war period - as demonstrated by the creation of lasting war memorials, veterans' associations and charities, and increased voter participation. In addition, we show that sons of soldiers killed in WWI were more likely to die in combat, suggesting that both community-level and family-level transmission of values were important in this context. |
Keywords: | world war; combat motivation; conflict; civic capital; memory; BA/Leverhulme Small Research Grant SRG2021- 210936 |
JEL: | D74 D91 O15 Z10 |
Date: | 2023–08–01 |
URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121292&r=hea |
By: | Volha Lazuka (University of Southern Denmark, Lund University, IZA); Peter Sandholt Jensen (Linnaeus University) |
Abstract: | Can the effect of a positive health shock, such as childhood vaccination, transmit across three generations? To answer this question, we estimate the impact of smallpox vaccination in childhood on the longevity and occupational achievements of three generations using unique individual-level data from Sweden, covering the last 250 years. We apply different estimation strategies based on linear and non-linear probability models. To address endogeneity concerns, we construct a shift-share instrumental variable, utilizing the fact that vaccination in Sweden was administered by the low-skilled clergy, who otherwise did not perform public health duties. Overall, our results show that a positive shock to the health of the first generation, such as smallpox vaccination, operating through various channels, enhances both health and socio-economic outcomes for at least two more generations. |
Keywords: | intergenerational transmission of health, smallpox vaccination, shift-share instrumental-variables |
JEL: | I18 J24 J62 |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:hes:wpaper:0251&r=hea |
By: | Clark, Andrew E. (Paris School of Economics); Zhu, Rong (Flinders University) |
Abstract: | We use nationally representative panel data from Australia to consider the impact of retirement on individual locus of control, a socio-emotional skill that has substantial explanatory power for a broad range of life outcomes. We establish causality via cohort-specific eligibility age for the Australian Age Pension. We show that retirement leads to increased internal locus of control. This greater sense of internal control can explain around one-third and one-fifth of the positive effects of retirement on health and subjective well-being, respectively. The impact of retirement on control beliefs varies along the distribution of locus of control, with the positive influence being most pronounced for men with a relatively high sense of internal control and for women with a relatively high sense of external control. Last, we provide evidence that locus of control is much more malleable at retirement than the other socio-emotional skills of the Big-Five personality traits, risk and time preferences, and trust. |
Keywords: | retirement, locus of control, socio-emotional skills, public pension |
JEL: | H55 J24 J26 |
Date: | 2023–12 |
URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16704&r=hea |
By: | Hall, Andrea |
Abstract: | In 2011, Pennsylvania passed regulations requiring abortion-providing facilities to meet ambulatory surgical facility standards, which ultimately caused the closure of almost half of the state's abortion facilities. All closing facilities were geographically near facilities that remained open, meaning distance to the nearest clinic was unchanged while local clinic capacity fell. I use a difference-in-differences design supplemented with a synthetic control method and find that reduced clinic capacity caused 20-30 percent fewer abortions in the first 8 weeks of gestation and more abortions at later gestational ages. While evidence suggests births may have increased slightly, the main impact closures had on local women was a delay in abortions. |
Keywords: | abortion; clinic closures; reproductive health |
JEL: | I11 I14 I18 J13 |
Date: | 2023–07 |
URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:119872&r=hea |
By: | Ferreira, Susana (University of Georgia); Martinez-de-Morentin, Sara (Universidad Pública de Navarra); Erro-Garcés, Amaya (Universidad Pública de Navarra) |
Abstract: | Hedonic wage regressions show little evidence that European workers facing larger job risks and other workplace disamenities receive higher wages. On the other hand, workers in more risky or unpleasant jobs are less satisfied with their jobs, ceteris paribus. If labor markets were perfectly competitive and workers fully informed of their working conditions ex ante, according to the theory of compensating differentials, there should be no relationship between on-the-job risk and job satisfaction because wages would fully adjust to compensate for differences in job characteristics. We show that when wages do not fully compensate for on-the-job risks, the willingness to pay to reduce mortality risks estimated from hedonic regressions needs to be complemented with a residual effect of job risks on utility which is not capitalized on wages. We explore the potential of job satisfaction regressions as an additional valuation approach to estimate the tradeoffs between wages and risks that keep job satisfaction constant. |
