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Journal of Health Economics

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https://www.readbyqxmd.com/read/28899566/unemployment-drugs-and-attitudes-among-european-youth
#1
Sara Ayllón, Natalia N Ferreira-Batista
This paper studies changes in the patterns of drug consumption and attitudes towards drugs in relation to sky-high (youth) unemployment rates brought about by the Great Recession. Our analysis is based on data for 28 European countries that refer to young people. We find that the consumption of cannabis and 'new substances' is positively related to increasing unemployment rates. An increase of 1% in the regional unemployment rate is associated with an increase of 0.7 percentage points in the ratio of young people who state that they have consumed cannabis at some point in time...
August 26, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28899565/local-neighbors-as-positives-regional-neighbors-as-negatives-competing-channels-in-the-relationship-between-others-income-health-and-happiness
#2
John Ifcher, Homa Zarghamee, Carol Graham
That well-being is decreasing in others' income is termed the "relative income hypothesis" (RIH) by scholars of subjective well-being (SWB) and has substantial empirical support. Some studies, however, present evidence of both positive and negative explanatory channels in the relationship between others' income and SWB. We develop a theoretical framework integrating four distinct channels through which neighbors' income can affect utility: public goods, cost of living, expectations of future income, and direct effects (RIH or altruism)...
August 22, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28864334/the-benefits-of-avoiding-cancer-or-dying-from-cancer-evidence-from-a-four-country-study
#3
Anna Alberini, Milan Ščasný
We use stated-preference methods to estimate the cancer Value per Statistical Life (VSL) and Value per Statistical Case (VSCC) from a representative sample of 45-60-year olds in four countries in Europe. We ask respondents to report information about their willingness to pay for health risk reductions that are different from those used in earlier valuation work because they are comprised of two probabilities-that of getting cancer, and that of dying from it (conditional on getting it in the first place). The product of these two probabilities is the unconditional cancer mortality risk...
August 19, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28893406/legal-access-to-alcohol-and-criminality
#4
Benjamin Hansen, Glen R Waddell
Previous research has found strong evidence that legal access to alcohol is associated with sizable increases in criminality. We revisit this relationship using the census of judicial records on criminal charges filed in Oregon Courts, the ability to separately track crimes involving firearms, and to track individuals over time. We find that crime increases at age 21, with increases mostly due to assaults that lack premeditation, and alcohol-related nuisance crimes. We find no evident increases in rape or robbery...
August 14, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28807331/health-insurance-subsidies-and-deductible-choice-evidence-from-regional-variation-in-subsidy-schemes
#5
Cornel Kaufmann, Christian Schmid, Stefan Boes
The extent to which premium subsidies can influence health insurance choices is an open question. In this paper, we explore the regional variation in subsidy schemes in Switzerland, designed as either in-kind or cash transfers, to study their impact on the choice of health insurance deductibles. Using health survey data and a difference-in-differences methodology, we find that in-kind transfers increase the likelihood of choosing a low deductible plan by approximately 4 percentage points (or 7%). Our results indicate that the response to in-kind transfers is strongest among women, middle-aged and unmarried individuals, which we explain by differences in risk-taking behavior, health status, financial constraints, health insurance and financial literacy...
August 5, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28811119/family-planning-funding-cuts-and-teen-childbearing
#6
Analisa Packham
Publicly funded family planning clinics provide low-cost and free contraception to nearly 1.5 million teens each year. In recent years, several states have considered legislation to defund family planning services, although little is known about how these cuts affect teen pregnancy. This paper fills this knowledge gap by exploiting a policy change in Texas that reduced funding for family planning services by 67% and resulted in over 80 clinic closures. I estimate the effects of the funding cuts on teen health outcomes using a difference-in-differences approach that compares the changes in teen birth rates in Texas counties that lost family planning funding to changes in counties outside of Texas with publicly funded clinics...
August 3, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28823796/moneyball-in-medicare
#7
Edward C Norton, Jun Li, Anup Das, Lena M Chen
US policymakers place high priority on tying Medicare payments to the value of care delivered. A critical part of this effort is the Hospital Value-based Purchasing Program (HVBP), which rewards or penalizes hospitals based on their quality and episode-based costs of care and incentivizes integration between hospitals and post-acute care providers. Within HVBP, each patient affects hospital performance on a variety of quality and spending measures, and performance translates directly to changes in program points and ultimately dollars...
