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Health Economics

Hannah Forbes, Eleonora Fichera, Anne Rogers, Matt Sutton
Better management by individuals of their long-term conditions is promoted to improve health and reduce healthcare expenditure. However, there is limited evidence on the determinants and consequences of self-management activity. We investigate the determinants of two forms of self-management, exercise and relaxation, and their impact on the health and wellbeing of 3472 individuals with long-term health conditions over a 1-year period. We use simultaneous recursive trivariate models to estimate the effects of these two inputs on three health and wellbeing outcomes: the EuroQol five-dimensional (EQ-5D) score, self-assessed health and happiness...
March 9, 2017: Health Economics
Anirban Basu, Norma B Coe
Using Monte-Carlo simulations, we compare the two-stage least-squares estimator with two-stage residual inclusion estimators, with varying forms of residuals, to estimate the local average treatment effect parameter for a binary outcome and endogenous binary treatment model in the presence of binary covariates and a binary instrumental variable. We vary the rarity of both the outcome and the treatment and find different estimators to produce the least bias in different settings. We develop guidance for applied researchers and illustrate the utility of this guidance with estimating the effects of long-term care insurance on a variety of binary health care use outcomes among the near-elderly using the Health and Retirement Study...
March 5, 2017: Health Economics
Daisy Duell, Xander Koolman, France Portrait
Universal access and generous coverage are important goals of the Dutch long-term care (LTC) system. It is a legal requirement that everyone eligible for LTC should be able to receive it. Institutional care (IC) made up for 90% of Dutch LTC spending. To investigate whether access to IC is as equitable as the Dutch government aspires, we explored practice variation in entitlements to IC across Dutch regions. We used a unique dataset that included all individual applications for Dutch LTC in January 2010-December 2013 (N = 3,373,358)...
March 2, 2017: Health Economics
Martin Andersen
I study the effect of prescription drug essential health benefits (EHB) requirements from the Affordable Care Act on prescription drug formularies of health insurance marketplace plans. The EHB regulates the number of drugs covered but leaves other dimensions (cost sharing and utilization management) of the formulary unregulated. Using data on almost all formularies in the country, I demonstrate that requiring insurers to cover one additional drug adds 0.22 drugs (3.3%) to the average formulary, mostly owing to firms increasing the number of drugs covered to comply with the EHB requirement...
February 24, 2017: Health Economics
Huong Thu Le, Ha Trong Nguyen
This paper examines the effects of parental health on cognitive and noncognitive development in Australian children. The underlying nationally representative panel data and a child fixed effects estimator are used to deal with unobserved heterogeneity. We find that only father's serious mental illness worsens selected cognitive and noncognitive skills of children. Maternal poor health also deteriorates some cognitive and noncognitive outcomes of children of lone mothers only. Our results demonstrate that either failing to account for parent-child fixed effects or using child noncognitive skills reported by parents could overestimate the harmful impact of poor parental health on child development...
February 23, 2017: Health Economics
Hans Bloemen, Stefan Hochguertel, Jochem Zweerink
This paper estimates the impact of early retirement on mortality using Dutch administrative micro panel data. An unexpected temporary decrease in the eligibility age for retirement benefits for civil servants is used to instrument the retirement choice. We find that induced early retirement decreased the probability that a man dies within 5 years by 2.6 percentage points. The result is robust to alternative specifications and data selection criteria.
February 23, 2017: Health Economics
Johanna Catherine Maclean, Brendan Saloner
We examine the impact of the 2006 Massachusetts healthcare reform on substance use disorder (SUD) treatment facilities' provision of care. We test the impact of the reform on treatment quantity and access. We couple data on the near universe of specialty SUD treatment providers in the USA with a synthetic control method approach. We find little evidence that the reform lead to changes in treatment quantity or access. Reform effects were similar among for-profit and non-profit facilities. In an extension, we show that the reform altered the setting in which treatment is received, the number of offered services, and the number of programs for special populations...
February 21, 2017: Health Economics
Timothy J Halliday, Bhashkar Mazumder
We investigate sibling correlations in youth health status using the Panel Study of Income Dynamics. We do so by estimating the covariance structure of a system of equations in latent variables using methods that have hitherto not been used in the literature on intergenerational transmissions of health. Across a battery of outcomes, we find that between 50 and 60% of health status can be attributed to shared familial or neighborhood characteristics. Taking the principal component across all outcomes, we obtain a sibling correlation of about 53%...
February 20, 2017: Health Economics
Barbara Broadway, Guyonne Kalb, Jinhu Li, Anthony Scott
This paper analyses doctors' supply of after-hours care (AHC), and how it is affected by personal and family circumstances as well as the earnings structure. We use detailed survey data from a large sample of Australian General Practitioners (GPs) to estimate a structural, discrete choice model of labour supply and AHC. This allows us to jointly model GPs' decisions on the number of daytime-weekday working hours and the probability of providing AHC. We simulate GPs' labour supply responses to an increase in hourly earnings, both in a daytime-weekday setting and for AHC...
February 20, 2017: Health Economics
Sven Neelsen, Owen O'Donnell
Like other countries seeking a progressive path to universalism, Peru has attempted to reduce inequalities in access to health care by granting the poor entitlement to tax-financed basic care without charge. We identify the impact of this policy by comparing the target population's change in health care utilization with that of poor adults already covered through employment-based insurance. There are positive effects on receipt of ambulatory care and medication that are largest among the elderly and the poorest...