Keywords: | on-the-job risk, experienced preference, job satisfaction, hedonic wages, stated preference, value of a statistical life |
JEL: | Q51 I12 I18 J17 J31 K32 |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16716&r=hea |
By: | Stenberg, Anders (SOFI, Stockholm University); Tudor, Simona (Stockholm University) |
Abstract: | We analyze whether field of study assigned at age 16 impacts mental health in adulthood. Using a regression discontinuity design that exploits GPA cut-offs, we find that admission to the preferred study field improves mental health, lowering both the incidence of antidepressant prescriptions and of mental health-related hospitalizations. Engineering contributes strongly but not uniquely to the positive results. As for mechanisms, earnings explain 40% of the estimates, but earlier proposed hypotheses based on school-age peer characteristics have little explanatory power. Our findings imply that restrictions on individuals' choices, to improve human capital allocations, entail costs that may have been underestimated. |
Keywords: | field of study, health, secondary education |
JEL: | I10 I21 I24 J24 J28 J32 |
Date: | 2023–12 |
URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16701&r=hea |
By: | Maczulskij, Terhi; Kanninen, Ohto; Karhunen, Hannu; Tahvonen, Ossi |
Abstract: | Abstract The paper investigates the impact of involuntary job loss on severe debt problems in Finland, where up to 50% of income may be subject to wage garnishment for 25 years. We use linked employer-employee data combined with unique administrative records covering debt enforcements from 2007 to 2018. Our event study analysis uncovers a robust and persistent impact of job loss, characterized by plant closures and mass layoffs, on debt-related challenges. Specifically, displaced workers have a 5% higher likelihood of enforced debts in the year of displacement compared to the control group. This effect increases, peaking at 16% four years post-displacement and maintaining a substantial level of roughly 10% nine years afterwards. Effects are particularly large for unpaid taxes, penal orders and fines, while job loss demonstrates only a modest impact on unpaid social or healthcare payments and alimonies. Moreover, these effects are more profound among males, less educated, and individuals already burdened with excessive debt, such as mortgages, prior to displacement. |
Keywords: | Default, Debt enforcement, Involuntary job loss, Employer-employee data |
JEL: | D14 G51 J64 J65 |
Date: | 2024–02–01 |
URL: | http://d.repec.org/n?u=RePEc:rif:wpaper:115&r=hea |
By: | Attanasio, Orazio; Lopez-Boo, Florencia; Perez-Lopez, Diana; Reynolds, Sarah Anne |
Abstract: | Gaps in child development by socioeconomic status (SES) start early in life, are large and can increase inequalities later in life. We use recent national-level, cross-sectional and longitudinal data to examine inequalities in child development (namely, language, cognition, and socio-emotional skills) of children 0-5 in five Latin American countries (Chile, Colombia, Mexico, Peru and Uruguay). In the cross-section analysis, we find statistically significant gaps with inequality patterns that widely differ across countries. For instance, gaps in language and cognition for Uruguay and Chile are much smaller than those for Colombia and Peru. When turning to the longitudinal data, average SES gaps are similar to those of the cross-section in language but differ substantially in cognition, mainly in Uruguay where they emerge as more unequal when cohort effects do not operate. Importantly, we also find that the ECD gaps found at early ages (0-5), still manifest 6-12 years later in almost all locations and realms in which we have measures of early child development, but they do not increase with age. Results are robust to using different measures of inequality (income and maternal education). Gaps are smaller but generally remain when adjusting for possible explanatory factors (e.g., family structure, parental education, geographic fixed effects). To reduce ECD inequality and promote equality in later life outcomes, policymakers should look to implementing evidence-based interventions at scale to improve developmental outcomes of the most disadvantaged children in society. |
JEL: | I00 |
Date: | 2024–01–01 |
URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121590&r=hea |
By: | Shen, Chi (Xi’an Jiaotong University); Chen, Xi (Yale University) |
Abstract: | There is mounting evidence indicating that the aging process initiates during early life stages, with in utero the individual's environment playing a significant role. Consequently, it is crucial to understand the enduring effects of early life circumstances on health in old age. In this study, we conducted a meta-analysis to examine the effects of the Great Chinese Famine (1959–1961) on the health of older adults. We also explored potential mechanisms underlying these effects. The complex interplay between early life circumstances, multiple health-related sectors, and healthy aging necessitates a comprehensive life-course approach and strategic interventions to enhance public health in an aging society. |
Keywords: | early life circumstances, famine, life course health, aging, meta-analysis |
JEL: | I14 J14 J13 I18 |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16733&r=hea |
