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The effects of sudden health reductions on labor market outcomes: Evidence from incidence of stroke Health Econ. (IF 2.25) Pub Date : 2021-04-05 Atsuko Tanaka
While increasing attention is given to how health reductions affect workers, estimating its their effects is usually challenging. This paper aims to identify the causal effect of health deterioration on labor market outcomes by exploiting the incidence of stroke. Stroke, which often reduces health suddenly and unexpectedly, allows us to exploit the within‐person random variation of the timing and isolate
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How do insurance firms respond to financial risk sharing regulations? Evidence from the Affordable Care Act Health Econ. (IF 2.25) Pub Date : 2021-04-01 Daniel W. Sacks, Khoa Vu, Tsan‐Yao Huang, Pinar Karaca‐Mandic
Many insurance markets have reinstated premium stabilization programs to ensure financial protection from market volatility. In this paper, we focus on one such regulation—risk corridors (RCs)—in the context of the Health Insurance Marketplaces established under the Affordable Care Act. We develop a model to show how the program provided incentives for some insurers to lower their premiums. The RCs
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The effect of alcohol sales restrictions on alcohol poisoning mortality: Evidence from Russia Health Econ. (IF 2.25) Pub Date : 2021-03-31 Alexander S. Skorobogatov
This paper examines the tough anti‐alcohol legislation recently introduced in Russia, which due to regional variation allows it to be used as a natural experiment. The effect of the restricted trading hours on alcoholic poisoning mortality is estimated. To establish a causal link, difference‐in‐differences and synthetic controls are used. The main conclusion is that the sales restrictions lead to higher
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The effects of structure, process and outcome incentives on primary care referrals to a national prevention programme Health Econ. (IF 2.25) Pub Date : 2021-03-30 Emma McManus, Jack Elliott, Rachel Meacock, Paul Wilson, Judith Gellatly, Matt Sutton
Despite widespread use, evidence is sparse on whether financial incentives in healthcare should be linked to structure, process or outcome. We examine the impact of different incentive types on the quantity and effectiveness of referrals made by general practices to a new national prevention programme in England. We measured effectiveness by the number of referrals resulting in programme attendance
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Dying from envy: The role of inequality Health Econ. (IF 2.25) Pub Date : 2021-03-30 Irakli Japaridze, Nagham Sayour
We hypothesize that when interpersonal comparisons, often referred to as “keeping up with the Joneses”, are operational, relative deprivation (income inequality) results in increased likelihood of morbidity among lower income households. Using a simple theoretical model, we show that the larger the income disparities between “the Joneses” and “the followers”, the higher is the followers' expenditure
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The future of the elderly population health status: Filling a knowledge gap Health Econ. (IF 2.25) Pub Date : 2021-03-26 Vincenzo Atella, Federico Belotti, Daejung Kim, Dana Goldman, Tadeja Gracner, Andrea Piano Mortari, Bryan Tysinger
The aging process in OECD countries calls for a better understanding of the future disease prevalence, life expectancy (LE) and patterns of inequalities in health outcomes. In this paper we present the results obtained from several dynamic microsimulation models of the Future Elderly Model family for 12 OECD countries, with the aim of reproducing for the first time comparable long‐term projections
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Consolidation of primary care physicians and its impact on healthcare utilization Health Econ. (IF 2.25) Pub Date : 2021-03-25 Jonathan Zhang, Yiwei Chen, Liran Einav, Jonathan Levin, Jay Bhattacharya
We use administrative data from Medicare to document the massive consolidation of primary care physicians over the last decade and its impact on patient healthcare utilization. We first document that primary care organizations have consolidated all over the United States between 2008 and 2014. We then show that regions that experienced greater consolidation are associated with greater decline in overall