February 16, 2017: Health Economics
Graham Cookson, Simon Jones, Ioannis Laliotis
This paper explores the role of incentives in the English National Health Service. Until financial year 2009/2010, elective procedures that were cancelled after admission received a fixed reimbursement associated with a specific healthcare resource group code. We investigate whether this induced trusts to admit and then cancel, rather than cancel before admission and/or to cancel low fee over high fee work. As the tariff was ended in April 2010, we conduct an interrupted time series analysis to examine if their behaviour was affected after the tariff removal...
February 16, 2017: Health Economics
Olukorede Abiona
We investigate the impact of unanticipated economic shocks on the use of contraceptives for childbirth control in Uganda using a nationally representative panel of women. To complement our reduced form analysis, we use both intra-village and inter-village variation in rainfall shocks between 2009 and 2012 to identify the impact of agricultural income on the adoption of contraceptives by Ugandan women and their husbands. Our results indicate that women in Uganda, along with their husbands, use contraceptives strategically to postpone childbirth during negative shocks...
February 7, 2017: Health Economics
Somi Shin, Christoph Schumacher, Eberhard Feess
One of the main concerns about capitation-based reimbursement systems is that tertiary institutions may be underfunded due to insufficient reimbursements of more complicated cases. We test this hypothesis with a data set from New Zealand that, in 2003, introduced a capitation system where public healthcare provider funding is primarily based on the characteristics of the regional population. Investigating the funding for all cases from 2003 to 2011, we find evidence that tertiary providers are at a disadvantage compared with secondary providers...
February 1, 2017: Health Economics
Chris Schilling, Dennis Petrie, Michelle M Dowsey, Peter F Choong, Philip Clarke
Many treatments are evaluated using quasi-experimental pre-post studies susceptible to regression to the mean (RTM). Ignoring RTM could bias the economic evaluation. We investigated this issue using the contemporary example of total knee replacement (TKR), a common treatment for end-stage osteoarthritis of the knee. Data (n = 4796) were obtained from the Osteoarthritis Initiative database, a longitudinal observational study of osteoarthritis. TKR patients (n = 184) were matched to non-TKR patients, using propensity score matching on the predicted hazard of TKR and exact matching on osteoarthritis severity and health-related quality of life (HrQoL)...
January 27, 2017: Health Economics
Brendan Saloner, Yaa Akosa Antwi, Johanna Catherine Maclean, Benjamin Cook
The relationship between insurance coverage and use of specialty substance use disorder (SUD) treatment is not well understood. In this study, we add to the literature by examining changes in admissions to SUD treatment following the implementation of a 2010 Affordable Care Act provision requiring health insurers to offer dependent coverage to young adult children of their beneficiaries under age 26. We use national administrative data on admissions to specialty SUD treatment and apply a difference-in-differences design to study effects of the expansion on the rate of treatment utilization among young adults and, among those in treatment, changes in insurance status and payment source...
January 27, 2017: Health Economics
Fabian Duarte, Srikanth Kadiyala, Samuel H Masters, David Powell
In July 2009, the World Health Organization declared the first flu pandemic in nearly 40 years. Although the health effects of the pandemic have been studied, there is little research examining the labor productivity consequences. Using unique sick leave data from the Chilean private health insurance system, we estimate the effect of the pandemic on missed days of work. We estimate that the pandemic increased mean flu days missed by 0.042 days per person-month during the 2009 peak winter months (June and July), representing an 800% increase in missed days relative to the sample mean...
January 25, 2017: Health Economics
Kisalaya Basu, Maxwell Pak
No abstract text is available yet for this article.
January 16, 2017: Health Economics
Christoph Strupat
This paper examines empirically whether midwives, as an integral part of the reproductive health and family planning programs in Indonesia, are effective in advising young women to delay their first birth and also influence the decision on post-primary school attendance. Using the Indonesian Family Life Survey, I investigate the extent to which the expansion of a midwife program affects the age at first birth and the number of school years of women. My findings suggest that women who were exposed to a midwife when they have to decide on further school attendance (aged 13-20 years) delay their first birth and also stay longer in school...
January 4, 2017: Health Economics
Priyanka Anand
This paper examines the relationship between rising health insurance costs and employee compensation. I estimate the extent to which total compensation decreases with a rise in health insurance costs and decompose these changes in compensation into adjustments in wages, non-health fringe benefits, and employee contributions to health insurance premiums. I examine this relationship using the National Compensation Survey, a panel dataset on compensation and health insurance for a sample of establishments across the USA...
December 27, 2016: Health Economics
Chuanchuan Zhang, Xiaoyan Lei, John Strauss, Yaohui Zhao
We document the recent profile of health insurance and health care among mid-aged and older Chinese using data from the China Health and Retirement Longitudinal Study conducted in 2011. Overall health insurance coverage is about 93%. Multivariate regressions show that respondents with lower income as measured by per capita expenditure have a lower chance of being insured, as do the less-educated, older, and divorced/widowed women and rural-registered people. Premiums and reimbursement rates of health insurance vary significantly by schemes...
April 2017: Health Economics
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