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Health Economics

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https://www.readbyqxmd.com/read/28524248/how-should-hospital-reimbursement-be-refined-to-support-concentration-of-complex-care-services
#1
Chris Bojke, Katja Grašič, Andrew Street
The English National Health Service is promoting concentration of the treatment of patients with relatively rare and complex conditions into a limited number of specialist centres. If these patients are more costly to treat, the prospective payment system based on Healthcare Resource Groups (HRGs) may need refinement because these centres will be financially disadvantaged. To assess the funding implications of this concentration policy, we estimate the cost differentials associated with caring for patients that receive complex care and examine the extent to which complex care services are concentrated across hospitals and HRGs...
May 19, 2017: Health Economics
https://www.readbyqxmd.com/read/28512845/work-retirement-and-muscle-strength-loss-in-old-age
#2
Marco Bertoni, Stefania Maggi, Guglielmo Weber
Reduced muscle strength is an accurate predictor of functional limitations, disability, and mortality. Hence, understanding which socio-economic factors contribute to preserve muscle strength in old age is central to the design of social policies that help reducing these health risks. Using data on handgrip strength collected by the Survey of Health, Ageing and Retirement in Europe for the population of Europeans aged 50+ and the exogenous variation in pension eligibility age across countries over time, we estimate that the retirement transition has a short-term positive causal effect on muscle strength...
May 17, 2017: Health Economics
https://www.readbyqxmd.com/read/28512768/nursing-home-prices-and-quality-of-care-evidence-from-administrative-data
#3
Arndt R Reichert, Magdalena A Stroka
There is widespread concern about the quality of care in nursing homes. On the basis of administrative data of a large health insurance fund, we investigate whether nursing home prices are associated with relevant quality of care indicators at the resident level. Our results indicate negative associations between price and both inappropriate and psychotropic medication. In contrast, we do not find any relationship between the price and impairments of physical health.
May 17, 2017: Health Economics
https://www.readbyqxmd.com/read/28508558/individual-survival-curves-comparing-subjective-and-observed-mortality-risks
#4
Luc Bissonnette, Michael D Hurd, Pierre-Carl Michaud
We compare individual survival curves constructed from objective (actual mortality) and elicited subjective information (probability of survival to a given target age). We develop a methodology to estimate jointly subjective and objective individual survival curves accounting for rounding on subjective reports of perceived survival. We make use of the long follow-up period in the Health and Retirement Study and the high quality of mortality data to estimate individual survival curves that feature both observed and unobserved heterogeneity...
May 15, 2017: Health Economics
https://www.readbyqxmd.com/read/28508452/mental-health-cost-of-terrorism-study-of-the-charlie-hebdo-attack-in-paris
#5
Dongyoung Kim, Young-I Albert Kim
This study examines whether a terrorist attack in a developed country, which does not cause major damage to its capital stocks, affects the mental health of its residents. By exploiting variations in survey dates of the European Social Survey, we use a difference-in-differences strategy to show that the attack adversely affects subjective well-being and mental health measures of French respondents. These negative effects are stronger for immigrants and low-income individuals. The impact is less dramatic for politically extreme right-wing supporters...
May 15, 2017: Health Economics
https://www.readbyqxmd.com/read/28497642/estimating-lifetime-medical-costs-from-censored-claims-data
#6
Jing-Shiang Hwang, Tsuey-Hwa Hu, Lukas Jyuhn-Hsiarn Lee, Jung-Der Wang
Claims databases consisting of routinely collected longitudinal records of medical expenditures are increasingly utilized for estimating expected medical costs of patients with a specific condition. Survival data of the patients of interest are usually highly censored, and observed expenditures are incomplete. In this study, we propose a survival-adjusted estimator for estimating mean lifetime costs, which integrates the product of the survival function and the mean cost function over the lifetime horizon. The survival function is estimated by a new algorithm of rolling extrapolation, aided by external information of age- and sex-matched referents simulated from national vital statistics...
May 12, 2017: Health Economics
https://www.readbyqxmd.com/read/28497638/bounding-the-causal-effect-of-unemployment-on-mental-health-nonparametric-evidence-from-four-countries
#7
Kamila Cygan-Rehm, Daniel Kuehnle, Michael Oberfichtner
An important, yet unsettled, question in public health policy is the extent to which unemployment causally impacts mental health. The recent literature yields varying findings, which are likely due to differences in data, methods, samples, and institutional settings. Taking a more general approach, we provide comparable evidence for four countries with different institutional settings-Australia, Germany, the UK, and the United States-using a nonparametric bounds analysis. Relying on fairly weak and partially testable assumptions, our paper shows that unemployment has a significant negative effect on mental health in all countries...