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An imperfect test for a virus can Be worse than No test at all Health Econ. (IF 2.25) Pub Date : 2021-03-24 Mark Whitmeyer
This note studies the effect of the availability of a test for a virus on the public health of a population. It is shown by example that the existence of a freely available and moderately informative test for a virus may lower society's welfare in comparison to the case where no test exists or access to the test is restricted. In this setting, any test provided to any subset of agents who would find
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Estimating determinants of healthcare establishment locations with restricted federal administrative data Health Econ. (IF 2.25) Pub Date : 2021-03-21 Anders Van Sandt, Craig Wesley Carpenter, Rebekka Dudensing, Scott Loveridge
We model the locational determinants of nine categories of healthcare services in the contiguous United States using restricted access federal establishment data. These data enable close examination of rural health services, which are subject to suppression in publicly published data sources. After reviewing differences in public and unsuppressed restricted data and testing underlying data generation
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Medicaid expansion and the mental health of college students Health Econ. (IF 2.25) Pub Date : 2021-03-19 Benjamin W. Cowan, Zhuang Hao
Reported mental health problems have risen dramatically among US college students over time, as has treatment for these problems. We examine the effect of state‐level Medicaid expansion following the 2014 implementation of the Affordable Care Act on the diagnosis of mental health conditions, psychotropic prescription drug use, and the mental health status of a national sample of college students. We
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Fetal origins—A life cycle model of health and aging from conception to death Health Econ. (IF 2.25) Pub Date : 2021-03-19 Carl‐Johan Dalgaard, Casper Worm Hansen, Holger Strulik
The fetal origins hypothesis suggests that health and nutrition shocks in utero are causally related to health deficits in old age. It has received considerable empirical support, both within epidemiology and economics but so far it has not been integrated into a life cycle theory of human aging and longevity. The present study shows that the health deficit model, based on the frailty index developed
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Weighting or aggregating? Investigating information processing in multi‐attribute choices Health Econ. (IF 2.25) Pub Date : 2021-03-19 Mesfin G. Genie, Nicolas Krucien, Mandy Ryan
Multi‐attribute choices are commonly analyzed in economics to value goods and services. Analysis assumes individuals consider all attributes, making trade‐offs between them. Such decision‐making is cognitively demanding, often triggering alternative decision rules. We develop a new model where individuals aggregate multi‐attribute information into meta‐attributes. Applying our model to a choice experiment
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Cost sharing and the demand for health services in a regulated market Health Econ. (IF 2.25) Pub Date : 2021-03-17 Natalia Serna
This paper measures consumer responsiveness to cost sharing in healthcare using a regression discontinuity design. I use a novel and detailed claims窶人evel dataset from the Colombian healthcare market, where the government exogenously determines a tier system for coinsurance rates and copays based on the enrollee's monthly income. I find that patients exposed to higher coinsurance rates demand fewer
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Facility standards and the quality of public sector primary care: Evidence from South Africa's “Ideal Clinics” program Health Econ. (IF 2.25) Pub Date : 2021-03-17 Nicholas Stacey, Andrew Mirelman, Noemi Kreif, Marc Suhrcke, Karen Hofman, Ijeoma Edoka
Primary healthcare systems are central to achieving universal healthcare coverage. However, in many low‐ and middle‐income country settings, primary care quality is challenged by inadequate facility infrastructure and equipment, limited human resources, and poor provider process. We study the effects of a recent large‐scale quality improvement policy in South Africa, the Ideal Clinics Realization and
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Issue Information Health Econ. (IF 2.25) Pub Date : 2021-03-13
No abstract is available for this article.