By: | Qi, Shouwei (School of Public Finance and Taxation, Zhongnan University of Economics and Law); Li, Xiang (School of Public Finance and Taxation, Zhongnan University of Economics and Law); Matthews, Kent (Cardiff Business School) |
Abstract: | We investigate the intergenerational effect of parental health shocks on the fertility choices of adult children in China. By using a comprehensive longitudinal dataset of Chinese households, severe and unexpected health shocks to parents have been identified. To address sample imbalance issues in survey data and endogeneity concerns characteristic of traditional health shock studies, we employ two matching methodologies: Coarsened Exact Matching (CEM) and Propensity Score Matching (PSM). Our findings indicate that parental health shocks significantly postpone the reproductive age of adult children and reduce their likelihood of having more children than they originally planned. We also find persistent differences in fertility decisions for the first, second and third child among adult children. The economic constraints inferred from this study have notable implications on the reduced fertility behavior of adult children, thereby affecting their entire reproductive life cycle. |
Keywords: | parental health shocks, fertility decisions, intergenerational effect |
JEL: | J18 |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:cdf:wpaper:2024/4&r=hea |
By: | Wang, Tianyu; Sun, Ruochen; Sindelar, Jody L.; Chen, Xi |
Abstract: | Retirement, a major transition in the life course, may affect many aspects of retirees' well-being, including health and health care utilization. Leveraging differential statutory retirement age (SRA) by occupation for China's urban female workers, we provide some of the first evidence on the causal effect of retirement on hospitalizations attributable to mental illness and its heterogeneity. To address endogeneity in retirement decisions, we take advantage of exogeneity of the differing SRA cut-offs for blue-collar (age 50) and white-collar (age 55) female urban employees. We apply a Fuzzy Regression Discontinuity Design (RDD) around the SRA cut-offs using nationally representative hospital inpatient claims data that cover these workers. We show that blue-collar females incur more hospitalizations for mental illness after retirement, while no similar change is found for white-collar females. Conditional on blue-collar females being hospitalized, probabilities of overall and ER admissions due to mental illness increase by 2.3 and 1.2 percentage points upon retirement, respectively. The effects are primarily driven by patients within the categories of schizophrenia, schizotypal and delusional disorders; and neurotic, stress-related and somatoform disorders. Moreover, the 'Donut' RDD estimates suggest that pent-up demand at retirement unlikely dominates our findings for blue-collar females. Rather, our results lend support to their worsening mental health at retirement. These findings suggest that occupational differences in mental illness and related health care utilization at retirement should be considered when optimizing retirement policy schemes. |
Keywords: | mental illness, behavioral disorders, retirement, inpatient care, blue-collar females, white-collar females |
JEL: | I11 J26 J14 I18 H55 |
Date: | 2024 |
URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:1380&r=hea |
By: | CARMONA, JULIO (University of Alicante, D. Quantitative Methods and Economic Theory) |
Abstract: | The recent sad news about the Robert Solow’s decease has motivated a review of his most celebrated contribution to Economics, his model of economic growth. In this paper, I illustrate its versatility and usefulness by combining it with the problem that endemic diseases has for the economic performance of most emerging economies. The literature about economic development have examined this problem with particular emphasis on the necessary sanitary measures to raise the level of health. These measures have been advocated on the basis that they will have big positive effects on productivity, real wages and per capita GDP. To illustrate to our undergraduate students both, the value of health for economic development and the intuitions the Solow model can provide, I couple it with the so called SIS model, a concise description of persistent diseases. This will help to illustrate how endemic diseases affect negatively society’s welfare and, for the case in which the endemic disease increases the mortality rate, the rate of economic growth. |
Keywords: | SIS Model; Solow Model; Poverty Trap |
JEL: | E00 I15 O40 |
Date: | 2024–02–05 |
URL: | http://d.repec.org/n?u=RePEc:ris:qmetal:2024_001&r=hea |
By: | Sebastian Bauhoff (Department of Global Health and Population, Harvard T.H. Chan School of Public Health); Eeshani Kandpal (Center for Global Development) |
Abstract: | A two-stage experiment disentangles the effect of various aspects of pay-for-performance contracts. The first is a lab-in-the-field experiment where 1, 359 health workers are primed with a checklist of salient clinical tasks, then randomized within 690 clinics to receive no incentives, rewards, or penalties for treating hypothetical patients. Both rewards and penalties improve performance by 20 percent and generate spillovers on unincentivized tasks, but small incentives capture most gains. In the second stage, lab impacts translate into the real world: lab PFP exposure improves by 20 percent the care provided to real-world patients even after the lab experiment. |
