nep-hea New Economics Papers
on Health Economics
Issue of 2010‒06‒11
eleven papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Asthma Medication Use and Air Pollution in California: A Cross-Sectional Analysis By Charles Griffiths; Nathalie B. Simon; Tracey J. Woodruff
  2. An Integrative Model of the Management of Hospital Physician Relationships By J. TRYBOU; P. GEMMEL; L. ANNEMANS;
  3. Equivalent income and the economic evaluation of health care By FLEURBAYE, Marc; LUCHINI, StŽphane; MULLER, Christophe; SCHOKKAERT, Eric
  4. Health Status and the Allocation of Time By Melinda Podor; Timothy Halliday
  6. HIV Counselling, Testing And Referrel Services in Mental Health Care Settings in Kolkata- A Provider Perspective By Arupkumar Chakrabartty
  7. Reproductive Health Practices And Health Seeking Behaviour Of Female Sex Workers in Tamil Nadu By Rachna Williams
  8. A Time-Series Analysis of U.S. Kidney Transplantation and the Waiting List: Donor Substitution Effects and "Dirty Altruism" By T. Randolph Beard; John D. Jackson; David Kaserman; Hyeongwoo Kim
  9. Analysing Catastrophic OOP Health Expenditure in India: Concepts, Determinants and Policy Implications By Rama Pal
  10. Who is responsible for your health: You, your doctor or new technologies? By Vincenzo Atella; Francesco D'Amico
  11. "Toward True Health Care Reform-- More Care, Less Insurance" By Marshall Auerback; L. Randall Wray

  1. By: Charles Griffiths; Nathalie B. Simon; Tracey J. Woodruff
    Abstract: In this study, we examine the effects of chronic exposure to air pollution on asthma exacerbation through a cross-sectional analysis of asthma prescriptions for quick-relief medications at the 5 digit zip code level in California. Using information on the use of maintenance therapies by each patient, we are able to stratify our data by asthma severity as well as by age. In general, we find a positive relationship between asthma and both PM10 and ozone levels. We find that prescriptions for quick-acting inhalers for children increases with PM10, and this relationship generally does not level off effect except for mild intermittent asthmatics. Ozone also generally increases the number of prescriptions for ages 5 through 17, as well as for severe asthmatics and some moderate asthmatics at younger ages. However, prescriptions and ozone show the opposite relationship for the adults and the very young (ages 0-4).
    Keywords: asthma, air pollution
    Date: 2009–10
    Abstract: Hospital Physician Relationships (HPRs) are of major importance to the health care sector. Drawing on agency theory and social exchange theory, we argue that both economic and noneconomic integration strategies are important to effective management of HPRs. We developed a model of related antecedents and outcomes and conducted a systematic review to assess the evidence base of both integration strategies and their interplay. We found that more emphasis should be placed on financial risk sharing, trust and physician organizational commitment.
    Date: 2010–04
  3. By: FLEURBAYE, Marc (UniversitŽ Paris-Descartes, CERSES, France; UniversitŽ catholique de Louvain, CORE, B-1348 Louvain- la-Neuve, Belgium); LUCHINI, StŽphane (CNRS, GREQAM and IDEP, France); MULLER, Christophe (DEFI, University of MŽditerranŽe, France); SCHOKKAERT, Eric (Department of Economics, Katholieke Universiteit Leuven and UniversitŽ catholique de Louvain, CORE, B-1348 Louvain-la-Neuve, Belgium)
    Abstract: We argue that the economic evaluation of health care (cost-benefit analysis) should respect individual preferences and should incorporate distributional consid- erations. Relying on individual preferences does not imply subjective welfarism. We propose a particular non- welfarist approach, based on the concept of equivalent income, and show how it helps to define distributional weights. We illustrate the feasibility of our approach with empirical results from a pilot survey.
    Keywords: cost-benefit analysis, cost-effectiveness analysis, willingness-to-pay, social welfare function, equivalent income
    JEL: D63 H21 H51 I18
    Date: 2010–01–01
  4. By: Melinda Podor (University of Hawaii, Department of Economics); Timothy Halliday (University of Hawaii, Department of Economics; Institute for the Study of Labor (IZA))
    Abstract: We consider the relationship between health and time allocation. Better health is associated with more time allocated towards production on the market and at home, but less consumption of leisure. This suggests that health exerts large effects on market productivity, but larger effects on non-market productivity. These responses are higher for single people than for married people, perhaps reflecting a lack of market substitutes for the time of married people.
    Keywords: Labor supply, Time Allocation, Health, Home Production
    JEL: I1 J2
    Date: 2010–05–27
  5. By: Azza El-Shinnawy (Microsoft Education, Dubai)
    Abstract: In this paper, trends in total factor productivity (TFP) growth in 13 of Egypt's largest and oldest pharmaceutical generics firms are examined. The paper relies on data envelopment analysis (DEA) the non-parametric frontier methodology to obtain the Malmquist productivity index for the sample firms, which account for 50% of Egypt's generics market. The study period ranges from 1993 to 2005. Best-practice firms and laggard firms in the three aspects of efficiency change, technical change and TFP change are identified. Empirical results indicate the best-practice firm in terms of TFP change belongs to the private sector, while the laggard firm belongs to the state-owned public business sector. No differences of significance exist between the performance of private sector and state-owned generics companies. Additionally, state-owned companies which have been subject to partial privatization did not exhibit higher levels of TFP change than those which remained under full state-ownership. Empirical results also indicated that mean TFP change for the sample firms throughout the study period (1.01) exceeded the mean TFP change for all Egyptian industries (0.75), and that there was evident disassociation, or weak correlation at best, between productivity growth/regress and the degree of export orientation.