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The intergenerational effects of socioeconomic inequality on unhealthy bodyweight Health Econ. (IF 2.25) Pub Date : 2021-01-13 Namal N. Balasooriya, Jayatilleke S. Bandara, Nicholas Rohde
We study the effects of inherited socioeconomic characteristics on markers of unhealthy bodyweight. Taking Australian microdata from 2007 to 2013, we show that approximately 4% of the variation in outcomes is determined by factors beyond an individual's control, such as their race, gender, and social class. Paternal socioeconomic status is the primary explanatory factor, with those born to more affluent
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The impact of mental health parity laws on birth outcomes Health Econ. (IF 2.25) Pub Date : 2021-01-15 Monica Harber Carney
Prior studies have found that poor mental health during pregnancy is associated with poor birth outcomes, but little is known about the ability of mental health care access and treatment to counteract these effects. I use a difference‐in‐differences strategy exploiting the staggered enactment of state mental health parity laws in 25 states from 1995 to 2002 to identify the impact of mental health care
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Impact of social accountability monitoring on health facility performance: Evidence from Tanzania Health Econ. (IF 2.25) Pub Date : 2021-01-17 Igor Francetic, Günther Fink, Fabrizio Tediosi
Social accountability programs are increasingly used to improve the performance of public service providers in low‐income settings. Despite their growing popularity, evidence on the effectiveness of social accountability programs remains mixed. In this manuscript, we assess the impact of a social accountability intervention on health facility management exploring quasiexperimental variation in program
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Does increasing health care access reduce disability insurance caseloads? Evidence from the rural United States Health Econ. (IF 2.25) Pub Date : 2021-01-21 Garrett Anstreicher
This paper leverages the expansion of the United States' Community Health Center program over the 21st century to investigate whether improved access to health care reduces disability insurance (DI) participation at the county level. I find that the introduction of a health center that specializes in mental health and substance abuse services is associated with a 0.09 to 0.40 percentage point reduction
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Prices and market power in mental health care: Evidence from a major policy change in the Netherlands Health Econ. (IF 2.25) Pub Date : 2021-01-27 Chiara Brouns, Rudy Douven, Ron Kemp
In the Dutch health care system of managed competition, insurers and mental health providers negotiate on prices for mental health services. Contract prices are capped by a regulator who sets a maximum price for each mental health service. In 2013, the majority of the contract prices equaled these maximum prices. We study price setting after a major policy change in 2014. In 2014, mental health care
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Divided by choice? For‐profit providers, patient choice and mechanisms of patient sorting in the English National Health Service Health Econ. (IF 2.25) Pub Date : 2021-02-05 Walter Beckert, Elaine Kelly
This paper studies patient choice of provider following government reforms in the 2000s, which allowed for‐profit surgical centers to compete with existing public National Health Service (NHS) hospitals in England. For‐profit providers offer significant benefits, notably shorter waiting times. We estimate the extent to which different types of patients benefit from the reforms, and we investigate mechanisms
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Epidemics and trust: The case of the Spanish Flu Health Econ. (IF 2.25) Pub Date : 2021-02-08 Arnstein Aassve, Guido Alfani, Francesco Gandolfi, Marco Le Moglie
Recent studies argue that major crises can have long‐lasting effects on individual behavior. While most studies focused on natural disasters, we explore the consequences of the global pandemic caused by a lethal influenza virus in 1918–19: the so‐called “Spanish Flu.” This was by far the worst pandemic of modern history, causing up to 100 million deaths worldwide. Using information about attitudes
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Instrumental variable‐based assessment of the effect of psychotherapy on suicide attempts, health, and economic outcomes in schizophrenia Health Econ. (IF 2.25) Pub Date : 2021-02-08 Emely Ek Blæhr, Rikke Søgaard
The literature on the effect of psychotherapy for schizophrenia is limited and characterized by small samples and possible bias from risk selection. We examined the effects of psychotherapy on suicide attempts and health and economic outcomes using an instrumental variable (IV) approach that exploits the variation in the propensities of hospital departments to prescribe psychotherapy. This was supplemented
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The link between health and economic preferences: Evidence from 22 OECD countries Health Econ. (IF 2.25) Pub Date : 2021-01-27 Xi Cen, David W. Johnston, Claryn S. J. Kung, Michael A. Shields, Eric C. Sun
