nep-hea New Economics Papers
on Health Economics
Issue of 2009‒02‒07
ten papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Estimates of patient costs related with population morbidity: can indirect costs affect the results? By M. Carreras; Manuel García-Goñi; Pere Ibern; J. Coderch; L. Vall-Llosera; José María Inoriza
  2. Hybrid Risk Adjustment for Pharmaceutical Benefits By Manuel García-Goñi; Pere Ibern; José María Inoriza
  3. The age separating early deaths from late deaths By Zhen Zhang; James W. Vaupel
  4. Public Governance, Health and Foreign Direct Investment in Sub-Saharan Africa By Céline Azémar; Rodolphe Desbordes
  5. The Production of Child Health in Kenya: A Structural Model of Birth Weight By Mwabu, Germano
  6. Healthy school meals and Educational Outcomes By Belot M; James J
  7. Health Risk Analysis of Heating Fuel Choice: Case Study in Kentucky By Liu, Zheng; Pagoulatos, Angelos; Hu, Wuyang
  8. Obesity, BMI, and Diet Quality: How does the South Measure Up? By Duffy, Patricia; Zizza, Claire; Kinnucan, Henry
  9. Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya By Pascaline Dupas
  10. Price Variation in Markets with Homogeneous Goods: The Case of Medigap By Nicole Maestas; Mathis Schroeder; Dana Goldman

  1. By: M. Carreras; Manuel García-Goñi; Pere Ibern; J. Coderch; L. Vall-Llosera; José María Inoriza
    Abstract: A number of health economics works require patient cost estimates as a basic information input. However the accuracy of cost estimates remains in general unspecified. We propose to investigate how the allocation of indirect costs or overheads can affect the estimation of patient costs in order to allow for improvements in the analysis of patient costs estimates. Instead of focusing on the costing method, this paper proposes to highlight changes in variance explained observed when a methodology is chosen. We compare three overhead allocation methods for a specific Spanish population adjusted using the Clinical Risk Groups (CRG), and we obtain different series of full-cost group estimates. As a result, there are significant gains in the proportion of the variance explained, depending upon the methodology used. Furthermore, we find that the global amount of variation explained by risk adjustment models depends mainly on direct costs and is independent of the level of aggregation used in the classification system.
    Keywords: Patient costs, Clinical Risk Groups, Variation explained, Overhead allocation
    JEL: B41 D24 I11
    Date: 2009–01
  2. By: Manuel García-Goñi; Pere Ibern; José María Inoriza
    Abstract: This paper analyses the application of hybrid risk adjustment versus either prospective or concurrent risk adjustment formulae in the context of funding pharmaceutical benefits for the population of an integrated healthcare delivery organization in Catalonia during years 2002 and 2003. We apply a mixed formula and find that a hybrid risk adjustment model increases incentives for efficiency in the provision of low risk individuals at health organizations not only as a whole but also at each internal department compared to only prospective models by reducing within-group variation of drug expenditures.
    Keywords: Drug expenditure, hybrid risk-adjustment, morbidity, clinical risk groups
    JEL: I18
    Date: 2009–01
  3. By: Zhen Zhang (Max Planck Institute for Demographic Research, Rostock, Germany); James W. Vaupel (Max Planck Institute for Demographic Research, Rostock, Germany)
    Abstract: There is one unique age separating early deaths from late deaths such that averting an early death decreases life disparity, but averting a late death increases inequality in lifespans.
    Keywords: World, mortality
    JEL: J1 Z0
    Date: 2009–01
  4. By: Céline Azémar; Rodolphe Desbordes
    Abstract: Using 1985-2004 yearly panel data for 70 developing countries, including 28 from Sub-Saharan Africa (SSA), the paper finds that once market size is accounted for, SSA's FDI deficit with other regions of the world is mainly explained by the insufficient provision of public goods: relatively low human capital accumulation, in terms of education and health in SSA. Based on additional cross-sectional data, the paper finds that in the absence of HIV and malaria, net FDI inflows in the median SSA country could have been one-third higher during 2000-2004, with slightly more than one-half of this deficit explained by malaria.