August 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28802746/is-it-who-you-are-or-where-you-live-residential-segregation-and-racial-gaps-in-childhood-asthma
#8
Diane Alexander, Janet Currie
Higher asthma rates are one of the more obvious ways that health inequalities between African American and other children are manifested beginning in early childhood. In 2010, black asthma rates were double non-black rates. Some but not all of this difference can be explained by factors such as a higher incidence of low birth weight (LBW) among blacks; however, even conditional on LBW, blacks have a higher incidence of asthma than others. Using a unique data set based on the health records of all children born in New Jersey between 2006 and 2010, we show that when we split the data by whether or not children live in a "black" zip code, this racial difference in the incidence of asthma among LBW children entirely disappears...
July 25, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28778349/competitive-effects-of-scope-of-practice-restrictions-public-health-or-public-harm
#9
Sara Markowitz, E Kathleen Adams, Mary Jane Lewitt, Anne L Dunlop
The demand for healthcare professionals is predicted to grow significantly over the next decade. Securing an adequate workforce is of primary importance to ensure the health and wellbeing of the population in an efficient manner. Occupational licensing laws and related restrictions on scope of practice (SOP) are features of the market for healthcare professionals and are also controversial. At issue is a balance between protecting the public health and removing anticompetitive barriers to entry and practice...
July 23, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28784289/do-health-insurers-innovate-evidence-from-the-anatomy-of-physician-payments
#10
Jeffrey Clemens, Joshua D Gottlieb, Tímea Laura Molnár
One of private health insurers' main roles in the United States is to negotiate physician payment rates on their beneficiaries' behalf. We show that these rates are often set in reference to a government benchmark, and ask how often private insurers customize their fee schedules away from this default. We exploit changes in Medicare's payments and dramatic bunching in markups over Medicare's rates to address this question. Although Medicare's rates are influential, 25 percent of physician services in our data, representing 45 percent of covered spending, deviate from the benchmark...
July 13, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28774725/endogenous-information-adverse-selection-and-prevention-implications-for-genetic-testing-policy
#11
Richard Peter, Andreas Richter, Paul Thistle
We examine public policy toward the use of genetic information by insurers. Individuals engage in unobservable primary prevention and have access to different prevention technologies. Thus, insurance markets are affected by moral hazard and adverse selection. Individuals can choose to take a genetic test to acquire information about their prevention technology. Information has positive decision-making value, that is, individuals may adjust their behavior based on the result of the test. However, testing also exposes individuals to uncertainty over the available insurance contract, so-called classification risk, which lowers the value of information...
July 13, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28743535/discharge-on-the-day-of-birth-parental-response-and-health-and-schooling-outcomes
#12
Hans Henrik Sievertsen, Miriam Wüst
Exploiting the Danish roll-out of same-day discharge policies after uncomplicated births, we find that treated newborns have a higher probability of hospital readmission in the first month after birth. While these short-run effects may indicate substitution of hospital stays with readmissions, we also find that-in the longer run-a same-day discharge decreases children's 9th grade GPA. This effect is driven by children and mothers, who prior to the policy change would have been least likely to experience a same-day discharge...
July 4, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28728808/wolves-in-sheep-s-clothing-is-non-profit-status-used-to-signal-quality
#13
Daniel B Jones, Carol Propper, Sarah Smith
Why do many firms in the healthcare sector adopt non-profit status? One argument is that non-profit status serves as a signal of quality when consumers are not well informed. A testable implication is that an increase in consumer information may lead to a reduction in the number of non-profits in a market. We test this idea empirically by exploiting an exogenous increase in consumer information in the US nursing home industry. We find that the information shock led to a reduction in the share of non-profit homes, driven by a combination of home closure and sector switching...
July 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28728807/the-impact-of-team-based-primary-care-on-health-care-services-utilization-and-costs-quebec-s-family-medicine-groups
#14
Erin Strumpf, Mehdi Ammi, Mamadou Diop, Julie Fiset-Laniel, Pierre Tousignant
We investigate the effects on health care costs and utilization of team-based primary care delivery: Quebec's Family Medicine Groups (FMGs). FMGs include extended hours, patient enrolment and multidisciplinary teams, but they maintain the same remuneration scheme (fee-for-service) as outside FMGs. In contrast to previous studies, we examine the impacts of organizational changes in primary care settings in the absence of changes to provider payment and outside integrated care systems. We built a panel of administrative data of the population of elderly and chronically ill patients, characterizing all individuals as FMG enrollees or not...
