nep-hea New Economics Papers
on Health Economics
Issue of 2010‒05‒02
fourteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Health Care and Health Outcomes of Migrants: Evidence from Portugal By Pedro Pita Barros; Isabel Medalho Pereira
  2. A comparison of ten principal component methods for forecasting mortality rates By Han Lin Shang; Rob J Hyndman; Heather Booth
  3. The Impact of Violent Conflict on Child Health: What Are the Channels? By Philip Verwimp; Tom Bundervoet
  4. Evaluating Nationwide Health Interventions When Standard Before-After Doesn’t Work: Malawi's ITN Distribution Program By Deuchert, Eva; Wunsch, Conny
  5. Mental Health and Labour Market Participation: Evidence from IV Panel Data Models By Frijters, Paul; Johnston, David W.; Shields, Michael A.
  6. Does Fiscal Discipline towards Sub-national Governments Affect Citizens’ Well-being? Evidence on Health By Massimiliano Piacenza; Gilberto Turati
  7. Decrease in the healthcare demand in rural China: A side effect of the industrialization process? By Carine Milcent; Feng Jim
  8. Risk and Rationalization – The role of affect and cognitive dissonance for sexual risk taking By Mannberg, Andréa
  9. Economic Transition and Health Care Reform: The Experience of Europe and Central Asia By Adam Leive
  10. Estimates of Survival and Mortality from Successive Cross-Sectional Surveys By Smith D; Mcfall S; Bradshaw B
  11. Can the Health Insurance Reforms stop an increase in medical costs of middle- and old-aged persons in Japan? By Tamie Matsuura; Masaru Sasaki
  12. Interrelations between Education, Health, Income and Economic Development in Europe with Emphasis on New Members of European Union By Boboc, Cristina; Driouchi, Ahmed; Titan, Emilia
  13. Managing infectious diseases over connected populations: a non-convex optimal control By Ceddia, M Graziano
  14. A Profile of Obesity in Ireland, 2002-2007 By David Madden

  1. By: Pedro Pita Barros (Department of the Universidade Nova de Lisboa (Portugal)); Isabel Medalho Pereira (Human Development Report Office (UNDP))
    Abstract: This paper studies the performance of immigrants relative to natives, in terms of their health status, use of health care services, lifestyles, and coverage of health expenditures. We base the analysis on international evidence that identified a healthy immigrant effect, complemented by empirical research on the Portuguese National Health Survey. Furthermore, we assess whether differences in health performance depend on the personal characteristics of the individuals or can be directly associated with their migration experience.
    Keywords: Migration, health status, health care, healthy immigrant effect, Portugal
    JEL: O1 O15 C3 C33 F22
    Date: 2009–07
  2. By: Han Lin Shang; Rob J Hyndman; Heather Booth
    Abstract: Using the age- and sex-specific data of 14 developed countries, we compare the short- to medium-term accuracy of ten principal component methods for forecasting mortality rates and life expectancy. These ten methods include the Lee-Carter method and many of its variants and extensions. For forecasting mortality rates, the weighted Hyndman-Ullah method provides the most accurate point forecasts, while the Lee-Miller method gives the best point forecast accuracy of life expectancy. Furthermore, the weighted Hyndman-Ullah method provides the most accurate interval forecasts of mortality rates, while the robust Hyndman-Ullah method provides the best interval forecast accuracy of life expectancy.
    Keywords: Mortality forecasting, life expectancy forecasting, principal component methods, Lee-Carter method, interval forecasts, forecasting time series
    JEL: C14 C23
    Date: 2010–04–09
  3. By: Philip Verwimp (University of Antwerp); Tom Bundervoet (Vrije Universiteit Brussel)
    Abstract: Child health during and after violent conflicts has been a priority for both policymakers and academics, as ill-health in early life can be impossible to make up for in later life, and has important effects on education and adult wages. In order for policy interventions to mitigate health impacts, it is essential to understand the channels through which conflict impacts on child health. This briefing uses empirical results of research in Burundi and Rwanda to identify these channels. It outlines the policy implications of these findings, arguing that policymakers should prioritise interventions to rebuild agricultural capacity and improve sanitation conditions and nutrition in displacement camps.