    Keywords: Public Governance, Foreign Direct Investment, Health
    JEL: F21
    Date: 2008–05
  5. By: Mwabu, Germano (U of Kenya)
    Abstract: The paper investigates birth weight and its correlates in Kenya using nationally representative data collected by the government in the early 1990s. I find that immunization of the mother against tetanus during pregnancy is strongly associated with improvements in birth weight. Other factors significantly correlated with birth weight include age of the mother at first birth and birth orders of siblings. It is further found that birth weight is positively associated with mother's age at first birth and with higher birth orders, with the first born child being substantially lighter than subsequent children. Newborn infants are heavier in urban than in rural areas and females are born lighter than males. There is evidence suggesting that a baby born at the clinic is heavier than a newborn baby drawn randomly from the general population.
    JEL: C31 C34 I11 I12 J13
    Date: 2008–06
  6. By: Belot M (Department of Economics, University of Essex); James J (Department of Economics, University of Essex)
    Abstract: This paper uses the "Jamie Oliver Feed Me Better" campaign to evaluate the impact of healthy school meals on educational outcomes. The campaign introduced drastic changes in the meals offered in the schools of one Borough, shifting from low-budget processed meals towards healthier options. We evaluate the effect of the campaign on educational outcomes using a difference in differences approach; comparing key stage 2 outcomes in primary schools before and after the reform, using the neighbouring Local Education Authorities as a control group. We find evidence that healthy school meals did improve educational outcomes, in particular in English and Science.
    Date: 2009–01–28
  7. By: Liu, Zheng; Pagoulatos, Angelos; Hu, Wuyang
    Abstract: Combustion-generated pollutants, principally those from solid-fuel including biomass and coal when cooking and heating, bring out a significant public health hazard predominantly affecting poor rural and urban communities in both developed and developing countries. Most of the studies that have been or are currently being performed on the health effects of indoor air pollution from solid fuel combustion focus on developing countries, and on exposure when cooking rather than heating. By using the Kentucky home-place health survey data, this research explore the exposure-response relationship between polluting heating option (such as coal, wood, kerosene)and some specific disease (respiratory disease, asthma and allergy). Logit model was used to get the estimation results. The results indicate that using polluting heating fuel increases the odds of suffering from respiratory disease although this positive effect is not significantly strong. Strong evidence from this study showed that the people with asthma or allergy are less likely to choose polluting heating and using coal as heating fuel has significant positive effect on the prevalence of respiratory disease. Some demographic, socioeconomic and lifestyle characteristics such as gender, race, smoke, exercise do have significant effect on the prevalence of the three diseases.
    Keywords: Combustion-generated pollutants, indoor air pollution, heating fuel choice, exposure-response relationship, Environmental Economics and Policy, Health Economics and Policy,
    Date: 2009
  8. By: Duffy, Patricia; Zizza, Claire; Kinnucan, Henry
    Abstract: This paper examines regional differences in obesity rates, Body Mass Index (BMI) and dietary quality, using data from the1999-2002 National Health and Nutrition Eamination Survey (NHANES), Mobile Examination Center (MEC). For women, BMI and obesity prevalence may be higher in the Deep South states, but the difference is explained by demographic characteristics. Diet quality was found to be lower in the South.
    Keywords: obesity, diet quality, food insecurity, Food Consumption/Nutrition/Food Safety, Health Economics and Policy, I10, I30,
    Date: 2009
  9. By: Pascaline Dupas
    Abstract: I use a randomized experiment to test whether information can change sexual behavior among teenagers in Kenya. Providing information on the relative risk of HIV infection by partner's age led to a 28% decrease in teen pregnancy, an objective proxy for the incidence of unprotected sex. Self-reported sexual behavior data suggests substitution away from older (riskier) partners and towards protected sex with same-age partners. In contrast, the national abstinence-only HIV education curriculum had no impact on teen pregnancy. These results suggest that teenagers are responsive to risk information but their sexual behavior is more elastic on the intensive than on the extensive margin.
    JEL: C93 I1 O12
    Date: 2009–02
  10. By: Nicole Maestas; Mathis Schroeder; Dana Goldman
    Abstract: Nearly 30 percent of Americans age 65 and older supplement their Medicare health insurance through the Medigap private insurance market. We show that prices for Medigap policies vary widely, despite the fact that all plans are standardized, and even after controlling for firm heterogeneity. Economic theory suggests that heterogeneous consumer search costs can lead to a non-degenerate price distribution within a market for otherwise homogenous goods. Using a structural model of equilibrium search costs first posed by Carlson and McAfee (1983), we estimate average search costs to be $72. We argue that information problems arise from the complexity of the insurance product and lead individuals to rely on insurance agents who do not necessarily guide them to the lowest prices.
    JEL: I2
    Date: 2009–01

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