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on Health Economics |
| By: | Schlenker, Oliver |
| Abstract: | This paper estimates the impact of nursing shortages in hospitals on healthcare provision and patient outcomes by exploiting a strong and stable appreciation of the Swiss franc in 2011. Due to collective bargaining hindering wage adjustments in the German healthcare sector, cross-border wage differentials increased and led to a significant outflow of German registered nurses to Switzerland, causing a 12.5% reduction in nurse staffing rates in German hospitals near the border. Using a matched difference-in-differences approach, I find that hospitals responded by decreasing care intensity, leading to a 12% decrease in surgeries. Although hospitals are increasingly performing triage, also patients with high medical needs - such as elderly and emergency cases - face a reduction in care and, consequently, a stark increase in mortality rates, resulting in a measurable decline in regional life expectancy. |
| Keywords: | Labor scarcity, cross-border commuting, wage differentials, nurse shortages, healthcare provision, triage, patient outcomes |
| JEL: | F22 I18 J22 J31 J61 I11 R23 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:cexwps:306342 |
| By: | Deiana, C; Dragone, D; Giua, L |
| Abstract: | We propose a model of addictive consumption to study the demand for imperfect substitutes involving substances like alcohol, nicotine and opioids, as well as behavioral addictions like gambling and digital addiction. We study a 2017 Italian policy aimed at reducing gambling by limiting the number of available slot machines. Despite the reduction in slot machines, the policy produced an unintended 25% increase in net expenditure, particularly among low-wealth and low-educated individuals who also engage in other addictive behaviors. This result can be rationalized as the consequence of changes in self-control costs due to social contagion effects. |
| Keywords: | addiction; gambling; horizontal differentiation; self-control; slot machines; temptation; |
| JEL: | I18 L43 L83 |
| Date: | 2024–12 |
| URL: | https://d.repec.org/n?u=RePEc:yor:hectdg:24/21 |
| By: | Mette Goertz (Department of Economics, University of Copenhagen); Ida Lykke Kristiansen (Department of Economics, University of Copenhagen); Tianyi Wang (Department of Economics, the University of Toronto) |
| Abstract: | While physicians are crucial to patient outcomes, what determines physician behavior and decision making remains to be understood. In this paper, we study how physicians family characteristics influence physicians behavior and patient health outcomes. Using administrative data from Denmark and the natural experiment of a childs gender, we find that having daughters affects male primary care physicians practices and the health of their female patients. Specifically, female patients cared for by male physicians with one additional daughter (compared to one additional son) are 5.5% less likely to die from female-specific cancers, including breast and gynecologic cancers. This improvement in outcomes appears to stem from enhanced cancer screening and preventive efforts, leading to earlier detection and more successful prevention. Exploring potential mechanisms, we find that male physicians with more daughters show greater attentiveness to female-specific health guidelines and are more likely to collaborate with women. We also find suggestive evidence from survey data that female patients report higher levels of trust, empathy, and clearer communication with these physicians. |
| Keywords: | Women’s Health, Primary Care Physician, Physician Behavior, Practice Style |
| JEL: | I10 I14 J12 |
| Date: | 2024–11–26 |
| URL: | https://d.repec.org/n?u=RePEc:kud:kucebi:2418 |
| By: | Wolfgang Frimmel; Felix Glaser |
| Abstract: | Health equality is an important objective in public healthcare systems, and still, we see substantial socio-economic differences. Using high-quality administrative data from Upper Austria, we analyze the socio-economic gradient in mortality and healthcare utilization following a cancer diagnosis. High-SES patients are less likely to die after a cancer hospitalization even when accounting for a comprehensive set of controls, including detailed pre-shock healthcare use. After hospital discharge, patients navigate the healthcare system differently depending on their socio-economic status. We explore potential explanations for the observed SES gradient. Our findings suggest that low-SES cancer patients go to the hospital at a later stage of the disease. Peer groups also matter in explaining SES differences, while healthcare providers do not appear to contribute significantly to the gap. Targeted policies that take into account disease heterogeneity, health awareness, and prevention behavior have the potential to reduce health inequalities. |
| Keywords: | Health Inequality, SES, Mortality, Health Behavior, Cancer. |
| JEL: | I14 I12 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:jku:econwp:2024-14 |
| By: | Clara Andresciani; Debora Di Gioacchino; Laura Sabani |
| Abstract: | This paper examines the "decongestion effect" argument, which suggests that the expansion of the private healthcare sector can reduce pressure on the public healthcare system, thereby improving access and quality of care for public sector patients. To this purpose, we develop a probabilistic voting model that endogenizes the public healthcare budget and incorporates a private sector where agents, differentiated by income, can opt out of the public system while still contributing to it fiscally. Our findings indicate that a higher proportion of individuals opting out leads to lower political support for public healthcare and a decline in public healthcare quality, ultimately negating the decongestion effect argument. Using data from 26 European countries, we empirically test our model by examining the relationship between unmet medical needs -used as a proxy for the quality of public healthcare sector- and private health insurance coverage. After controlling for individual and country-level characteristics, our results indicate that as private insurance coverage expands, income disparities in unmet medical needs widen: wealthier individuals benefit more, while poorer individuals face increased unmet needs, providing no evidence supporting the decongestion effect. |
