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Pricing above value: Selling to a market with selection problems J. Health Econ. (IF 3.5) Pub Date : 2024-03-05 Jan Boone
This paper shows that selection incentives in downstream markets distort upstream prices. It is possible for inputs to be priced above the value that the good has for final consumers. We apply this idea to pharmaceutical companies selling drugs to a health insurance market with selection problems. We specify the conditions under which drugs are sold at prices exceeding treatment value. Another feature
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Safer sex? The effect of AIDS risk on birth rates J. Health Econ. (IF 3.5) Pub Date : 2024-03-01 Melissa K. Spencer
Behavioral adjustments to mitigate increasing risk of STIs can increase or decrease the likelihood of pregnancy. This paper measures the effects of the arrival and spread of AIDS across U.S. cities in the 1980s and 1990s on births and abortions. I show that the AIDS epidemic increased the birth rate by 0.55 percent and the abortion rate by 1.77 percent. I find support for two underlying mechanisms
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Effects of nurse visit copayment on primary care use: Do low-income households pay the price? J. Health Econ. (IF 3.5) Pub Date : 2024-02-28 Tapio Haaga, Petri Böckerman, Mika Kortelainen, Janne Tukiainen
Nurses are increasingly providing primary care, yet the literature on cost-sharing has paid little attention to nurse visits. We employ a staggered difference-in-differences design to examine the effects of adopting a 10-euro copayment for nurse visits on the use of public primary care among Finnish adults. We find that the copayment reduced nurse visits by 9%–10% during a one-year follow-up. There
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Optimal intertemporal curative drug expenses: The case of hepatitis C in France J. Health Econ. (IF 3.5) Pub Date : 2024-02-16 Pierre Dubois, Thierry Magnac
We study intertemporal tradeoffs that health authorities face when considering the control of an epidemic using innovative curative medical treatments. We set up a dynamically controlled susceptible–infected–recovered (SIR) model for an epidemic in which patients can be asymptomatic, and we analyze the optimality conditions of the sequence of cure expenses decided by health authorities at the onset
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A new look at physicians’ responses to financial incentives: Quality of care, practice characteristics, and motivations J. Health Econ. (IF 3.5) Pub Date : 2024-02-15 Jeannette Brosig-Koch, Heike Hennig-Schmidt, Nadja Kairies-Schwarz, Johanna Kokot, Daniel Wiesen
There is considerable controversy about what causes (in)effectiveness of physician performance pay in improving the quality of care. Using a behavioral experiment with German primary-care physicians, we study the incentive effect of performance pay on service provision and quality of care. To explore whether variations in quality are based on the incentive scheme and the interplay with physicians’
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The value of improving insurance quality: Evidence from long-run Medicaid attrition J. Health Econ. (IF 3.5) Pub Date : 2024-02-10 Ajin Lee, Boris Vabson
The US government increasingly provides public health insurance coverage through private firms. We examine associated welfare implications for beneficiaries, using a ‘revealed preference’ framework based on beneficiaries’ program attrition rates. Focusing on the Medicaid program in New York State, we exploit quasi-random variation in the initial assignment at birth to public versus private Medicaid
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The causal effect of a health treatment on beliefs, stated preferences and memories J. Health Econ. (IF 3.5) Pub Date : 2024-02-06 Alberto Prati, Charlotte Saucet
The paper estimates the causal effect of a health treatment on patients’ beliefs, preferences and memories about the treatment. It exploits a natural experiment which occurred in the United Kingdom during the COVID-19 vaccination campaign. UK residents could choose to opt into the vaccination program, but not which vaccine they received. The assignment to a vaccine offered little objective information
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Financial incentives and private health insurance demand on the extensive and intensive margins J. Health Econ. (IF 3.5) Pub Date : 2024-02-06 Nathan Kettlewell, Yuting Zhang
In countries with dual public and private healthcare systems, individuals are often incentivized to purchase private health insurance through subsidies and penalty. We use administrative data from Australia to study how high-income earners respond on both the intensive and extensive margins to the simultaneous withdrawal of a premium subsidy, and the increase of a tax penalty. We estimate regression
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Estimating the effects of tobacco-21 on youth tobacco use and sales J. Health Econ. (IF 3.5) Pub Date : 2024-02-02 Rahi Abouk, Prabal K. De, Michael F. Pesko
