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Journal of Health Economics

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https://www.readbyqxmd.com/read/28478344/the-gender-gap-in-mortality-how-much-is-explained-by-behavior
#1
Johannes Schünemann, Holger Strulik, Timo Trimborn
In developed countries, women are expected to live about 4-5 years longer than men. In this paper, we develop a novel approach to gauge the extent to which gender differences in longevity can be attributed to gender-specific preferences and health behavior. We set up a physiologically founded model of health deficit accumulation and calibrate it using recent insights from gerontology. From fitting life cycle health expenditure and life expectancy, we obtain estimates of the gender-specific preference parameters...
April 25, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28482215/solving-the-kidney-shortage-via-the-creation-of-kidney-donation-co-operatives
#2
K C Eames, Patrick Holder, Eduardo Zambrano
Many people object to the creation of a market for kidneys on the grounds that such reform would hurt those patients unable to afford the market price of a kidney and that donors do not understand the risks they are taking when donating. In this paper, we propose a mechanism, the kidney co-operative, designed to provide sufficient incentives to alleviate the kidney shortage while at the same time addressing the concerns regarding the potential losers from reform. We show that it is reasonable to expect that the number of transplants will be larger under the kidney co-operative mechanism than under either the status quo or a conventional market mechanism...
April 18, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28448950/promoting-innovation-in-small-markets-evidence-from-the-market-for-rare-and-intractable-diseases
#3
Toshiaki Iizuka, Gyo Uchida
In many medical care markets with limited profit potential, firms often have little incentive to innovate. These include the market for rare diseases, "neglected" tropical diseases, and personalized medicine. Governments and not-for-profit organizations promote innovation in such markets but empirical evidence on the policy effect is limited. We study this issue by analyzing the impact of a demand-side policy in Japan, which reduces the cost sharing of patients with some rare and intractable diseases and attempts to establish and promote the treatment of those diseases...
April 1, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28505541/retirement-blues
#4
Gabriel Heller-Sahlgren
This paper analyses the short- and longer-term effects of retirement on mental health in ten European countries. It exploits thresholds created by state pension ages in an individual-fixed effects instrumental-variable set-up, borrowing intuitions from the regression-discontinuity design literature, to deal with endogeneity in retirement behaviour. The results display no short-term effects of retirement on mental health, but a large negative longer-term impact. This impact survives a battery of robustness tests, and applies to women and men as well as people of different educational and occupational backgrounds similarly...
March 31, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28414953/health-shocks-and-their-long-lasting-impact-on-health-behaviors-evidence-from-the-2009-h1n1-pandemic-in-mexico
#5
Jorge M Agüero, Trinidad Beleche
Worldwide, the leading causes of death could be avoided with health behaviors that are low-cost but also difficult to adopt. We show that exogenous health shocks could facilitate the adoption of these behaviors and provide long-lasting effects on health outcomes. Specifically, we exploit the spatial and temporal variation of the 2009 H1N1 influenza pandemic in Mexico and show that areas with a higher incidence of H1N1 experienced larger reductions in diarrhea-related cases among young children. These reductions continue even three years after the shock ended...
March 31, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28380346/uncovering-waste-in-us-healthcare-evidence-from-ambulance-referral-patterns
#6
Joseph J Doyle, John A Graves, Jonathan Gruber
There is widespread agreement that the US healthcare system wastes as much as 5% of GDP, yet much less agreement on the source of the waste. This paper uses the effectively random assignment of patients to ambulance companies to generate comparisons across similar patients treated at different hospitals. We find that assignment to hospitals whose patients receive large amounts of care over the three months following a health emergency have only modestly better survival outcomes compared to hospitals whose patients receive less...
March 22, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28349865/bans-on-electronic-cigarette-sales-to-minors-and-smoking-among-high-school-students
#7
Rahi Abouk, Scott Adams
Many states have banned electronic cigarette sales to minors under the rationale that using e-cigarettes leads to smoking traditional combustion cigarettes. Such sales bans would be counterproductive, however, if e-cigarettes and traditional cigarettes are substitutes, as bans might push teenagers back to smoking the more dangerous combustion cigarettes. We provide evidence that these sales bans reduce the incidence of smoking conventional cigarettes among high school seniors. Moreover, we provide evidence suggesting that sales bans reduced e-cigarette usage as well...