May 12, 2017: Health Economics
https://www.readbyqxmd.com/read/28497510/the-effect-of-health-care-expenditure-on-patient-outcomes-evidence-from-english-neonatal-care
#8
Samuel Watson, Wiji Arulampalam, Stavros Petrou
The relationship between health care expenditure and health outcomes has been the subject of recent academic inquiry in order to inform cost-effectiveness thresholds for health technology assessment agencies. Previous studies in public health systems have relied upon data aggregated at the national or regional level; however, there remains debate about whether the supply side effect of changes to expenditure are identifiable using data at this level of aggregation. We use detailed patient data derived from electronic neonatal records across England along with routinely available cost data to estimate the effect of changes to patient expenditure on clinical health outcomes in a well-defined patient population...
May 12, 2017: Health Economics
https://www.readbyqxmd.com/read/28497483/incentives-to-patients-versus-incentives-to-health-care-providers-the-users-perspective
#9
Izabela Jelovac, Philippe Polomé
In theory, health care providers may adapt their professional behavior to the financial incentives resulting from their remuneration. Our research question is whether the users of health care services anticipate such behavior from their general practitioner (GP) and, if they do, what consequences such anticipation has on their preferences regarding financial incentives. Our theoretical model explains users' preferences for one or another incentives scheme, disentangling the financial motives (incentives amounts, wealth) from the behavioral ones (perceived GPs' sensitivity to incentives)...
May 12, 2017: Health Economics
https://www.readbyqxmd.com/read/28474368/the-impact-of-provider-consolidation-on-physician-prices
#10
Caroline S Carlin, Roger Feldman, Bryan Dowd
When a clinic system is acquired by an integrated delivery system (IDS), the ownership change includes both vertical integration with the hospital(s), and horizontal integration with the IDS's previously owned or "legacy" clinics, causing increased market concentration in physician services. Although there is a robust literature on the impact of hospital market concentration, the literature on physician market concentration is sparse. The objective of this study is to determine the impact on physician prices when two IDSs acquired three multispecialty clinic systems in Minneapolis-St Paul, Minnesota at the end of 2007, using commercial claims data from a large health plan (2006-2011)...
May 4, 2017: Health Economics
https://www.readbyqxmd.com/read/28449410/the-impact-of-the-affordable-care-act-on-self-employment
#11
Bradley T Heim, Lang Kate Yang
This paper estimates the impact of the implementation of the Affordable Care Act (ACA) in 2014 on the decision to be self-employed. Using data from the Current Population Survey, we employ two identification strategies. Utilizing prereform variation in state nongroup health insurance market regulations, we find that the ACA did not increase self-employment overall in states that lacked similar provisions in their nongroup markets prior to 2014. In specifications that utilize variation across individuals in characteristics that could make it harder for them to purchase insurance if they left their current employer, we also do not find that the ACA differentially increased self-employment...
April 27, 2017: Health Economics
https://www.readbyqxmd.com/read/28449388/unobserved-health-care-expenditures-how-important-is-censoring-in-register-data
#12
Christian Philipp Rudolf Schmid
Accurate information on individuals' health service use is important for evaluating health policies and analyzing health care demand. Although register data are considered to be more reliable than survey data, little is known about the extent and effect of censoring of the expenditure distribution in register data. We exploit a recent change in the health provider remuneration system in several Swiss cantons to empirically investigate whether censoring occurs when individuals do not have to disclose their health service use below their deductible level...
April 27, 2017: Health Economics
https://www.readbyqxmd.com/read/28449353/how-excluding-some-benefits-from-value-assessment-of-new-drugs-impacts-innovation
#13
Joseph P Cook, Joseph Golec
Payers often assess the benefits of new drugs relative to costs for reimbursement purposes, but they frequently exclude some drugs' option-related benefits, reducing their reimbursement chances, and making them less attractive R&D investments. We develop and test a real options model of R&D investment that shows that excluding option-related benefits heightens drug developers' incentives to avoid high-risk (volatile) R&D investments and instead encourages them to focus on "safer" (positively skewed) investments...
April 27, 2017: Health Economics
https://www.readbyqxmd.com/read/28449329/valuing-productivity-costs-using-the-friction-cost-approach-estimating-friction-period-estimates-by-occupational-classifications-for-the-uk
#14
Jesse Kigozi, Sue Jowett, Martyn Lewis, Pelham Barton, Joanna Coast
The friction cost approach has been proposed as an alternative to the human capital approach in estimating productivity costs. However, it is difficult, in practice, to apply this approach due to limited availability of context-specific data. Using national and firm-level data on vacancy durations sourced from 4 organisations, we estimated vacancy durations, and consequently, length of friction period for the United Kingdom disaggregated by occupational classification. We found comparable estimates to previously reported friction periods elsewhere...