We examine the effect of raising the minimum legal sale age of tobacco to 21 (i.e., “T21”). We estimate difference-in-differences models using the Monitoring the Future (MTF) survey data and Nielsen Retail Scanner data from 2012 to 2019. Outcomes include cigarette and e-cigarette use and sales. We find sizable reductions in e-cigarette and cigarette use for 12th graders. T21 also reduced cigarette
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Aversion to health inequality — Pure, income-related and income-caused J. Health Econ. (IF 3.5) Pub Date : 2024-01-23 Matthew Robson, Owen O’Donnell, Tom Van Ourti
We design a novel experiment to identify aversion to pure (univariate) health inequality separately from aversion to income-related and income-caused health inequality. Participants allocate resources to determine health of individuals. Identification comes from random variation in resource productivity and information on income and its causal effect. We gather data (26,286 observations) from a sample
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Immigration enforcement and the institutionalization of elderly Americans J. Health Econ. (IF 3.5) Pub Date : 2024-01-19 Abdulmohsen Almuhaisen, Catalina Amuedo-Dorantes, Delia Furtado
This paper examines the relationship between immigration enforcement and institutionalization rates of the elderly. Exploiting the staggered implementation of the Secure Communities (SC) immigration enforcement program across U.S. counties from 2008 through 2014, we show that SC led to a 0.26 percentage points (6.8 percent) increase in the likelihood that Americans aged 65 and above live in an institution
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Regulating ethical experimentation: Impacts of the breakthrough therapy designation on drug R&D J. Health Econ. (IF 3.5) Pub Date : 2024-01-18 Manuel Hermosilla
This article investigates patterns of pharmaceutical development activity around the 2012 creation of the FDA’s Breakthrough Therapy Designation (BTD). The BTD introduced regulatory flexibility and support to avoid ethical challenges created by experimental therapies of exceptional performance in early stage clinical trials. We argue that the program’s design indirectly created substantial incentives
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The impact of Medicaid expansion and travel distance on access to transplantation J. Health Econ. (IF 3.5) Pub Date : 2024-01-14 Bethany Lemont
Most transplant centers require candidates be insured before they can join the waitlist for a deceased donor organ. After the Affordable Care Act, many uninsured Americans gained improved access to Medicaid. I examine the effect of this increase in access to insurance and find that Medicaid expansions significantly increase Medicaid-insured waitlist registrations by 39% and deceased donor transplants
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Risk preferences over health: Empirical estimates and implications for medical decision-making J. Health Econ. (IF 3.5) Pub Date : 2024-01-09 Karen Mulligan, Drishti Baid, Jason N. Doctor, Charles E. Phelps, Darius N. Lakdawalla
Mainstream health economic theory implies that an expected gain in health-related quality of life (HRQoL) produces the same value for consumers, regardless of baseline health. Several strands of recent research call this implication into question. Generalized Risk-Adjusted Cost-Effectiveness (GRACE) demonstrates theoretically that baseline health status influences value, so long as consumers are not
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The impact of scope-of-practice restrictions on access to medical care J. Health Econ. (IF 3.5) Pub Date : 2024-01-05 Jiapei Guo, Angela E. Kilby, Mindy S. Marks
We study the impact of scope-of-practice laws in a highly regulated and important policy setting, the provision of medication-assisted treatment for opioid use disorder. We consider two natural experiments generated by policy changes at the state and federal level that allow nurse practitioners more practice autonomy. Both experiments show that liberalizations of prescribing authority lead to large
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Do responses to news matter? Evidence from interventional cardiology J. Health Econ. (IF 3.5) Pub Date : 2024-01-05 Daniel Avdic, Stephanie von Hinke, Bo Lagerqvist, Carol Propper, Johan Vikström
We examine physician responses to a global information shock and how these impact their patients. We exploit international news over the safety of an innovation in healthcare, the drug-eluting stent. We use data on interventional cardiologists’ use of stents to define and measure cardiologists’ responsiveness to the initial positive news and link this to their patients’ outcomes. We find substantial
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Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design J. Health Econ. (IF 3.5) Pub Date : 2023-12-27 Maria Knoth Humlum, Marius Opstrup Morthorst, Peter Rønø Thingholm