We study the link between health status and economic preferences using survey data from 22 Organisation for Economic Co‐operation and Development (OECD) countries. We hypothesize that there is a relationship between poor health and the preferences that people hold, and therefore their choices and decisions. We find that individuals with a limiting health condition are more risk averse and less patient
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Private coverage mandates, business cycles, and provider treatment intensity Health Econ. (IF 2.25) Pub Date : 2021-03-12 Michael R. Richards, Sebastian Tello‐Trillo
The Affordable Care Act (ACA) is the source of multiple large‐scale health insurance expansions affecting various segments of the US population. Although much has been done to quantify the first‐order effects of these policies, less empirical investigation has been devoted to the effects on the supply‐side of health care. We focus on a well‐known ACA initiative (the young adult dependent coverage mandate)
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Impact of later retirement on mortality: Evidence from France Health Econ. (IF 2.25) Pub Date : 2021-03-12 Antoine Bozio, Clémentine Garrouste, Elsa Perdrix
This paper investigates the impact of delaying retirement on mortality among the French population. We take advantage of the 1993 pension reform in the private sector to identify the causal effect of an increase in claiming age on mortality. We use administrative data which provide detailed information on career characteristics, dates of birth and death. Our results, precisely estimated, show that
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The effect of British Columbia's Pharmacare coverage expansion for opioid agonist treatment Health Econ. (IF 2.25) Pub Date : 2021-03-12 Natt Hongdilokkul, Emanuel Krebs, Xiao Zang, Haoxuan Zhou, Fahmida Homayra, Jeong Eun Min, Bohdan Nosyk
Opioid agonist treatment (OAT) is the evidence‐based standard of care for people with opioid use disorder. In British Columbia, Canada, only social assistance registrants received full coverage for OAT prior to the introduction of the Pharmacare Plan G coverage expansion on February 1st, 2017. We aimed to determine the effect of the coverage expansion on OAT initiation, re‐initiation, and retention
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International differences in interspousal health correlations Health Econ. (IF 2.25) Pub Date : 2021-03-11 James Banks, Iris Kesternich, James P. Smith
Using objective measures of lung function, we document strong positive associations in health within couples in all European countries but large and significant differences in this correlation within broad European regions, with Southern Europe having by far stronger correlations than elsewhere. We analyze potential explanations for such differences, investigating the role of measures capturing current
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The economic theory of cost‐effectiveness thresholds in health: Domestic and international implications Health Econ. (IF 2.25) Pub Date : 2021-03-11 Javad Moradpour, Aidan Hollis
Public health insurers often use an implicit or explicit cost‐effectiveness threshold to determine which health products and services should be insured. We challenge the convention of a single threshold. For competitively provided products and services, prices are determined by cost; but for products with market power, patentees will increase the price according to the perceived threshold. As a result
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Electronic medical records and primary care quality: Evidence from Manitoba Health Econ. (IF 2.25) Pub Date : 2021-03-10 Elisabet Rodriguez Llorian, Gregory Mason
Improvements in quality of care through supporting decision‐making processes and increased efficiency have prompted widespread implementation of electronic medical records (EMRs) in Canada. Using a set of indicators of preventive care, chronic disease management, and hospitalizations due to ambulatory care sensitive conditions (ACSC), this study measures the effect of EMR adoption on quality of primary
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Stated versus revealed preferences: An approach to reduce bias Health Econ. (IF 2.25) Pub Date : 2021-03-09 Kaat de Corte, John Cairns, Richard Grieve
Stated preference (SP) survey responses may not predict actual behavior, leading to hypothetical bias. We developed an approach that harnesses large‐scale routine data to help SP surveys provide more accurate estimates of revealed preferences (RPs), within a study which elicited preferences for alternative changes to the blood service in England. The SP survey responses were used to predict the mean
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Financing needs, spending projection, and the future of health in Brazil Health Econ. (IF 2.25) Pub Date : 2021-03-09 Rudi Rocha, Isabela Furtado, Paula Spinola
In this paper we adopt a growth accounting projection model to estimate and characterize health‐financing needs in Brazil as well as to assess the extent to which financing needs may diverge from spending capacity in the future. We estimate an annual increase of 0.71% in the share of projected financing needs relative to GDP, with excess growth rates being 0.74% and 0.69% for the public and private