    Keywords: violent conflict; child health; Burundi; Rwanda; policy
    JEL: C78 D72 D74 D83
    Date: 2010
  4. By: Deuchert, Eva (University of St. Gallen); Wunsch, Conny (University of St. Gallen)
    Abstract: Nationwide health interventions are difficult to evaluate as contemporaneous control groups do not exist and before-after approaches are usually infeasible. We propose an alternative semi-parametric estimator that is based on the assumption that the intervention has no direct effect on the health outcome but influences the outcome only through its effect on individual behavior. We show that in this case the evaluation problem can be divided into two parts: (i) the effect of the intervention on behavior, for which a conditional before-after assumption is more plausible; and (ii) the effect of the behavior on the health outcome, where we exploit that a contemporaneous control groups exists for behavior. The proposed estimator is used to evaluate one of Malawi's main malaria prevention campaigns, a nationwide insecticide-treated-net (ITN) distribution scheme, in terms of its effect on infant mortality. We exploit that the program affects child mortality only via bed net usage. We find that Malawi's ITN distribution campaign reduced child mortality by 1 percentage point, which corresponds to about 30% of the total reduction in infant mortality over the study period.
    Keywords: treatment effect, semi-parametric estimation, health intervention
    JEL: C14 C21 I18
    Date: 2010–04
  5. By: Frijters, Paul (University of Queensland); Johnston, David W. (Queensland University of Technology); Shields, Michael A. (University of Melbourne)
    Abstract: A large body of empirical research links mental health and labour market outcomes; however, there are few studies that effectively control for the two-way causality between work and health and the existence of unobserved individual characteristics that might jointly determine health and labour market outcomes. In this study, we estimate the effect of mental health on labour market participation using various models, including instrumental variable models that exploit individual variation observed in panel data. We find robust evidence that a reduction in mental health has a substantial negative impact on the probability of actively participating in the labour market. We calculate that a one standard deviation decrease in mental health decreases the probability of participation by around 17 percentage points. This effect is larger for females and for older individuals. We therefore provide robust evidence that there are substantial costs due to the lost productivity resulting from poor mental health.
    Keywords: measurement error, mental health, labour market participation, causality
    JEL: I10 J21 J22
    Date: 2010–04
  6. By: Massimiliano Piacenza (Department of Economics and Public Finance "G. Prato", University of Torino); Gilberto Turati (Department of Economics and Public Finance "G. Prato", University of Torino)
    Abstract: This paper aims at assessing the impact of fiscal discipline towards sub-national governments on citizens’ well-being. We model fiscal discipline by considering the expectations of deficit bailouts by Central Government, and focus on a particular dimension of well-being, namely health outcomes at the regional level. We study then how bailout expectations affect the expenditure for health care policies carried out by Regional Governments: in the presence of opportunistic behaviours by local governments – induced by soft budget constraints – bailout expectations should affect only spending inefficiency, and should not have any real effects on citizens’ health. To investigate this issue, we model the efficient use of public resources for health care delivery as an input requirement frontier, and assess the effects of bailout expectations on both the structural component of health spending and its deviations from the best practice. The evidence from a sample of 15 Italian Regions observed from 1993 to 2006 highlights that bailout expectations do not significantly influence the position of the frontier, thus do not affect citizens’ health. However, they appear to exert a remarkable impact on excess spending.
    Keywords: Intergovernmental relationships, Soft budget constraint, Bailout expectations, Health care policy, Spending efficiency
    JEL: H51 H77 I12 I18
    Date: 2010–04
  7. By: Carine Milcent; Feng Jim
    Abstract: In China, with the economic reforms leading to the raise in agricultural productivity, the rural healthcare organisation has been weakened. In a 1991-2006 database, a decrease in the healthcare demand is observed. If many papers study the effect of the insurance system (NCMS) on the healthcare demand, other factors explaining the healthcare demand have not received much research attention yet. We use a matching and difference in difference model to correct for the selection bias on insurance effect. If the income level and insurance enrollment plays a major role on the healthcare demand, we shed light on the peer effect of the industrialization process and the changes affecting healthcare facilities. In a context of healthcare price widely increasing, the change in villagers working activity leads to an increase in the inequality of healthcare access (due to inequality of wage, mobility, and private insurance). The result is a reduction and sometimes worse, an exclusion from the healthcare access for the poorest. A public policy has to be conducted to support farmers, in particular in areas where a significant part of the village inhabitants have an industrial activity.
    Date: 2010
  8. By: Mannberg, Andréa (Department of Economics, Umeå University)
    Abstract: This paper analyzes the mechanisms underlying excessive sexual risk taking in the presence of HIV. Drawing ideas from psychology on decision-making processes and risk evaluation, a theoretical model interacting affect-induced myopia and cognitive dissonance is developed and analyzed. The results of the theoretical analysis suggest that the effect of rationalization of personal risk depends on the risk of being HIV positive. Although rationalization causes excessive risk taking behavior for individuals with a relatively low lifetime risk, it may prevent fatalism among individuals whose lifetime risk of HIV is perceived as overwhelming.
