nep-hea New Economics Papers
on Health Economics
Issue of 2008‒02‒02
ten papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. A new preference reversal in health utility measurement By Han Bleichrodt; Jose Luis Pinto-Prades
  2. Inequality Measurement forOrdered Response Health Data By Ramses H. Abul Naga; Tarik Yalcin
  3. The Value of a Statistical Life By Andersson, Henrik; Treich, Nicolas
  4. Covering the Uninsured in the U.S. By Jonathan Gruber
  5. Social influence and neighbourhood effects in the health care market. By Montefiori, Marcello; Resta, Marina
  6. Living on the edge -- risk, protection, behavior, and outcomes of Argentine youth By Justesen , Michael
  7. Mental health patterns and consequences : results from survey data in five developing countries By Friedman, Jed; Do, Quy-Toan; Das, Jishnu
  8. Determinants of Child Care Participation By Coneus, Katja; Goeggel, Kathrin; Muehler, Grit
  9. Productivity in the National Health Service By Peter Hart
  10. Measuring the Welfare Effect of Entry in Differentiated Product Markets: The Case of Medicare HMOs By Shiko Maruyama

  1. By: Han Bleichrodt (Erasmus University of Rotterdam); Jose Luis Pinto-Prades (Centro de Estudios Andaluces)
    Abstract: A central assumption in health utility measurement is that preferences are invariant to the elicitation method that is used. This assumptioin is challenged by preferences reversals. Previous studies have observed prefrence resersals between choise and matching tasks and between choise and ranking tasks. We present a new preference reversal that entirely choise-based. Because choise is the basic primitive of economics and utility theory, this preference reversal is more fundamental and troubling. The preference reversal was observed in two studies regarding health states after stroke. Both studies involved large representative samples from the Spanish population, interwied professionally and face-to-face. Possible explanations for the preference reversal are the anticipation of disappointment and elation is risky choise anda the impact of ethical co0nsiderations about the value of live.
    Keywords: Health utility measurement, preference reversal, choice behavior
    JEL: D81 L10
    Date: 2007
  2. By: Ramses H. Abul Naga; Tarik Yalcin
    Abstract: When health status is an ordered response variable, Allison and Foster (2004)postulate that a distribution Q ?exhibits more inequality than a distribution P ?if Q ?isobtained from P ?via a sequence of median preserving spreads. This paper introduces aparametric family of inequality indices which are founded on the Allison and Fosterordering.
    Keywords: Self-reported health status, inequality orderings, inequalitymeasures.
    Date: 2007–06
  3. By: Andersson, Henrik (VTI); Treich, Nicolas (Toulouse School of Economics (INRA, LERNA))
    Abstract: This paper on the value of a statistical life (VSL) has been prepared for the Handbook in Transport Economics, edited by André de Palma, Robin Lindsey, Emile Quinet and Roger Vickerman. The paper's first objective is to survey some classical theoretical and empirical findings in the VSL literature; but it also attempts to clarify some of these issues often raised by the application of the WTP approach to study of mortality risks.
    Keywords: Mortality Risk; Transport; Value of a Statistical Life; Willingness to Pay
    JEL: D61 D81 I10 Q51
    Date: 2008–01–25
  4. By: Jonathan Gruber
    Abstract: One of the major social policy issues facing the U.S. in the first decade of the 21st century is the large number of Americans lacking health insurance. This article surveys the major economic issues around covering the uninsured. I review the facts on insurance coverage and the nature of the uninsured; focus on explanations for why the U.S. has such a large, and growing, uninsured population; and discuss why we should care if individuals are uninsured. I then focus on policy options to address the problem of the uninsured, beginning with a discussion of the key issues and available evidence, and then turning to estimates from a micro-simulation model of the impact of alternative interventions to increase insurance coverage.
    JEL: H1 I1
    Date: 2008–01
  5. By: Montefiori, Marcello; Resta, Marina
    Abstract: This work is intended to analyze the market for health care through a computational approach based on unsupervised neural networks. The paper provides a theoretical framework for a computational model that relies on Kohonen's self organizing maps (SOM), arranged into two layers: in the upper layer the competition dynamics of health care providers is modelled, whereas in the lower level patients behaviour is monitored. Interactions take place both vertically between the layers (in a bi–directional way), and horizontally, inside each level, exploiting neighbourhood features of SOM: signals move vertically from hospitals to patients and vice-versa, but they also spread out sideward, from patient to patient, and from hospital to hospital. The result is a new approach addressing the issue of hospital behaviour and demand mechanism modelling, which conjugates a robust theoretical implementation together with an instrument of deep graphical impact.