    Date: 2010–05
  6. By: Arupkumar Chakrabartty
    Abstract: This paper assess the adherence of and barriers to HIV counselling, testing and referral services on the part of the providers.[Working Paper No. 9]
    Keywords: HIV, AIDS, public health, complexities, Testing, Referral services, Sexual Activity,Successful intervention, Ethical Conflicts, controversial issues, client participation
    Date: 2010
  7. By: Rachna Williams
    Abstract: This paper is about the research study of health practices and health-seeking behaviour of the Female Sex Workers for their reproductive health needs in terms of pregnancy and postpartum care, contraception, abortion, menstrual hygiene and gynecological morbidity.[Working Paper No.12]
    Keywords: Female, Sex Workers, reproductive health, pregnancy, postpartum care, contraception, abortion, menstrual hygiene, gynecological, Rameshwaram, Tirunelveli, vaginal discharge, urinary tract infections,
    Date: 2010
  8. By: T. Randolph Beard; John D. Jackson; David Kaserman; Hyeongwoo Kim
    Abstract: This paper provides an econometric analysis of the relationship between live and deceased (cadaveric) kidney donations for the United States for the period 1992:IV through 2006:II. We find strong evidence for deceased donor kidneys "crowding out" living donations, potentially undermining conventional efforts to reduce the shortage. We also find evidence for the "dirty altruism" hypothesis of Osterkamp (2006), in which heavy reliance on living donors undermines cadaveric donor transplants.
    Keywords: Kidney Transplantations, Donor Substitution Effects, Dirty Altruism, Cointegration, Vector Error Correction Model
    JEL: I18 I19
    Date: 2010–04
  9. By: Rama Pal (Indira Gandhi Institute of Development Research)
    Abstract: The present paper attempts to modify definition of catastrophic out-of-pocket health expenditure by characterising it based on consumption of necessities. In literature, catastrophic expenditure is defined as that level of OOP health expenditure which exceeds some fixed proportion of household income or household’s capacity to pay. In the present paper, catastrophic health expenditure is defined as one which reduces the non-health expenditure to a level where household is unable to maintain consumption of necessities. Based on this definition of catastrophic health expenditure, the paper examines determinants of catastrophic OOP health expenditure in India. Findings suggest that it is important to carefully revise the concept of catastrophic health care spending and the method developed in this paper can be considered as one of the possible alternatives. We find that education is one of the important policy instruments that can be used to reduce incidence of catastrophic spending in India. The findings also suggest that even after efforts to reduce differences among various social classes in India, socially deprived classes are still vulnerable as they are more likely to experience financial catastrophe due to illness.
    Keywords: Catastrophic health expenditure; Consumption of Necessities; India
    JEL: I12 I19
    Date: 2010
  10. By: Vincenzo Atella (Faculty of Economics, University of Rome "Tor Vergata"); Francesco D'Amico (Faculty of Economics, University of Rome "Tor Vergata")
    Abstract: The aim of the paper is to disentangle the roles that patients, physicians and technology can have on patient health outcomes using a large and detailed dataset of Italian patients collected by the Italian College of General Practitioners (SIMG) over the period 2001–2006. As our data show the existence of heterogeneity in the time needed to reach an optimal level of health stock, we study this measure of health outcome rather than simply the level of health stock. Limiting our analysis to patients suffering from hypercholesterolemia, the empirical work is based on two different analyses. We first explore whether patients recovering faster exhibit lower hospitalization rates and then we study the determinants of the speed of recovery to a good health status. The results confirm that a 10% increase in the speed of recovery can reduce hospitalization rates by about 1.0%. Furthermore, we show that recovering to a good health status is a multifaceted phenomenon, with technology explaining at best 62% of the combined effect, while patient and physician behaviors share the residual effect. These results are then discussed in terms of policy.
    Keywords: Health outcomes, Technical progress, Physician behavior
    JEL: I12 O31 O33
    Date: 2010–05–28
  11. By: Marshall Auerback; L. Randall Wray
    Abstract: The United States has the most expensive health care system in the world, yet its system produces inferior outcomes relative to those in other countries. This brief examines the health care reform debate, and argues that the basic structure of the health care system is unlikely to change, because "reform" measures actually promote the status quo. The authors believe that the fundamental problem facing the U.S. health care system is the unhealthy lifestyle of many Americans. They prefer to see a reduced role for private insurers and an increased role for government funding, along with greater public discussion of environmental and lifestyle factors. A Medicare buy-in ("public option") for people under 65 would provide more cost control (by competing with private insurance), help to solve the problem of treatment denial based on preexisting conditions, expand the risk pool of patients, and enhance the global competitiveness of U.S. corporations--thus bringing the U.S. health care system closer to the "ideal" low-cost, universal (single-payer) insurance plan.
    Date: 2010–03

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