    Keywords: HIV/AIDS; Self-control; Time inconsistency; Dissonance theory; Regret
    JEL: D81 D84 D91 I12
    Date: 2010–04–21
  9. By: Adam Leive
    Abstract: Economic Transition and Health Care Reform: The Experience of Europe and Central Asia
    Keywords: Central Asia , Cross country analysis , Economic models , Economic reforms , Europe , Government expenditures , Health care , Statistics , Transition economies ,
    Date: 2010–03–24
  10. By: Smith D (London School of Hygiene and Tropical Medicine); Mcfall S (Institute for Social and Economic Research); Bradshaw B (University of Texas School of Public Health)
    Abstract: Survival ratios and death rates for chronic conditions can be estimated from successive, cross-sectional surveys when the condition and the age of onset are obtained. Survival ratios use the estimated population in the first survey period as the denominator and the estimated number of survivors at a later survey period as the numerator. These ratios have independent numerators and denominators and their variance estimates are a modification of the usual formulas. We illustrate the method by estimating annual death rates and their standard errors among diabetics in the United States.
    Date: 2010–04–27
  11. By: Tamie Matsuura (NLI Research Institute); Masaru Sasaki (ISER, Osaka University)
    Abstract: Using two-period panel data from the Nippon Life Insurance Research Institute, this paper tests the hypothesis that an increase in the self-pay ratio of medical expenditures associated with the Japanese health insurance reforms of April 2003 reduced individual medical costs. We find that the increase in the self-pay ratio of medical expenditures has a trivial effect on household medical expenses, implying that a decrease in the quantity demanded for medical services offsets the increase in medical costs. However, according to quantile regression estimates, an increase in the self-pay ratio of medical expenditures has a significantly positive effect on the share of medical costs for relatively high quantile values. This provides corroborating evidence that an increase in the self-pay ratio cannot cut the demand for medical services relatively more for those bearing a higher share of medical costs in household expenditure. An additional finding is that medical services are a necessity good, particularly for those with a relatively high share of medical costs in household expenditure.
    Keywords: health insurance, medical costs, Engle curve, middle- and old-aged persons, Japan
    JEL: I11 I18
    Date: 2010–04
  12. By: Boboc, Cristina; Driouchi, Ahmed; Titan, Emilia
    Abstract: This study looks at how health, education, and economic development are inter-related in the case of Europe. Factorial analyses besides econometric models, implemented on a panel data from EUROSTAT show that the included variables are interrelated. The new members of the European Union are found to be investing in education, research and development and health care. Furthermore, they have high economic growth and high improvements in education and health state indicators. However, the instability and economic risks that have appeared during the transition process do affect the level of social protection. The existing social protection system increases poverty rates and slows the convergence towards developed economies. Two main directions for enhancing human development in EU new member economies are identified. They include the strengthening of the social protection system to target the vulnerable members affected by the transition process besides increasing expenditure on research and development.
    Keywords: Interdependencies; Health; Education; Economic Development
    JEL: D31
    Date: 2010–01–19
  13. By: Ceddia, M Graziano
    Abstract: The paper develops an optimal control model to analyse various management options for infectious diseases that occur in metapopulations, under both Nash and cooperative behaviour. As pathogens are renewable resources with negative value, the problem may be non-convex. Since the disease can be transmitted across various connected populations, externalities are involved. Both aspects deserve attention as two issues arise: a) is eradication of the disease in finite time preferable to indefinite treatment? b) are cooperative solutions well-behaved? The problem is solved numerically and the results indicate that while eradication is likely to be an optimal strategy when initial levels of infections are relatively low, the internalisation of between-population externalities (as indicated by the first order necessary conditions of the cooperative optimal control problem) might not always be possible. Also, ignoring these two aspects can lead to inadequate policy design.
    Keywords: infectious diseases; metapopulation; non-convexities; optimal control
    JEL: C71 Q28 C02 C61 H00 C72
    Date: 2010
  14. By: David Madden (University College Dublin)
    Abstract: Using the nationally representative Slan dataset we take a number of approaches to profile the change in obesity in Ireland over the 2002-2007 period. There is no evidence of either first or second order stochastic dominance between the two years. There is evidence that obesity and overweight are relatively more concentrated amongst males, the old and those with lower educational achievement. While obesity rose slightly over the period this was due to a rise in the average level of body mass index rather than a change in the shape of the distribution. Finally a semi-parametric decomposition of the change in the distribution over time indicates that the change in obesity arose not because of changes in population characteristics but rather the in the impact of these characteristics on body mass index.
    Keywords: Obesity, Body Mass Index, Decomposition
    JEL: I12 I31 I32
    Date: 2010–04–21

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