nep-hea New Economics Papers
on Health Economics
Issue of 2007‒06‒18
seven papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. "Economic Perspectives on Aging" By Dimitri B. Papadimitriou
  2. The Rise of Obesity in Transition Economies: Theory and Evidence from the Russian Longitudinal Monitoring Survey By Sonya K. Huffman; Marian Rizov
  3. Current and Future Prevalence of Obesity and Severe Obesity in the United States By Christopher J. Ruhm
  4. Improving the Efficiency of Health Care Spending: Selected Evidence on Hospital Performance By Espen Erlandsen
  5. The living conditions of children By Patrinos, Harry Anthony
  6. Health insurance status and physician-induced demand for medical services in Germany: new evidence from combined district and individual level data By Hendrik Jürges
  7. When Knowledge Is Not Enough: HIV/AIDS Information and Risky Behavior In Botswana By Taryn Dinkelman; James Levinsohn; Rolang Majelantle

  1. By: Dimitri B. Papadimitriou
    Abstract: The aging of the U.S. population will be a critical public policy issue in the years ahead. This paper surveys the recent literature on the economics of aging, with a special emphasis on government spending on the aged. The U.S. Census Bureau projects that the proportion of the elderly in the total population will increase while the proportion of the working-age population will decline. This demographic shift implies a significant growth in the number of beneficiaries of major federal entitlement programs. Existing rules and escalating health care costs are expected to lead to fiscal pressures and to pose challenges for economic growth. The paper offers the author's assessment of the forces that determine government spending on retirees. It also examines how the retirement and health care of older citizens might be financed, and measures the potential impact of different reform proposals. Finally, it provides an introduction to an edited volume, Government Spending on the Elderly.
    Date: 2007–05
  2. By: Sonya K. Huffman; Marian Rizov
    Abstract: This study integrates theoretical and empirical models to facilitate understanding of human obesity and the factors contributing to rising obesity in Russia during the transition from a planned to a market economy. Recent individual level data from the Russian Longitudinal Monitoring Survey for 1994 and 2004 show that diet/caloric intake, smoking, gender and education are important determinants of obesity in Russia. Empirical results strongly support our model for production of health and demand for inputs in the health production function. The analysis provides information on dietary patterns and other determinants of obesity which is essential for formulation and implementation of effective policies designed to improve overall nutritional wellbeing and reduce obesity and mortality of the population. Interventions, which enhance education toward healthy lifestyles and healthy diet, could play a vital role in preventing obesity in Russia.
    Keywords: health, obesity, transition economies, Russia
    Date: 2007
  3. By: Christopher J. Ruhm
    Abstract: The prevalence of obesity has increased rapidly since the mid-1970s, following a period of relative stability. This study examines past patterns and projects future prevalence rates of obesity and severe obesity among US adults through 2020. Trends in body mass index (BMI), overweight (BMI 25), obesity (BMI 30), class 2 obesity (BMI 35), class 3 obesity (BMI 40) and class 4 obesity (BMI 45) of 20-74 year olds are obtained using data from the first National Health Examination Survey and the Nutrition Health and Nutrition Examination Surveys. Quantile regression methods are then used to forecast future prevalence rates through 2020. By that year, 77.6% of men are predicted to be overweight and 40.2% obese, with class 2, 3 and 4 obesity prevalence rates projected at 16.4%, 6.3% and 3.1%. The corresponding forecasts for women are 71.1%, 43.3%, 25.3%, 12.8% and 5.8%. The large growth predicted for severe obesity represents a major public health challenge, given the accompanying high medical expenditures and elevated risk of mortality and morbidity. Combating severe obesity is likely to require strategies targeting the particularly large weight gains of the heaviest individuals.