We investigate the effects of introducing population-wide free-of-charge Human Papillomavirus (HPV) vaccination programs on the targeted adolescent cohorts and their siblings. For identification, we rely on regression discontinuity designs and high-quality Danish administrative data to exploit that date of birth determines program eligibility. We find that the programs increased the HPV vaccine take-up
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Do risk, time and prosocial preferences predict risky sexual behaviour of youths in a low-income, high-risk setting? J. Health Econ. (IF 3.5) Pub Date : 2023-12-11 Ranjeeta Thomas, Matteo M. Galizzi, Louisa Moorhouse, Constance Nyamukapa, Timothy B. Hallett
Young people in sub-Saharan Africa are particularly at high risk of sexually transmitted infections. Little is known about their preferences and even less about their association with risky sexual behaviour. We conducted incentivized economic experiments to measure risk, time and prosocial preferences in Zimbabwe. Preferences measured at baseline predict biomarker and self-reported measures of risky
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Distributionally sensitive measurement and valuation of population health J. Health Econ. (IF 3.5) Pub Date : 2023-12-15 Shaun Da Costa, Owen O’Donnell, Raf Van Gestel
We introduce a measure of population health that is sensitive to inequality in both age-specific health and lifespan and can be calculated from a health-extended period life table. By allowing for inequality aversion, the measure generalises health-adjusted life expectancy without requiring more data. A transformation of change in the (life-years) measure gives a distributionally sensitive monetary
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Socioeconomic status and access to mental health care: The case of psychiatric medications for children in Ontario Canada J. Health Econ. (IF 3.5) Pub Date : 2023-12-12 Janet Currie, Paul Kurdyak, Jonathan Zhang
We examine differences in the prescribing of psychiatric medications to lower-income and higher-income children in the Canadian province of Ontario using rich administrative data that includes diagnosis codes and physician identifiers. Our most striking finding is that conditional on diagnosis and medical history, low-income children are more likely to be prescribed antipsychotics and benzodiazepines
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Valuing life over the life cycle J. Health Econ. (IF 3.5) Pub Date : 2023-12-01 Pascal St-Amour
Adjusting the valuation of life along the (i) person-specific (age, health, wealth) and (ii) mortality risk-specific (beneficial or detrimental, temporary or permanent changes) dimensions is relevant in prioritizing healthcare interventions. These adjustments are provided by solving a life cycle model of consumption, leisure and health choices and the associated Hicksian variations for mortality changes
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The labour market returns to sleep J. Health Econ. (IF 3.5) Pub Date : 2023-11-20 Joan Costa-Font, Sarah Fleche, Ricardo Pagan
Despite the growing prevalence of insufficient sleep among individuals, we still know little about the labour market return to sleep. To address this gap, we use longitudinal data from Germany and leverage exogenous fluctuations in sleep duration caused by variations in time and local sunset times. Our findings reveal that a one-hour increase in weekly sleep is associated with a 1.6 percentage point
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Reminder design and childhood vaccination coverage J. Health Econ. (IF 3.5) Pub Date : 2023-11-14 Jonas Cuzulan Hirani, Miriam Wüst
A major policy concern across public vaccination programs is non-compliance. Exploiting Danish population data and three national reforms in regression discontinuity designs, we document the effects of reminders for childhood vaccination coverage. Retrospective reminders are primarily effective for families with small children and when sent out close to the recommended vaccination age. Digital and
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The effect of primary healthcare on mortality: Evidence from Costa Rica J. Health Econ. (IF 3.5) Pub Date : 2023-11-08 Claudio A. Mora-García, Madeline Pesec, Andrea M. Prado
This paper uses the gradual implementation of a primary healthcare (PHC) intervention in Costa Rica to examine the long-term effect of PHC on mortality. Nine years after opening a primary care center, known as a Health Area, there was an associated 13% reduction in age-adjusted mortality rate in the assigned patient population. The effect was highest among adults over 65 years of age and for those
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Pharmaceutical demand response to utilization management J. Health Econ. (IF 3.5) Pub Date : 2023-11-07 Oren Sarig
Prescription drug insurance increasingly imposes prior authorization (requiring providers to request coverage before claim approval) to manage utilization. Prior authorization has been criticized because of its administrative burden on providers. The primary alternative to managing utilization is imposing out-of-pocket (OOP) payment to incentivize beneficiaries to seek lower-cost care, effectively
