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Journal of Health Economics

Caroline Hall, Erica Lindahl
We evaluate the effect of a preschool health intervention aimed at reducing infections through improved hygiene practices and training of the staff. The large-scale design enables us to study heterogeneous effects with respect to several child and preschool characteristics that are related to the level of illness-related absence. We find no reduction, on average, in children's illness-related absence. This conclusion holds across different age groups of preschool children, and for preschools with varying levels of absence before the intervention...
October 18, 2017: Journal of Health Economics
Michael T Cooper, Michael F Pesko
We estimate the effect of county-level e-cigarette indoor vaping restrictions on adult prenatal smoking and birth outcomes using United States birth record data for 7 million pregnant women living in places already comprehensively banning the indoor use of traditional cigarettes. We use both cross-sectional and panel data to estimate our difference-in-difference models. Our panel model results suggest that adoption of a comprehensive indoor vaping restriction increased prenatal smoking by 2.0 percentage points, which is double the estimate obtained from a cross-sectional model...
October 16, 2017: Journal of Health Economics
Christopher M Whaley, Chaoran Guo, Timothy T Brown
This paper examines the effects of the reference pricing program implemented by the California Public Employees Retirement System (CalPERS) in 2012. The program uses targeted cost-sharing to incentivize patient price shopping. We find that the program leads to a 10.3% increase in the use of low-price providers and reduces the average cost per procedure by 12.5%. We further estimate that the program reduces medical spending by $218.8 per procedure, which we estimate is approximately 53.7% of the excessive spending that is due to patient choice of higher price providers caused by insurance coverage, at the expense of a $94...
October 12, 2017: Journal of Health Economics
Ayona Bhattacharjee, Jong Kook Shin, Chetan Subramanian, Shailender Swaminathan
This paper examines how the relative shares of public and private health expenditures impact income inequality. We study a two period overlapping generation's growth model in which longevity is determined by both private and public health expenditure and human capital is the engine of growth. Increased investment in health, reduces mortality, raises return to education and affects income inequality. In such a framework we show that the cross-section earnings inequality is non-decreasing in the private share of health expenditure...
October 7, 2017: Journal of Health Economics
Apostolos Davillas, Stephen Pudney
We use self-reported health measures, nurse-administered measurements and blood-based biomarkers to examine the concordance between health states of partners in marital/cohabiting relationships in the UK. A model of cumulative health exposures is used to interpret the empirical pattern of between-partner health correlation in relation to elapsed relationship duration, allowing us to distinguish non-causal correlation due to assortative mating from potentially causal effects of shared lifestyle and environmental factors...
September 29, 2017: Journal of Health Economics
Rong Fu, Haruko Noguchi, Akira Kawamura, Hideto Takahashi, Nanako Tamiya
We evaluate a spillover effect of the Japanese public long-term care insurance (LTCI) as a policy to stimulate family caregivers' labor force participation. Using nationally representative data from 1995 to 2013, we apply difference-in-difference propensity score matching to investigate the spillover effect in two periods: before and after the introduction of the LTCI in 2000 and before and after its major amendment in 2006. Our results show that the LTCI introduction has significant and positive spillover effects on family caregivers' labor force participation and the effects vary by gender and age...
September 28, 2017: Journal of Health Economics
Martina Celidoni, Chiara Dal Bianco, Guglielmo Weber
We show that a new measure of cognitive decline, that can be computed in longitudinal surveys where respondents perform the same recall memory tests over the years, is highly predictive of the onset of dementia. Using SHARE data, we investigate the way retirement affects cognitive decline over time controlling for age, education and other confounding factors. We find that retirement has a long-term detrimental effect on cognition for individuals who retire at the statutory eligibility age. It plays instead a protective role for those who retire on an early retirement scheme...
September 23, 2017: Journal of Health Economics
Dimitrios Nikolaou
Even though several youth fatal suicides have been linked with school victimization, there is lack of evidence on whether cyberbullying victimization causes students to adopt suicidal behaviors. To investigate this issue, I use exogenous state-year variation in cyberbullying laws and information on high school students from the Youth Risk Behavioral Survey within a bivariate probit framework, and complement these estimates with matching techniques. I find that cyberbullying has a strong impact on all suicidal behaviors: it increases suicidal thoughts by 14...