July 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28811120/impact-of-caregiver-incentives-on-child-health-evidence-from-an-experiment-with-anganwadi-workers-in-india
#15
Prakarsh Singh, William A Masters
This paper tests the effectiveness of performance pay and bonuses among government childcare workers in India. In a controlled study of 160 ICDS centers serving over 4000 children, we randomly assign workers to either fixed bonuses or payments based on the nutritional status of children in their care, and also collect data from a control group receiving only standard salaries. In all three study arms mothers receive nutrition information. We find that performance pay reduces underweight prevalence by about 5 percentage points over 3 months, and height improves by about one centimeter...
September 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28802747/the-market-for-paid-sick-leave
#16
Simen Markussen, Knut Røed
In many countries, general practitioners (GPs) are assigned the task of controlling the validity of their own patients' insurance claims. At the same time, they operate in a market where patients are customers free to choose their GP. Are these roles compatible? Can we trust that the gatekeeping decisions are untainted by private economic interests? Based on administrative registers from Norway with records on sick pay certification and GP-patient relationships, we present evidence to the contrary: GPs are more lenient gatekeepers the more competitive is the physician market, and a reputation for lenient gatekeeping increases the demand for their services...
September 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28801131/health-care-demand-elasticities-by-type-of-service
#17
Randall P Ellis, Bruno Martins, Wenjia Zhu
We estimate within-year price elasticities of demand for detailed health care services using an instrumental variable strategy, in which individual monthly cost shares are instrumented by employer-year-plan-month average cost shares. A specification using backward myopic prices gives more plausible and stable results than using forward myopic prices. Using 171 million person-months spanning 73 employers from 2008 to 2014, we estimate that the overall demand elasticity by backward myopic consumers is -0.44, with higher elasticities of demand for pharmaceuticals (-0...
September 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28778350/econometric-modelling-of-multiple-self-reports-of-health-states-the-switch-from-eq-5d-3l-to-eq-5d-5l-in-evaluating-drug-therapies-for-rheumatoid-arthritis
#18
Mónica Hernández-Alava, Stephen Pudney
EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. It comprises a survey instrument describing health states across five domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but the consequences of this change are uncertain. We develop a multi-equation ordinal response model incorporating a copula specification with normal mixture marginals to analyse joint responses to EQ-5D-3L and EQ-5D-5L in a survey of people with rheumatic disease, and use it to generate mappings between the alternative descriptive systems...
September 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28743536/vitamin-panacea-is-advertising-fueling-demand-for-products-with-uncertain-scientific-benefit
#19
Matthew D Eisenberg, Rosemary J Avery, Jonathan H Cantor
This study examines the effect of advertising on demand for vitamins-products with spiraling sales despite little evidence of efficacy. We merge seven years (2003-2009) of advertising data from Kantar Media with the Simmons National Consumer Survey to estimate individual-level vitamin print and television ad exposure effects. Identification relies on exploiting exogenous variation in year-to-year advertising exposure by controlling for each individual's unique media consumption. We find that increasing advertising exposure from zero to the mean number of ads increases the probability of consumption by 1...
September 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28712437/the-long-term-effects-of-consumer-directed-health-plans-on-preventive-care-use
#20
Matthew D Eisenberg, Amelia M Haviland, Ateev Mehrotra, Peter J Huckfeldt, Neeraj Sood
"Consumer-Directed" Health Plans (CDHPs), those with high deductibles and personal medical accounts, have been shown to reduce health care spending. The impact of CDHPs on preventive care is unclear. On the one hand CDHPs might increase use of preventive care as such care is exempt from the deductible. However, CDHPs also decrease visits to physicians which might results in less screening. Prior research has found conflicting results. In this study, using data from 37 employers we examine the effects of CDHPs on the use of cancer screenings up to three years after the initial CDHP offering with ITT and LATE approaches...
September 2017: Journal of Health Economics
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