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How do hospitals respond to input regulation? Evidence from the California nurse staffing mandate J. Health Econ. (IF 3.5) Pub Date : 2023-11-06 Chandni Raja
Mandated minimum nurse-to-patient ratios have been the subject of active debate in the U.S. for over twenty years and are under legislative consideration today in several states and at the federal level. This paper uses the 1999 California nurse staffing mandate as an empirical setting to estimate the causal effects of minimum ratios on hospitals. Minimum ratios led to a 58 min increase in nursing
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Do minimum wage laws affect employer-sponsored insurance provision? J. Health Econ. (IF 3.5) Pub Date : 2023-10-27 Mark K. Meiselbach, Jean M. Abraham
Employers may respond to minimum wage increases by adjusting their health benefits. We examine the impact of state minimum wage increases on employer health benefit offerings using the 2002–2020 Medical Expenditure Panel Survey – Insurance/Employer Component data. Our primary regression specifications are difference-in-differences models that estimate the relationship between within-state changes in
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Physician responses to Medicare reimbursement rates J. Health Econ. (IF 3.5) Pub Date : 2023-10-24 Aileen M. Devlin, Grace McCormack
This paper investigates how office-based physicians respond to Medicare reimbursement changes. Using variation from an Affordable Care Act policy that increased reimbursements for office-based care in four states, we use a triple difference analysis, comparing physicians with higher and lower reimbursement changes in treated states to similar physicians in untreated states. We find two mechanisms through
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The long-term effects of early-life pollution exposure: Evidence from the London smog J. Health Econ. (IF 3.5) Pub Date : 2023-10-16 Stephanie von Hinke, Emil N. Sørensen
This paper uses a large UK cohort to investigate the impact of early-life pollution exposure on individuals’ human capital and health outcomes in older age. We compare individuals who were exposed to the London smog in December 1952 whilst in utero or in infancy to those born after the smog and those born at the same time but in unaffected areas. We find that those exposed to the smog have substantially
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Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data J. Health Econ. (IF 3.5) Pub Date : 2023-10-20 Julien Bergeot, Marianne Tenand
We assess whether informal care receipt affects the probability of transitioning to a nursing home. Available evidence derives from the US, where nursing home stays are often temporary. Exploiting linked survey and administrative data from the Netherlands, we use the gender mix of children to retrieve exogenous variation in informal care receipt. We find that informal care increases the chance of an
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Mass vaccination and educational attainment: Evidence from the 1967–68 Measles Eradication Campaign J. Health Econ. (IF 3.5) Pub Date : 2023-10-10 Philipp Barteska, Sonja Dobkowitz, Maarit Olkkola, Michael Rieser
We show that the first nationwide mass vaccination campaign against measles increased educational attainment in the United States. Our empirical strategy exploits variation in exposure to the childhood disease across states right before the Measles Eradication Campaign of 1967–68, which reduced reported measles incidence by 90 percent within two years. Our results suggest that mass vaccination against
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Tax incidence for menthol cigarettes by race: Evidence from Nielsen Homescan data J. Health Econ. (IF 3.5) Pub Date : 2023-10-06 Hyunchul Kim, Dongwon Lee
We use Nielsen Homescan data to examine whether the incidence of cigarette taxes on menthol products varies with race. We find that taxes are shifted at significantly lower rates to Black smokers of menthol cigarettes than any other smokers. One possible explanation is that the industry targets price promotions to Black menthol smokers because they tend to be more responsive to cigarette prices relative
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Physician-patient race-match reduces patient mortality J. Health Econ. (IF 3.5) Pub Date : 2023-10-04 Andrew J. Hill, Daniel B. Jones, Lindsey Woodworth
This paper assesses the impacts of physician-patient race-match, especially Black patients paired with Black physicians, on patient mortality. We draw on administrative data from Florida, linking hospital encounters from mid-2011 through 2014 to information from the Florida Physician Workforce Survey. Focusing on uninsured patients experiencing unscheduled hospital admissions who are conditionally
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Consequences of a shortage and rationing: Evidence from a pediatric vaccine J. Health Econ. (IF 3.5) Pub Date : 2023-09-29 Eli Liebman, Emily C. Lawler, Abe Dunn, David B. Ridley