    JEL: I1 I12
    Date: 2007–06
  4. By: Espen Erlandsen
    Abstract: There are no ready-made data on hospital outputs and inputs which would allow comprehensive international comparisons of hospital efficiency to be carried out. This paper, therefore, relies on selected evidence to compare hospital efficiency in a subset of OECD countries, based on three different approaches relying on, respectively: i) unit costs for standard hospital treatments; ii) overall efficiency levels in a set of paired countries; iii) within-country dispersion in individual hospital efficiency. The analysis suggests substantial cross-country differences in hospital performance. Although country coverage varies between the different approaches, making it difficult to assess the extent to which comparisons provide a consistent picture of national efficiency levels, cross-checks between the different indicator sets tend to support the robustness of the country rankings. <P>Améliorer l’efficacité des dépenses de santé : Indicateurs sélectifs de la performance des hôpitaux <BR>Il n’existe pas de données toutes faites sur les services fournis par les hôpitaux et les ressources qu’ils consomment qui permettraient d’effectuer des comparaisons internationales d’ensemble de l’efficacité des hôpitaux. Ce document s’appuie donc sur des indicateurs sélectifs pour comparer l’efficacité des hôpitaux dans un échantillon de pays de l’OCDE, sur la base de trois approches différentes, à savoir : i) les coûts unitaires pour des interventions hospitalières types ; ii) les niveaux d’efficacité globale entre pays pris deux à deux ; iii) la variabilité de l’efficacité entre hôpitaux d’un même pays. L’analyse montre des différences substantielles de performance entre pays. S’il est difficile d’évaluer dans quelle mesure ces comparaisons donnent une image cohérente des niveaux d’efficacité nationaux, car le nombre de pays couverts varie d’une approche à l’autre, des vérifications par recoupement des différents jeux d’indicateurs tendent à confirmer la robustesse du classement des pays.
    Keywords: health care, services de santé, méthodes non paramétriques, hospital efficiency, efficacité des hôpitaux, unit costs, coûts unitaires, diagnosis related groups, groupes homogènes de malades, non-parametric methods
    JEL: C14 D24 H41 H51 I11 I12 I18
    Date: 2007–06–11
  5. By: Patrinos, Harry Anthony
    Abstract: This paper summarizes the socioeconomic conditions of children around the world. It explores solutions to the main problems, along with a summary of the costs and benefits of some of the solutions. Emphasis is on the results from rigorous studies, impact evaluations, and randomized experiments. Although the cost-evidence literature is scarce, a good case for early interventions and key quality-enhancing education interventions exists.
    Keywords: Primary Education,Education For All,Teaching and Learning,Population Policies,Health Monitoring & Evaluation
    Date: 2007–06–01
  6. By: Hendrik Jürges (Mannheim Research Institute for the Economics of Aging (MEA))
    Abstract: Germany is one of the few OECD countries with a two-tier system of statutory and primary private health insurance. Both types of insurance provide fee-for-service insurance, but chargeable fees for identical services are more than twice as large for privately insured patients than for statutorily insured patients. This price variation creates incentives to induce demand primarily among the privately insured. Using German SOEP 2002 data, I analyze the effects of insurance status and district (Kreis-) level physician density on the individual number of doctor visits. The paper has four main findings. First, I find no evidence that physician density is endogenous. Second, conditional on health, privately insured patients are less likely to contact a physician but more frequently visit a doctor following a first contact. Third, physician density has a significant positive effect on the decision to contact a physician and on the frequency of doctor visits of patients insured in the statutory health care system, whereas, fourth, physician density has no effect on privately insured patients' decisions to contact a physician but an even stronger positive effect on the frequency of doctor visits than the statutorily insured. These findings give indirect evidence for the hypothesis that physicians induce demand among privately insured patients but not among statutorily insured.
    Date: 2007–03–18
  7. By: Taryn Dinkelman (Department of Economics, University of Michigan); James Levinsohn (University of Michigan Ford School of Public Policy and NBER); Rolang Majelantle (Department of Population Studies University of Botswana)
    Abstract: The spread of the HIV/AIDS epidemic is still fueled by ignorance in many parts of the world. Filling in knowledge gaps, particularly between men and women, is considered key to preventing future infections and to reducing female vulnerabilities to the disease. However, such knowledge is arguably only a necessary condition for targeting these objectives. In this paper, we describe the extent to which HIV/AIDS knowledge is correlated with less risky sexual behavior. We ask: even when there are no substantial knowledge gaps between men and women, do we still observe sex-specific differentials in sexual behavior that would increase vulnerability to infection? We use data from two recent household surveys in Botswana to address this question. We show that even when men and women have very similar types of knowledge, they have different probabilities of reporting safe sex. Our findings are consistent with the existence of non-informational barriers to behavioral change, some of which appear to be sex-specific. The descriptive exercise in this paper suggests that it may be overly optimistic to hope for reductions in risky behavior through the channel of HIV-information provision alone.
    JEL: I18 O10
    Date: 2006–07

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