March 18, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28349864/why-does-the-health-of-mexican-immigrants-deteriorate-new-evidence-from-linked-birth-records
#8
Osea Giuntella
This study uses a unique dataset linking the birth records of two generations of children born in California and Florida (1970-2009) to analyze the mechanisms behind the generational decline observed in birth outcomes of children of Mexican origin. Calibrating a simple model of intergenerational transmission of birth weight, I show that modest positive selection on health at the time of migration can account for the initial advantage in birth outcomes of second-generation Mexicans. Moreover, accounting for the socioeconomic differences between second-generation Mexicans and white natives and the observed intergenerational correlation in birth weight, the model predicts a greater deterioration than that observed in the data...
March 18, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28343094/effects-of-posted-point-of-sale-warnings-on-alcohol-consumption-during-pregnancy-and-on-birth-outcomes
#9
Gulcan Cil
In 23 states and Washington D.C., alcohol retailers are required by law to post alcohol warning signs (AWS) that warn against the risks of drinking during pregnancy. Using the variation in the adoption of these laws across states and within states over time, I find a statistically significant reduction in prenatal alcohol use associated with AWS. I then use this plausibly exogenous change in drinking behavior to establish a causal link between prenatal alcohol exposure and birth outcomes. I find that AWS laws are associated with decreases in the odds of very low birth weight and very pre-term birth...
March 18, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28342363/war-during-childhood-the-long-run-effects-of-warfare-on-health
#10
Mevlude Akbulut-Yuksel
This paper estimates the causal long-term consequences of an exposure to war in utero and during childhood on the risk of obesity and the probability of having a chronic health condition in adulthood. Using the plausibly exogenous city-by-cohort variation in the intensity of WWII destruction as a unique quasi-experiment, I find that individuals who were exposed to WWII destruction during the prenatal and early postnatal periods have higher BMIs and are more likely to be obese as adults. I also find an elevated incidence of chronic health conditions such as stroke, hypertension, diabetes, and cardiovascular disorder in adulthood among these wartime children...
March 7, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28340393/when-public-health-intervention-is-not-successful-cost-sharing-crowd-out-and-selection-in-korea-s-national-cancer-screening-program
#11
Hyuncheol Bryant Kim, Sun-Mi Lee
This study investigates the impact of and behavioral responses to cost sharing in Korea's National Cancer Screening Program, which provides free stomach and breast cancer screenings to those with an income below a certain cutoff. Free cancer screening substantially increases the screening take up rate, yielding more cancer detections. However, the increase in cancer detection is quickly crowded out by cancer detection through other channels such as diagnostic testing and private cancer screening. Further, compliers are much less likely to have cancer than never takers...
March 6, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28319791/premium-subsidies-the-mandate-and-medicaid-expansion-coverage-effects-of-the-affordable-care-act
#12
Molly Frean, Jonathan Gruber, Benjamin D Sommers
Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions' effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014-2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange...
March 6, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28288356/the-effect-of-prices-on-nutrition-comparing-the-impact-of-product-and-nutrient-specific-taxes
#13
Matthew Harding, Michael Lovenheim
This paper provides an analysis of the role of prices in determining food purchases and nutrition using very detailed transaction-level observations for a large, nationally-representative sample of US consumers over the period 2002-2007. Using product-specific nutritional information, we develop a new method of partitioning the product space into relevant nutritional clusters that define a set of nutritionally-bundled goods, which parsimoniously characterize consumer choice sets. We then estimate a large utility-derived demand system over this joint product-nutrient space that allows us to calculate price and expenditure elasticities...