Shortages and rationing are common in health care, yet we know little about the consequences. We examine an 18-month shortage of the pediatric Haemophilus Influenzae Type B (Hib) vaccine. Using insurance claims data and variation in shortage exposure across birth cohorts, we find that the shortage reduced uptake of high-value primary doses by 4 percentage points and low-value booster doses by 26 percentage
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The impact of a long-term care information campaign on insurance coverage J. Health Econ. (IF 3.5) Pub Date : 2023-09-26 Jessica H. Brown
I estimate the impact of an information campaign on long-term care planning behaviors. I identify this effect using the staggered timing of the federal-state “Own Your Future” campaign, which urged individuals to plan ahead for long-term care needs and reached 26 states over five years. I find the campaign increased long-term care insurance coverage for individuals in the top quintile of the asset
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Inequality in the golden years: Wealth gradients in disability-free and work-free longevity in the United States J. Health Econ. (IF 3.5) Pub Date : 2023-09-26 Hessam Bavafa, Anita Mukherjee, Tyler Q. Welch
We study the relationship of wealth with the “quality” of longevity as measured by years after age 65 containing disability or work. By comparing cohorts turning 65 in 1996 and 2006, we observe strong within-cohort gradients of wealth in which the more wealthy live more years disability-free and work more years, yet also experience more work-free years. We document that these gradients steepened over
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The health effects of nursing home specialization in post-acute care J. Health Econ. (IF 3.5) Pub Date : 2023-09-25 Zachary S. Templeton, Nate C. Apathy, R. Tamara Konetzka, Meghan M. Skira, Rachel M. Werner
Nursing homes serve both long-term care and post-acute care (PAC) patients, two groups with distinct financing mechanisms and requirements for care. We examine empirically the effect of nursing home specialization in PAC using 2011–2018 data for Medicare patients admitted to nursing homes following a hospital stay. To address patient selection into specialized nursing homes, we use an instrumental
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Changing preferences: An experiment and estimation of market-incentive effects on altruism J. Health Econ. (IF 3.5) Pub Date : 2023-09-20 Undral Byambadalai, Ching-to Albert Ma, Daniel Wiesen
This paper studies how altruistic preferences are changed by markets and incentives. We conduct a laboratory experiment with a within-subject design. Subjects are asked to choose health care qualities for hypothetical patients in monopoly, duopoly, and quadropoly. Prices, costs, and patient benefits are experimental incentive parameters. In monopoly, subjects choose quality by trading off between profits
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Patient and peer: Guideline design and expert response J. Health Econ. (IF 3.5) Pub Date : 2023-09-18 Jane Greve, Søren Rud Kristensen, Nis Lydiksen
We examine how patients’ medical expertise influences adherence to clinical guidelines for a treatment that is common, costly, and rationed by the clinical guidelines. Using administrative data on prenatal diagnostic testing (PDT), we compare the testing rates of medically trained patients (experts) and non-medically trained patients (non-experts) on the margin of eligibility thresholds in clinical
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Do tobacco 21 laws work? J. Health Econ. (IF 3.5) Pub Date : 2023-09-22 Benjamin Hansen, Joseph J. Sabia, Drew McNichols, Calvin Bryan
Tobacco 21 (T-21) laws raise the minimum legal purchasing age for all tobacco products to 21. This study is the first to examine the impact of statewide T21 laws on teenage and young adult cigarette and electronic cigarette (e-cigarette) use. Using survey data from the Behavioral Risk Factor Surveillance System (BRFSS) and a difference-in-differences approach, we find that statewide adoption of a T-21
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Long-Term Health Benefits of Occupational Licensing: Evidence from Midwifery Laws J. Health Econ. (IF 3.5) Pub Date : 2023-09-16 Hamid Noghanibehambari, Jason Fletcher
During the late 19th and early 20th century, several states mandated midwifery licensing requirements to improve midwives’ knowledge, education, and quality. Previous studies point to the health benefits of midwifery quality improvements for maternal and infant health outcomes. This paper exploits the staggered adoption of midwifery laws across states using event-study and difference-in-difference
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The intergenerational transmission of mental and physical health in the United Kingdom J. Health Econ. (IF 3.5) Pub Date : 2023-09-16 Panka Bencsik, Timothy J. Halliday, Bhashkar Mazumder