September 21, 2017: Journal of Health Economics
Thomas DeLeire, Andre Chappel, Kenneth Finegold, Emily Gee
The Affordable Care Act (ACA) provides assistance to low-income consumers through both premium subsidies and cost-sharing reductions (CSRs). Low-income consumers' lack of health insurance literacy or information regarding CSRs may lead them to not take-up CSR benefits for which they are eligible. We use administrative data from 2014 to 2016 on roughly 22 million health insurance plan choices of low-income individuals enrolled in ACA Marketplace coverage to assess whether they behave in a manner consistent with being aware of the availability of CSRs...
September 20, 2017: Journal of Health Economics
Thomas G McGuire, Richard C van Kleef
No abstract text is available yet for this article.
September 15, 2017: Journal of Health Economics
Annika Herr, Moritz Suppliet
Health insurance companies curb price-insensitive behavior and the moral hazard of insureds by means of cost-sharing, such as tiered co-payments or reference pricing in drug markets. This paper evaluates the effect of price limits - below which drugs are exempt from co-payments - on prices and on demand. First, using a difference-in-differences estimation strategy, we find that the new policy decreases prices by 5 percent for generics and increases prices by 4 percent for brand-name drugs in the German reference price market...
September 15, 2017: Journal of Health Economics
Hendrik Schmitz, Matthias Westphal
In this paper we estimate long-run effects of informal care provision on female caregivers' labor market outcomes up to eight years after care provision. We compare a static version, where average effects of care provision in a certain year on later labor market outcomes are estimated, to a partly dynamic version where the effects of up to three consecutive years of care provision are analyzed. Our results suggest that there are significant initial negative effects of informal care provision on the probability to work full-time...
September 15, 2017: Journal of Health Economics
Gerard J van den Berg, Ulf G Gerdtham, Stephanie von Hinke, Maarten Lindeboom, Johannes Lissdaniels, Jan Sundquist, Kristina Sundquist
There has been much interest recently in the relationship between economic conditions and mortality, with some studies showing that mortality is pro-cyclical, while others find the opposite. Some suggest that the aggregation level of analysis (e.g. individual vs. regional) matters. We use both individual and aggregated data on a sample of 20-64 year-old Swedish men from 1993 to 2007. Our results show that the association between the business cycle and mortality does not depend on the level of analysis: the sign and magnitude of the parameter estimates are similar at the individual level and the aggregate (county) level; both showing pro-cyclical mortality...
September 14, 2017: Journal of Health Economics
John P Tang
Economic development improves long-run health outcomes through access to medical treatment, sanitation, and higher income. Short run impacts, however, may be ambiguous given disease exposure from market integration. Using a panel dataset of Japanese vital statistics and multiple estimation methods, I find that railroad network expansion is associated with a six percent increase in gross mortality rates among newly integrated regions. Communicable diseases accounted for most of the rail-associated mortality, which indicate railways behaved as transmission vectors...
September 11, 2017: Journal of Health Economics
Climent Quintana-Domeque, Pedro Ródenas-Serrano
We study the effects of in utero exposure to terrorism in Spain on birth outcomes, focusing on terrorism perpetrated by ETA during the period 1980-2003. We find that in utero exposure to terrorism early in pregnancy, as measured by the number of bomb casualties in the mother's province of residence in the first trimester of pregnancy, has detrimental effects on birth outcomes: in terms of average birth weight (lower), prevalence of low birth weight (higher) and fraction of "normal" babies (lower). While our findings are robust to a host of potential threats to validity, they seem to be driven by exposure to a relatively large number of bomb casualties...
September 4, 2017: Journal of Health Economics
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
Alex Hollingsworth, Christopher J Ruhm, Kosali Simon
We examine how deaths and emergency department (ED) visits related to use of opioid analgesics (opioids) and other drugs vary with macroeconomic conditions. As the county unemployment rate increases by one percentage point, the opioid death rate per 100,000 rises by 0.19 (3.6%) and the opioid overdose ED visit rate per 100,000 increases by 0.95 (7.0%). Macroeconomic shocks also increase the overall drug death rate, but this increase is driven by rising opioid deaths. Our findings hold when performing a state-level analysis, rather than county-level; are primarily driven by adverse events among whites; and are stable across time periods...
August 23, 2017: Journal of Health Economics
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
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
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
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