February 28, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28236720/do-hospital-mergers-reduce-costs
#14
Matt Schmitt
Proponents of hospital consolidation claim that mergers lead to significant cost savings, but there is little systematic evidence backing these claims. For a large sample of hospital mergers between 2000 and 2010, I estimate difference-in-differences models that compare cost trends at acquired hospitals to cost trends at hospitals whose ownership did not change. I find evidence of economically and statistically significant cost reductions at acquired hospitals. On average, acquired hospitals realize cost savings between 4 and 7 percent in the years following the acquisition...
March 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28235697/economic-conditions-illicit-drug-use-and-substance-use-disorders-in-the-united-states
#15
Christopher S Carpenter, Chandler B McClellan, Daniel I Rees
We provide the first analysis of the relationship between economic conditions and the use of illicit drugs other than marijuana. Drawing on US data from 2002 to 2015, we find mixed evidence on the cyclicality of illicit drug use. However, we find robust evidence that economic downturns lead to increases in the intensity of prescription pain reliever use as well as increases in clinically relevant substance use disorders involving opioids. These effects are concentrated among working-age white males with low educational attainment...
March 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28285141/mitigating-the-consequences-of-a-health-condition-the-role-of-intra-and-interhousehold-assistance
#16
Michael Dalton, Daniel LaFave
The behavior of noncoresident family members motivates much of the literature on consumption smoothing, risk-sharing, and informal networks, yet little is known empirically on the topic due to a lack of data simultaneously observing multiple households in an extended family. This study utilizes genealogically linked longitudinal data to examine how extended family networks insure against financial risks from severely limiting health conditions. We find that nonhealth consumption of unmarried households declines in response to worsening health, whereas married households smooth expenditures in a way that is consistent with full insurance...
February 20, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28242432/medicaid-family-spending-and-the-financial-implications-of-crowd-out
#17
Marcus Dillender
A primary purpose of health insurance is to protect families from medical expenditure risk. Despite this goal and despite the fact that research has found that Medicaid can crowd out private coverage, little is known about the effect of Medicaid on families' spending patterns. This paper implements a simulated instrumental variables strategy with data from the Consumer Expenditure Survey to estimate the effect of an additional family member becoming eligible for Medicaid on family-level health insurance coverage and spending...
February 16, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28273626/did-medicare-part-d-reduce-mortality
#18
Jason Huh, Julian Reif
We investigate the implementation of Medicare Part D and estimate that this prescription drug benefit program reduced elderly mortality by 2.2% annually. This was driven primarily by a reduction in cardiovascular mortality, the leading cause of death for the elderly. There was no effect on deaths due to cancer, a condition whose drug treatments are covered under Medicare Part B. We validate these results by demonstrating that the changes in drug utilization following the implementation of Medicare Part D match the mortality patterns we observe...
February 14, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28182999/employment-effects-of-active-labor-market-programs-for-sick-listed-workers
#19
Anders Holm, Jan Høgelund, Mette Gørtz, Kristin Storck Rasmussen, Helle Sofie Bøje Houlberg
We use register data of 88,948 sick-listed workers in Denmark over the period 2008-2011 to investigate the effect of active labor market programs on the duration until returning to non-subsidized employment and the duration of this employment. To identify causal treatment effects, we exploit over-time variation in the use of active labor market programs in 98 job centers and time-to- event. We find that ordinary education and subsidized job training have significant positive employment effects. Subsidized job training has a large, positive effect on the transition into employment but no effect on the subsequent employment duration...
January 30, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28319792/safety-regulation-in-professional-football-empirical-evidence-of-intended-and-unintended-consequences
#20
Andrew Hanson, Nicholas A Jolly, Jeremy Peterson
In response to increasing public awareness and negative long-term health effects of concussions, the National Football League implemented the "Crown-of-the-Helmet Rule" (CHR). The CHR imposes penalties on players who initiate contact using the top of the helmet. This paper examines the intended effect of this policy and its potential for unintended consequences. We find evidence supporting the intended effect of the policy- a reduction in weekly concussion reports among defensive players by as much as 32% (34% for all head and neck injuries), but also evidence of an increase in weekly lower extremity injury reports for offensive players by as much as 34%...
January 29, 2017: Journal of Health Economics
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