As health is increasingly recognized as a key component of human welfare, a new line of research on intergenerational mobility has emerged that focuses on broad measures of health. We extend this research to consider two key components of health: physical health and mental health. We use rich survey data from the United Kingdom linking the health of adult children at around age 30 to their parents
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Causal effects of mental health on food security J. Health Econ. (IF 3.5) Pub Date : 2023-09-13 Helen H. Jensen, Brent E. Kreider, John V. Pepper, Oleksandr Zhylyevskyy, Kimberly A. Greder
Although mental health conditions are known to be associated with socioeconomic hardships, their causal effects remain largely unexplored. Using a sample of low-income families in the National Health Interview Survey (NHIS), we assess causal effects of serious mental illness (SMI) and related mental health conditions on family food security. We apply partial identification methods to account for fundamental
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Health outcomes and provider choice under full practice authority for certified nurse-midwives J. Health Econ. (IF 3.5) Pub Date : 2023-09-12 Lauren Hoehn-Velasco, Diana R. Jolles, Alicia Plemmons, Adan Silverio-Murillo
Full practice authority grants non-physician providers the ability to manage patient care without physician oversight or direct collaboration. In this study, we consider whether full practice authority for certified nurse-midwives (CNMs/CMs) leads to changes in health outcomes or CNM/CM use. Using U.S. birth certificate and death certificate records over 2008–2019, we show that CNM/CM full practice
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Cognitive ability, health policy, and the dynamics of COVID-19 vaccination J. Health Econ. (IF 3.5) Pub Date : 2023-08-19 Mikael Elinder, Oscar Erixson, Mattias Öhman
We examine the relationship between cognitive ability and prompt COVID-19 vaccination using individual-level data on more than 700,000 individuals in Sweden. We find a strong positive association between cognitive ability and swift vaccination, which remains even after controlling for confounding variables with a twin-design. The results suggest that the complexity of the vaccination decision may make
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Effects of organized screening programs on breast cancer screening, incidence, and mortality in Europe J. Health Econ. (IF 3.5) Pub Date : 2023-08-20 Sophie Guthmuller, Vincenzo Carrieri, Ansgar Wübker
We link data on regional Organized Screening Programs (OSPs) throughout Europe with survey data and population-based cancer registries to estimate effects of OSPs on breast cancer screening (mammography), incidence, and mortality. Identification is from regional variation in the existence and timing of OSPs, and in their age-eligibility criteria. We estimate that OSPs, on average, increase mammography
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Pricing regulations in individual health insurance: Evidence from Medigap J. Health Econ. (IF 3.5) Pub Date : 2023-08-07 Vilsa E. Curto
I compare two pricing regulations that protect those with health conditions—“community rating,” which requires insurers to charge uniform premiums, and “guaranteed renewal,” which requires insurers to increase future premiums uniformly. Using individual-level Medigap data from 2006–2010, I compare individuals within 25 miles of borders between 3 community rating and 6 guaranteed renewal states. Relative
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Private equity and healthcare firm behavior: Evidence from ambulatory surgery centers J. Health Econ. (IF 3.5) Pub Date : 2023-08-06 Haizhen Lin, Elizabeth L. Munnich, Michael R. Richards, Christopher M. Whaley, Xiaoxi Zhao
Healthcare firms regularly seek outside capital; yet, we have an incomplete understanding of external investor influence on provider behavior. We investigate the effects of private equity investment, divestment, and an initial public offering (IPO) on ambulatory surgery centers (ASCs). Throughput is unchanged while charges grow by up to 50% for the same service mix. Affected ASCs witness declines in
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The rise and fall of SES gradients in heights around the world J. Health Econ. (IF 3.5) Pub Date : 2023-08-05 Elisabetta Aurino, Adriana Lleras-Muney, Alessandro Tarozzi, Brendan Tinoco
We use data from a large sample of low- and middle-income countries to study the association (or “gradient”) between child height and maternal education. We show that the gap in height between high- and low-SES children is small at birth, rises throughout childhood, and declines in adolescence as girls and boys go through puberty. This inverted U-shaped pattern is consistent with a degree of catch-up
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Heat and worker health J. Health Econ. (IF 3.5) Pub Date : 2023-08-01 Andrew Ireland, David Johnston, Rachel Knott