| Keywords: | public/private healthcare mix; voluntary health insurance; unmet medical needs; probabilistic voting; bivariate probit model |
| JEL: | I13 I14 H51 P35 C35 |
| Date: | 2024–10 |
| URL: | https://d.repec.org/n?u=RePEc:sap:wpaper:wp253 |
| By: | Abe C. Dunn; Lasanthi Fernando; Eli Liebman |
| Abstract: | Medical innovation is a key driver of cost growth and improved life expectancy, but measuring the welfare contribution of innovations is challenging. We leverage thousands of medical studies to estimate the quality of treatments for 13 health conditions and combine these estimates with insurance claims data to quantify how innovations diffuse and their impact on costs and quality. Across nearly all conditions we study, we find higher quality innovations diffuse. Like markets outside of healthcare, we find innovations can improve consumer welfare substantially. However, we also observe a phenomena arguably unique to healthcare, cases where innovation reduces consumer welfare. |
| JEL: | E31 O30 I10 |
| Date: | 2024–12 |
| URL: | https://d.repec.org/n?u=RePEc:bea:papers:0132 |
| By: | Michael D. Krämer; Wiebke Bleidorn |
| Abstract: | How does informal care affect caregivers’ well-being? Theories and existing research provide conflicting answers to this question, partly because the temporal processes and conditions under which different aspects of well-being are affected are unknown. Here, we used longitudinal data from Dutch, German, and Australian representative panels (281, 884 observations, 28, 663 caregivers) to examine theoretically derived hypotheses about changes in caregivers’ life satisfaction, affective experiences, depression/anxiety, and loneliness. Overall, results provided evidence for negative well-being effects after the transition into a caregiver role, with more pronounced and longer-lasting well-being losses in women than men. We further found that well-being losses were larger with more time spent on caregiving, in both men and women. These results were robust across moderators of the caregiving context (care tasks, relationship with care recipient, and fulltime employment). Together, the present findings support predictions of stress theory and highlight lingering questions in theoretical frameworks of care-related well-being costs |
| Keywords: | informal care, caregiving, well-being, life satisfaction, affect, mental health |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp1214 |
| By: | Mariia Vasiakina (Max Planck Institute for Demographic Research, Rostock, Germany); Christian Dudel (Max Planck Institute for Demographic Research, Rostock, Germany) |
| Abstract: | Automation transforms work at a rapid pace, with gradually increasing shares of the workforce being at risk of replacement by machines. However, little is known about how this risk is affecting workers. In this study, we investigate the impact of exposure to a high risk of automation at work on the subjective (self-reported health, anxiety, and health satisfaction) and objective (healthcare use and sickness absence) health outcomes of workers in Germany. We base our analysis on survey data from the German Socio-Economic Panel (SOEP) and administrative data from the Occupational Panel for Germany (2013-2018). Employing panel regression, we demonstrate that for workers, exposure to a high risk of automation at the occupational level is associated with lower self-reported health and health satisfaction, increased sickness absence, and, depending on how the risk is measured, anxiety. No effect on healthcare use is found. Our heterogeneity analysis provides evidence that none of the analyzed demographic and occupational groups is disproportionally affected by high automation risk. We also conduct several robustness checks (i.e., alternative model specifications and risk measures with different thresholds), with the results remaining largely consistent with our main findings. |
| Keywords: | Germany, automation, health |
| JEL: | J1 Z0 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:dem:wpaper:wp-2024-041 |
| By: | Zilong Li (School of Economics, University College Dublin; Geary Institute for Public Policy, University College Dublin, Ireland); Xidong Guo (Vanke School of Public Health, Tsinghua University, Beijing 100084, China); Zuzanna Studnicka (School of Economics, University College Dublin, Ireland); Jiming Zhu (Vanke School of Public Health, Tsinghua University, Beijing 100084, China) |
| Abstract: | We examine the home advantage in the Chinese Basketball Association during the “neutral venues policy”, a period of approximately 2.5 years when games were relocated to neutral sites due to China’s strict COVID-19 regulations. We observe a reduced home advantage under this policy, providing a natural experiment to analyze the heterogeneous effects of neutral venues. We investigate these effects from two perspectives: (1) the relative strength of the home team and (2) the climate conditions of the home team’s original location. We find that stronger home teams are less affected by playing in neutral venues, suggesting that such teams rely less on the benefits of their home ground. Moreover, teams based in colder regions experience a more pronounced decline in home advantage during winter when they are unable to play on their home courts. |
| Keywords: | Home advantage; COVID-19; Neutral venues; Cold temperature; Team strength |
| JEL: | D91 L83 Q54 Z20 |
| Date: | 2024–12–16 |
| URL: | https://d.repec.org/n?u=RePEc:ucd:wpaper:202408 |