April 27, 2017: Health Economics
https://www.readbyqxmd.com/read/28449316/does-my-high-blood-pressure-improve-your-survival-overall-and-subgroup-learning-curves-in-health
#15
Raf Van Gestel, Tobias Müller, Johan Bosmans
Learning curves in health are of interest for a wide range of medical disciplines, healthcare providers, and policy makers. In this paper, we distinguish between three types of learning when identifying overall learning curves: economies of scale, learning from cumulative experience, and human capital depreciation. In addition, we approach the question of how treating more patients with specific characteristics predicts provider performance. To soften collinearity problems, we explore the use of least absolute shrinkage and selection operator regression as a variable selection method and Theil-Goldberger mixed estimation to augment the available information...
April 27, 2017: Health Economics
https://www.readbyqxmd.com/read/28436139/improving-scope-sensitivity-in-contingent-valuation-joint-and-separate-evaluation-of-health-states
#16
José Luis Pinto-Prades, José Antonio Robles-Zurita, Fernando-Ignacio Sánchez-Martínez, José María Abellán-Perpiñán, Jorge Martínez-Pérez
We present data of a contingent valuation survey, testing the effect of evaluation mode on the monetary valuation of preventing road accidents. Half of the interviewees was asked to state their willingness to pay (WTP) to reduce the risk of having only 1 type of injury (separate evaluation, SE), and the other half of the sample was asked to state their WTP for 4 types of injuries evaluated simultaneously (joint evaluation, JE). In the SE group, we observed lack of sensitivity to scope while in the JE group WTP increased with the severity of the injury prevented...
April 24, 2017: Health Economics
https://www.readbyqxmd.com/read/28425680/adaptation-to-health-states-sick-yet-better-off
#17
Patricia Cubí-Mollá, Mireia Jofre-Bonet, Victoria Serra-Sastre
Healthcare funding decisions in the UK rely on health state valuations of the general public. However, it has been shown that there is disparity between the valuation of the impact of hypothetical conditions on health and the reported health by those experiencing them. Patients' adaptation to health states is among the most common explanations for this discrepancy. Being diagnosed with a disease appears to affect individual perception of health over time so that better subjective health may be reported over a disease trajectory...
April 20, 2017: Health Economics
https://www.readbyqxmd.com/read/28421691/the-impact-of-maternal-employment-on-children-s-adiposity-evidence-from-china-s-labor-policy-reform
#18
Young Jo, Qing Wang
BACKGROUND: China has experienced a rapid growth in childhood adiposity in recent years. Although a large number of studies examine the effect of maternal employment on children's adiposity in developed countries, only a few studies investigate the issue in developing countries. Moreover, existing studies tend to suffer from a potential endogeneity issue. AIMS: We provide new evidence on the causal effect of maternal employment on children's adiposity in China. MATERIALS AND METHODS: We employ a difference-in-difference strategy that takes advantage of China's 1995 legislative change to labor regulations, which reduced the number of workdays from 6 to 5 days per week...
April 19, 2017: Health Economics
https://www.readbyqxmd.com/read/28387427/love-conquers-all-but-nicotine-spousal-peer-effects-on-the-decision-to-quit-smoking
#19
Ali Palali, Jan C Van Ours
If two partners smoke, their quit behavior may be related through correlation in unobserved individual characteristics and through common shocks. However, there may also be a causal effect whereby the quit behavior of one partner is affected by the quit decision of the other partner. If so, there is a spousal peer effect on the decision to quit smoking. We use data containing retrospective information of Dutch partnered individuals about their age of onset of smoking and their age of quitting smoking. We estimate mixed proportional hazard models of starting rates and quit rates of smoking in which we allow unobserved heterogeneity to be correlated across partners...
April 7, 2017: Health Economics
https://www.readbyqxmd.com/read/28370758/market-environment-and-medicaid-acceptance-what-influences-the-access-gap
#20
Amelia Bond, William Pajerowski, Daniel Polsky, Michael R Richards
The U.S. health care system is undergoing significant changes. Two prominent shifts include millions added to Medicaid and greater integration and consolidation among firms. We empirically assess if these two industry trends may have implications for each other. Using experimentally derived ("secret shopper") data on primary care physicians' real-world behavior, we observe their willingness to accept new privately insured and Medicaid patients across 10 states. We combine this measure of patient acceptance with detailed information on physician and commercial insurer market structure and show that insurer and provider concentration are each positively associated with relative improvements in appointment availability for Medicaid patients...
March 28, 2017: Health Economics
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