Extreme heat negatively impacts cognition, learning, and task performance. With increasing global temperatures, workers may therefore be at increased risk of work-related injuries and illness. This study estimates the effects of temperature on worker health using records spanning 1985–2020 from an Australian mandatory insurance scheme. High temperatures are found to cause significantly more claims
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Does drug decriminalization increase unintentional drug overdose deaths?: Early evidence from Oregon Measure 110 J. Health Econ. (IF 3.5) Pub Date : 2023-07-28 Noah Spencer
This paper evaluates the causal effect of drug decriminalization on unintentional drug overdose deaths in a context with relatively poor access to drug treatment services. Using the synthetic control method, I find that when Oregon decriminalized small amounts of drugs in February 2021, it caused 182 additional unintentional drug overdose deaths to occur in Oregon in 2021. This represents a 23% increase
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An optimal mechanism to fund the development of vaccines against emerging epidemics J. Health Econ. (IF 3.5) Pub Date : 2023-07-20
We derive the optimal funding mechanism to incentivize development and production of vaccines against diseases with epidemic potential. In the model, suppliers’ costs are private information and investments are noncontractible, precluding cost-reimbursement contracts, requiring fixed-price contracts conditioned on delivery of a successful product. The high failure risk for individual vaccines calls
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Mothers as insurance: Family spillovers in WIC J. Health Econ. (IF 3.5) Pub Date : 2023-06-28 Marianne Bitler, Janet Currie, Hilary Hoynes, Krista Ruffini, Lisa Schulkind, Barton Willage
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a widely used program. Previous research shows that WIC improves birth outcomes, but evidence about impacts on older children and their families is limited. We use a regression discontinuity leveraging a loss of benefits at age five when children become ineligible for WIC and examine nutritional and laboratory outcomes
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The effects of becoming a physician on prescription drug use and mental health treatment J. Health Econ. (IF 3.5) Pub Date : 2023-06-25 D. Mark Anderson, Ron Diris, Raymond Montizaan, Daniel I. Rees
There is evidence that physicians disproportionately suffer from substance use disorder and mental health problems. It is not clear, however, whether these phenomena are causal. We use data on Dutch medical school applicants to examine the effects of becoming a physician on prescription drug use and the receipt of treatment from a mental health facility. Leveraging variation from lottery outcomes that
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The effect of RCTs on drug demand: Evidence from off-label cancer drugs J. Health Econ. (IF 3.5) Pub Date : 2023-06-21 Rebecca McKibbin
This paper investigates the effect of scientific information from randomized controlled clinical trials (RCTs) on the demand for off-label uses of cancer drugs. This is a unique setting where demand for a drug for a specific use is observable both before and after the first RCT results are released. Using variation in the timing of RCTs across off-label uses of drugs, I find that demand responds asymmetrically
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Hidden hazards and screening policy: Predicting undetected lead exposure in Illinois J. Health Econ. (IF 3.5) Pub Date : 2023-06-20 Ali Abbasi, Francis J. DiTraglia, Ludovica Gazze, Bridget Pals
Lead exposure still threatens children’s health despite policies aiming to identify lead exposure sources. Some US states require de jure universal screening while others target screening, but little research examines the relative benefits of these approaches. We link lead tests for children born in Illinois between 2010 and 2014 to geocoded birth records and potential exposure sources. We train a
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The intracorrelation of family health insurance and job lock J. Health Econ. (IF 3.5) Pub Date : 2023-06-19 Marion Aouad
This paper tests for the presence of job lock and “health insurance plan lock” stemming from the health shock of a child family member. Using the onset of an acute, unanticipated health shock, I estimate a 7–14 percent decreased likelihood of all family members leaving their current health insurance network and health plan within one year of the emergency. This corresponds to a reduced one-year job
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Adoption and utilization of device-assisted telemedicine J. Health Econ. (IF 3.5) Pub Date : 2023-06-16 Dan Zeltzer, Liran Einav, Joseph Rashba, Yehezkel Waisman, Motti Haimi, Ran D. Balicer
We estimate the effect of adopting a digital device for performing medical exams at home during telehealth visits. We match visits of adopters and non-adopters who used the same virtual care clinic but without the device and compare healthcare utilization after the matched visits. We find that device adoption, partially offset by decreased use of other primary care modalities, results in a 12% higher