Keywords: | Pay-for-performance; Health workers; Lab-in-the-field experiment |
JEL: | C93 I11 I15 J41 J45 M52 O15 |
Date: | 2024–01–29 |
URL: | http://d.repec.org/n?u=RePEc:cgd:wpaper:677&r=hea |
By: | Daniel Tuki (Research Fellow, WZB Berlin Social Science Center, Berlin, Germany) |
Abstract: | Using the Wave 7 World Values Survey (WVS) dataset, this study examined the determinants of happiness among Nigerians with a focus on exposure to violent conflict, socioeconomic condition, religiosity, and self-rated health. The regression results showed that exposure to violent conflict reduced the likelihood of being happy, but socioeconomic condition and self-rated health were positively correlated with happiness. Religiosity, which was measured using the frequency of prayer, had no effect on happiness. The respondents’ demographic attributes like gender, age, and marital status also had no effect on happiness. |
Keywords: | Happiness, Violent conflict, Heath, Poverty, Religiosity, Nigeria |
JEL: | D74 I31 Z12 |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:hic:wpaper:407&r=hea |
By: | G. Arbia; V. Nardelli; N. Salvini; I. Valentini |
Abstract: | In health econometric studies we are often interested in quantifying aspects related to the accessibility to medical infrastructures. The increasing availability of data automatically collected through unconventional sources (such as webscraping, crowdsourcing or internet of things) recently opened previously unconceivable opportunities to researchers interested in measuring accessibility and to use it as a tool for real-time monitoring, surveillance and health policies definition. This paper contributes to this strand of literature proposing new accessibility measures that can be continuously feeded by automatic data collection. We present new measures of accessibility and we illustrate their use to study the territorial impact of supply-side shocks of health facilities. We also illustrate the potential of our proposal with a case study based on a huge set of data (related to the Emergency Departments in Milan, Italy) that have been webscraped for the purpose of this paper every 5 minutes since November 2021 to March 2022, amounting to approximately 5 million observations. |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:arx:papers:2401.13370&r=hea |
By: | Orin Levine (Center for Global Development); Janeen Madan Keller (Center for Global Development); Morgan Pincombe (Center for Global Development); Javier Guzman (Center for Global Development) |
Abstract: | For nearly 25 years, Gavi has delivered impact and value for money and remained one of the most successful global health initiatives. Gavi’s success has been driven by its use of three primary levers: (1) accelerating new vaccine introductions, (2) increasing equitable immunization coverage, and (3) utilizing eligibility criteria to target support to the most impactful geographies. For Gavi to be as successful going forward, its leadership and board need to reevaluate and adjust its operational model. Several imminent disruptions are exerting pressure on Gavi’s ability to deliver results across these three levers. For the upcoming 2026-2030 strategic period (known as “Gavi 6.0”), Gavi should adopt a new playbook to leverage its strengths, mitigate the impacts of disruptions associated with these levers, and enable greater agility and effectiveness in its model. We offer seven policy recommendations for Gavi’s board as it sets the course for Gavi 6.0. These include: (1) revising Gavi’s eligibility policy to better align with countries’ abilities to pay and disease burdens; (2) recalibrating the global-regional balance in vaccine manufacturing and procurement; (3) creating a mechanism across Gavi and other global health initiatives to assure integrated approaches to disease control that optimize value for money and simplify implementation for countries; (4) leveraging Gavi’s experience, including in market shaping, to accelerate innovations for immunization systems and primary health care more broadly; (5) replacing existing financing arrangements with an envelope financing approach that is driven by local priorities; (6) establishing a stand-alone subsidiary that operates in fragile and conflict-affected settings with high-risk appetite; and (7) incorporating second year of life and adolescent platform building as an explicit objective for Gavi 6.0. |
Date: | 2024–01–30 |
URL: | http://d.repec.org/n?u=RePEc:cgd:ppaper:320&r=hea |
By: | Guyonne Kalb (Melbourne Institute: Applied Economic & Social Research, The University of Melbourne); Jordy Meekes (Department of Economics, Leiden University, Netherlands) |
