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Health Economics

Yan Feng, Arne Risa Hole, Milad Karimi, Aki Tsuchiya, Ben van Hout
Time Trade-Off (TTO) usually relies on "iteration," which is susceptible to bias. Discrete Choice Experiment with duration (or DCETTO ) is free of such bias, but respondents find this cognitively more challenging. This paper explores non-iterative TTO with or without lead time: NI(LT)TTO. In NI(LT)TTO, respondents see a series of independent pairwise choices without iteration (similar to DCETTO ), but one of the two scenarios always involves full health for a shorter duration (similar to TTO). We compare three different "types" of NI(LT)TTO relative to DCETTO ...
May 17, 2018: Health Economics
Michel Mougeot, Florence Naegelen
In many countries, health insurers or health plans choose to contract either with any willing providers or with preferred providers. We compare these mechanisms when two medical services are imperfect substitutes in demand and are supplied by two different firms. In both cases, the reimbursement is higher when patients select the in-network provider(s). We show that these mechanisms yield lower prices, lower providers' and insurer's profits, and lower expense than in the uniform-reimbursement case. Whatever the degree of product differentiation, a not-for-profit insurer should prefer selective contracting and select a reimbursement such that the out-of-pocket expense is null...
May 17, 2018: Health Economics
Luiz Felipe Campos Fontes, Otavio Canozzi Conceição, Paulo de Andrade Jacinto
This study aims to evaluate the More Doctors Program (Programa Mais Médicos) in terms of the provision of physicians, presenting estimates of its impact on hospitalization for ambulatory care sensitive conditions. The differences-in-differences method was used with propensity score matching (double difference matching), using 3 specifications, a falsification test, and also a dynamic endogeneity test to confirm the robustness of the results. For the application of this methodology, a panel of municipal data was constructed covering several variables related to socioeconomic, demographic, and public health infrastructure characteristics in the cities for the period from 2010 to 2016...
May 16, 2018: Health Economics
José Luis Pinto-Prades, Fernando Ignacio Sánchez-Martínez, José María Abellán-Perpiñán, Jorge E Martínez-Pérez
Preferences elicited with matching and choice usually diverge (as characterised by preference reversals), violating a basic rationality requirement, namely, procedure invariance. We report the results of an experiment that shows that preference reversals between matching (Standard Gamble in our case) and choice are reduced when the matching task is conducted using nontransparent methods. Our results suggest that techniques based on nontransparent methods are less influenced by biases (i.e., compatibility effects) than transparent methods...
May 16, 2018: Health Economics
Miriam Wüst, Erik Lykke Mortensen, Merete Osler, Thorkild I A Sørensen
Three recent studies have documented short- and long-run benefits of early-infancy health interventions in Norway, Sweden, and Denmark: Universal nurse home visiting (NHV) and well-baby center care decreased infant mortality and positively impacted long-run survival (DK, S), morbidity (DK, N), and educational and labor market outcomes (N). Using Danish conscription data, this paper examines intermediate outcomes to assess both potential mechanisms and the importance of selective survival for the long-run health effects of NHV...
May 16, 2018: Health Economics
Thomas F Crossley, Federico Zilio
Each year, the UK records 25,000 or more excess winter deaths, primarily among the elderly. A key policy response is the "Winter Fuel Payment" (WFP), a labelled but unconditional cash transfer to households with a member above the female state pension age. The WFP has been shown to raise fuel spending among eligible households. We examine the causal effect of the WFP on health outcomes, including self-reports of chest infection, measured hypertension, and biomarkers of infection and inflammation. We find a robust, 6 percentage point reduction in the incidence of high levels of serum fibrinogen...
May 9, 2018: Health Economics
Santosh Kumar, Fidel Gonzalez
This paper estimates the effect of mother's insurance coverage on neonatal outcomes in Mexico using hospital-based administrative data. Using an instrumental variable approach to identify the causal effects of health insurance on infant health, we find that mother's insurance coverage has positive impacts on neonatal outcomes. Children born to insured mothers weighed 108 g higher and had reduced probability of low birth weight by 7.5 percentage points. These effects appear to be stronger for mothers with higher levels of education and in municipalities with a higher development index...
May 8, 2018: Health Economics
Jamie T Mullins
This paper utilizes a unique dataset of competitive outcomes from intercollegiate track and field competition to identify the relationship between recent ambient pollution exposure histories and human performance among a young and fit population in a diverse range of physically demanding "tasks". I find that higher contemporaneous ozone levels are associated with poorer performances in events that heavily tax the respiratory system. This is the case despite the low exposure levels observed in the studied sample, which are similar to those regularly experienced across the developed world...
May 8, 2018: Health Economics
Raf Van Gestel, Tobias Müller, Johan Bosmans
Procedural failures of physicians or teams in interventional healthcare may positively or negatively predict subsequent patient outcomes. We identify this effect by applying (non)linear dynamic panel methods to data from the Belgian transcatheter aorta valve implantation registry containing information on the first 860 transcatheter aorta valve implantation procedures in Belgium. We find that a previous death of a patient positively and significantly predicts subsequent survival of the succeeding patient. We find that these learning from failure effects are not long-lived and that learning from failure is transmitted across adverse events...
May 2, 2018: Health Economics
Lenisa V Chang
In the wake of strong, although later refuted, claims of a link between autism and the measles-mumps-rubella (MMR) vaccine, I examine whether fewer parents immunized or delayed vaccinations for their children and if there was a differential response by mother's education level. Using various controls and a differencing strategy that compares in MMR take-up with other vaccines, I find that the MMR-autism controversy led to a decline in the immediate years and that there were negative spillovers onto other vaccines...