    Keywords: self organizing maps; health market; adaptive behaviour; incomplete information; mixed market
    JEL: I18 C60
    Date: 2008–01
  6. By: Justesen , Michael
    Abstract: Risk and protective factors influence behaviors and outcomes for youth. While risk factors expose youth to risk-taking behavior that compromises well-being and hinders personal development, protective factors mediate risk and act as protective mechanisms that insulate youth from negative outcomes. This paper groups youth by risk levels using a cluster analysis methodology, and identifies the risk and protective factors that characterize these groups. Using data from a new household survey co vering youth in four urban areas of Argentina in 2005, youth are clustered by characteristics in relation to family and health, education and income, substance abuse, and crime and violence as indicators of risk and protective factors, and behaviors and consequences. Almost half of Argentine youth are at an elevated risk level, and one in four is at serious risk of experiencing negative outcomes or already suffering the consequences. The findings show, for example, that higher income protects against risk factors, such as an insecure neighborhood, and facilitates youth attending school. Furthermore, parents ' lack of education is negatively related to the behaviors and outcomes of their children.
    Keywords: Adolescent Health,Youth and Governance,Gender and Health,Population Policies,Housing & Human Habitats
    Date: 2008–01–01
  7. By: Friedman, Jed; Do, Quy-Toan; Das, Jishnu
    Abstract: The social and economic consequences of poor mental health in the developing world are presumed to be significant, yet are largely under-researched. The authors argue that mental health modules can be meaningfully added to multi-purpose household surveys in developing countries, and used to investigate this relationship. Data from nationally representative surveys in Bosnia and Herzegovina, Indonesia, and Mexico, along with special surveys from India and Tonga, show similar patterns of association between mental health and socioeconomic characteristics across countries. Individuals who are older, female, widowed, and report poor physical health are more likely to report worse mental health outcomes. Individuals living with others with poor mental health are also significantly more likely to report worse mental health themselves. In contrast, there is little observed relationship between mental health and poverty or education, common measures of socio-economic status. The results instead suggest that economic and multi-dimensional shocks such as illness or crisis can have a greater impact on mental health than overall levels of poverty. This may have important implications for social protection policy. The authors also find significant associations between poor mental health and lowered labor force participation (especially for women) and higher frequency visits to health centers, suggesting that poor mental health can have significant economic consequences for households and the health system. Finally, the paper discusses how measures of mental health are distinct from general subjective welfare measures such as happiness and indicate useful directions of future research.
    Keywords: Health Monitoring & Evaluation,Disease Control & Prevention,Gender and Health,Health Systems Development & Reform,Mental Health
    Date: 2008–01–01
  8. By: Coneus, Katja; Goeggel, Kathrin; Muehler, Grit
    Abstract: When estimating the determinants of child care participation, the simultaneity in mothers' decision to work and in the decision to use child care is a major challenge. In this study, we provide evidence on the determinants of institutional child care use accounting for the endogeneity of mothers' labor supply by applying an instrumental variables approach. This endogeneity has been neglected in studies on this issue so far, even though the decision to use child care outside the home is strongly connected to mothers' decision to work after childbirth and vice versa. Based on the German Socio-economic Panel (GSOEP) from 1989{2006 we show that children living in Western Germany have a higher probability to attend institutional care if their mothers increase their actual weekly working time. Estimating the determining factors of child care participation without correcting for simultaneity underestimates the influence of maternal working time by more than a half.
    Keywords: child care choice, kindergarten attendance, maternal employment
    JEL: I21 J13 J22
    Date: 2007
  9. By: Peter Hart (Centre for Institutional Performance, Department of Economics, University of Reading Business School)
    Date: 2007
  10. By: Shiko Maruyama (School of Economics, The University of New South Wales)
    Abstract: Should governments subsidize entry to promote competition? In general, theory models cannot determine whether entry under the free-entry condition is socially excessive, optimal, or insufficient. In this paper I propose an empirical framework to evaluate welfare consequences of policy intervention through entry in differentiated product markets, with a case study of the US Medicare HMO market. In endogenizing firms' entry-exit decision, a technical breakthrough is to explicitly incorporate firm heterogeneity by employing a sequential move game. This enables us to exploit detailed firm level data and makes policy simulations relevant. I find no evidence of socially excessive entry. The government may achieve higher social welfare by expanding the program.
    Date: 2008–01

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