Abstract: | We study nurses’ labour dynamics in light of continuing nurse shortages and the COVID-19 pandemic. Using Dutch monthly administrative microdata, all nursing-qualified persons observed in January 2016 and/or in January 2020 are compared and followed for one year before and three years after both baseline months. Compared to the 2016 Cohort, women and men in the 2020 Cohort who were employed in the healthcare sector at baseline were 0.3 and 1 percentage point more likely to have left employment; and, conditional on still being employed, 0.8 and 1.2 percentage points more likely to have left healthcare employment after three years. The 2020 Cohort women and men were also 1 and 1.7 percentage points more likely to transition from salaried employment to self-employment, and they reduced working hours by 0.6% and 1.5% more by December 2022. Except during COVID outbreaks, there is no higher inflow into healthcare employment by nursing-qualified women and men who were not employed in healthcare at baseline. Finally, other healthcare professionals fared better, with similar healthcare sector retention rates in 2019-2022 compared with 2015-2018. Overall, the pandemic accelerated nurse shortages through reduced retention and increased self-employment, and its impact is still felt at the end of 2022. |
Keywords: | nurses, labour dynamics, self-employment, healthcare, gender, COVID-19 |
JEL: | I11 J16 J20 J44 J62 |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:iae:iaewps:wp2024n01&r=hea |
By: | Tijs W. Alleman; Jan M. Baetens |
Abstract: | During the COVID-19 pandemic, governments faced the challenge of managing population behavior to prevent their healthcare systems from collapsing. Sweden adopted a strategy centered on voluntary sanitary recommendations while Belgium resorted to mandatory measures. Their consequences on pandemic progression and associated economic impacts remain insufficiently understood. This study leverages the divergent policies of Belgium and Sweden during the COVID-19 pandemic to relax the unrealistic -- but persistently used -- assumption that social contacts are not influenced by an epidemic's dynamics. We develop an epidemiological-economic co-simulation model where pandemic-induced behavioral changes are a superposition of voluntary actions driven by fear, prosocial behavior or social pressure, and compulsory compliance with government directives. Our findings emphasize the importance of early responses, which reduce the stringency of measures necessary to safeguard healthcare systems and minimize ensuing economic damage. Voluntary behavioral changes lead to a pattern of recurring epidemics, which should be regarded as the natural long-term course of pandemics. Governments should carefully consider prolonging lockdown longer than necessary because this leads to higher economic damage and a potentially higher second surge when measures are released. Our model can aid policymakers in the selection of an appropriate long-term strategy that minimizes economic damage. |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:arx:papers:2401.08442&r=hea |
By: | Esposito, P.; Mendolia, S.; Scicchitano, S.; Tealdi, C. |
Abstract: | In this paper we investigate the effect of working-from home (WFH) on job satisfaction. We use longitudinal data from Italy to estimate a difference-in-differences model, in which the treatment group includes individuals who transitioned to remote work in 2020 due to the COVID-19 pandemic and continued to work from home in 2021. We perform the analysis, which extends to various aspects of self-reported job satisfaction, by gender and personality traits as per the Big-Five framework, encompassing Openness to Experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism. Our findings reveal that WFH exhibits a positive influence on job satisfaction, albeit exclusively among women, and with some heterogeneity, depending on personal characteristics. Specifically, this effect seems more noticeable in women characterized by elevated Openness to Experience, whereas those with heightened conscientiousness or neuroticism levels tend to experience less satisfaction when working remotely. |
Keywords: | remote working, difference in differences, longitudinal analysis, gender differences, Big-Five framework |
JEL: | J28 J81 J16 |
Date: | 2024 |
URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:1382&r=hea |
By: | Colleen Heflin (Center for Policy Research, Maxwell School, Syracuse University, 426 Eggers Hall, Syracuse, NY 13244); William Clay Fannin (Center for Policy Research, Maxwell School, Syracuse University, 426 Eggers Hall, Syracuse, NY 13244); Leonard Lopoo (Center for Policy Research, Maxwell School, Syracuse University, 426 Eggers Hall, Syracuse, NY 13244); Siobhan O'Keefe |
Abstract: | Food insecurity in the United States reached historically high rates during the COVID-19 pandemic, thus substantially increasing demand for the Supplemental Nutrition Assistance Program (SNAP). To facilitate access to SNAP during the pandemic, the federal government granted state SNAP offices the option to waive the interview requirement – an administrative burden associated with the SNAP certification process. This brief summarizes findings from a recent study that used data from SNAP offices across 10 states to examine the impact of SNAP interview waivers on SNAP caseloads from January 5th to April 30th of 2021. Findings reveal that counties that implemented the SNAP interview waiver experienced an estimated 5% increase in SNAP caseloads compared to counties that did not. |
Keywords: | Food Insecurity, Supplemental Nutrition Assistance Program, COVID-19 |
Date: | 2024–01 |
URL: | http://d.repec.org/n?u=RePEc:max:cprpbr:67&r=hea |