May 2, 2018: Health Economics
Johannes Geyer, Thorben Korfhage
Many informal caregivers are of working age, facing the double burden of providing care and working. Negative labor supply effects can severely reduce the comparative cost advantage of informal over formal care arrangements. When designing long-term care (LTC) policies, it is crucial to understand the effects not only on health outcomes but also on labor supply behavior of informal caregivers. We evaluate labor supply reactions to the introduction of the German long-term care insurance in 1995 using a difference-in-differences approach...
April 26, 2018: Health Economics
Ludovico Carrino, Cristina Elisa Orso, Giacomo Pasini
In this paper, we study how elderly individuals adjust their informal long-term care utilization to changes in the provision of formal care. Despite this is crucial to design effective policies of formal elderly care, empirical evidence is scant due to the lack of credible identification strategies to account for the endogeneity of formal care. We propose a novel instrument, an index that captures individuals' eligibility status for the long-term care programs implemented in the region of residence. Our estimates, which are robust to a number of different specifications, suggest that higher formal care provision would lead to an increase in informal care utilization as well...
April 25, 2018: Health Economics
Liqiu Zhao, Minghai Zhou
This paper examines whether only children have poor vision by exploiting the quasinatural experiment generated by the Chinese One-Child Policy. The results suggest that being an only child increases the incidence of myopia by 9.1 percentage points. We further investigate the mechanisms through which being an only child affects the myopia and find that only children, as the only hope in a household, receive higher expectations in terms of academic performance and future educational attainment and pressure to succeed in life from parents, which contribute to the increased myopia...
April 23, 2018: Health Economics
Alexander Silbersdorff, Julia Lynch, Stephan Klasen, Thomas Kneib
We reconsider the relationship between income and health taking a distributional perspective rather than one centered on conditional expectation. Using structured additive distributional regression, we find that the association between income and health is larger than generally estimated because aspects of the conditional health distribution that go beyond the expectation imply worse outcomes for those with lower incomes. Looking at German data from the Socio-Economic Panel, we find that the risk of bad health is roughly halved when doubling the net equivalent income from 15,000 to 30,000€...
April 19, 2018: Health Economics
Abdulkarim M Meraya, Nilanjana Dwibedi, Xi Tan, Kim Innes, Sophie Mitra, Usha Sambamoorthi
We examine the dynamic relationships between economic status and health measures using data from 8 waves of the Panel Study of Income Dynamics from 1999 to 2013. Health measures are self-rated health (SRH) and functional limitations; economic status measures are labor income (earnings), family income, and net wealth. We use 3 different types of models: (a) ordinary least squares regression, (b) first-difference, and (c) system-generalized method of moment (GMM). Using ordinary least squares regression and first difference models, we find that higher levels of economic status are associated with better SRH and functional status among both men and women, although declines in income and wealth are associated with a decline in health for men only...
April 18, 2018: Health Economics
José-Ignacio Antón, Zuleika Ferre, Patricia Triunfo
This study investigates the short-term impact on the quantity and quality of births of an abortion reform in Uruguay that legalised termination of pregnancy until the 12th week of pregnancy in the short run. We employ a differences-in-differences approach, comprehensive administrative records of births, and a novel identification strategy based on the planned or unplanned nature of pregnancies that came to term. Our results suggest that this policy change has led to an 8% decline in the number of births from unplanned pregnancies, driven by the group of mothers aged between 20 and 34 years old who have secondary education...
April 18, 2018: Health Economics
Young Jo
I exploit substantial increases in the earned income tax credit to study how a policy-driven change in family income affects childhood obesity. Using the National Longitudinal Survey of Youth 1979, my difference-in-differences estimates indicate that the probability of being obese increased by 3 percentage points among children whose families experienced a greater income shock. A further investigation suggests that a reduction in maternal time with children played a greater role in children's weight gain than income...
April 17, 2018: Health Economics
Andrew Spieker, Jason Roy, Nandita Mitra
As medical expenses continue to rise, methods to properly analyze cost outcomes are becoming of increasing relevance when seeking to compare average costs across treatments. Inverse probability weighted regression models have been developed to address the challenge of cost censoring in order to identify intent-to-treat effects (i.e., to compare mean costs between groups on the basis of their initial treatment assignment, irrespective of any subsequent changes to their treatment status). In this paper, we describe a nested g-computation procedure that can be used to compare mean costs between two or more time-varying treatment regimes...
April 16, 2018: Health Economics
Camilla Beck Olsen, Hans Olav Melberg
Copayments for primary care services may lead to decreased access to and underconsumption of necessary health care for vulnerable patient groups, such as adolescents. In Norway, in 2010, adolescents aged 12 to 15 years were exempted from copayments for general practitioner (GP) services, and the aim of this study is to estimate whether being exempted from copayments led to increases in GP visits. We apply the synthetic control method using the elastic net regression as a data-driven approach to construct a relevant counterfactual from our pool of age groups not affected by the reform...
April 16, 2018: Health Economics
Karl Claxton, James Lomas, Stephen Martin
Several recent studies have estimated the responsiveness of mortality to English National Health Service spending. Although broadly similar, the studies differ in how they identify the outcome equation. One approach uses conventional socio-economic variables as instruments for endogenous health care expenditure, whereas the other exploits exogenous elements in the resource allocation formula for local budgets. The former approach has usually been applied to specific disease areas (e.g., for cancer and circulatory disease), whereas the other has only been applied to all-cause mortality...
April 2, 2018: Health Economics
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