nep-hea New Economics Papers
on Health Economics
Issue of 2010‒06‒26
ten papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Disease Prevalence, Disease Incidence, and Mortality in the United States and in England By Banks, James; Muriel, Alastair; Smith, James P.
  2. The value of a statistical life for out-of-hospital cardiac arrest victims By Sund, Björn
  3. Integration and Cooperation in Public Hospitals By Rehn, Eric
  4. A Multichannel Framework for Multimedia Content Deployment in e-Health Environments By Crescenzio Gallo; Lorenzo Cola; Fernando Triggiani
  5. Health Seeking Behaviour And Delays In Diagnosis And Treatment In Patients Reporting With Cough Of Three Weeks Or More To Tuberculosis Units & Microscopy Centres In East Sikkim By Karma Jigme Tobgay
  6. Limitations on Universality: The “Right to Health†and the Necessity of Legal Nationality By Lindsey N. Kingston; Christopher P. Morley; Elizabeth F. Cohen
  7. Child Undernutrition in India By Raghav Gaiha; Raghbendra Jha; Vani S. Kulkarni
  8. A Profile of Obesity in Ireland, 2002-2007 By Madden, D.
  9. HIV and Fertility Revisited By Sebnem Kalemli-Ozcan; Belgi Turan
  10. Estimating Heterogeneous Treatment Effects of Medicaid Expansions on Take-up and Crowd-out By John C. Ham; I. Serkan Ozbeklik; Lara Shore-Sheppard

  1. By: Banks, James (Institute for Fiscal Studies, London); Muriel, Alastair (Institute for Fiscal Studies, London); Smith, James P. (RAND)
    Abstract: We find disease incidence and prevalence are both higher among Americans in age groups 55-64 and 70-80 indicating that Americans suffer from higher past cumulative disease risk and experience higher immediate risk of new disease onset compared to the English. In contrast, age specific mortality rates are similar in the two countries with an even higher risk among the English after age 65. Our second aim explains large financial gradients in mortality in the two countries. Among 55-64 year olds, we estimate similar health gradients in income and wealth in both countries, but for 70-80 year old, we find no income gradient in UK. Standard behavioral risk factors (work, marriage, obesity, exercise, and smoking) almost fully explain income gradients among 55-64 years old in both countries and a significant part among Americans 70-80 years old. The most likely explanation of no English income gradient relates to their income benefit system. Below the median, retirement benefits are largely flat and independent of past income and hence past health during the working years. Finally, we report evidence using a long panel of American respondents that their subsequent mortality is not related to large changes in wealth experienced during the prior ten year period.
    Keywords: health
    JEL: I10
    Date: 2010–06
  2. By: Sund, Björn (Department of Business, Economics, Statistics and Informatics)
    Abstract: Background: Economic evaluation of policies regarding out-of-hospital cardiac arrest (OHCA) is important and we estimate the value of a statistical life (VSL) for OHCA victims. Method: Responses to a national Swedish mail survey in 2007, based on the stated-preference technique (contingent valuation) to directly elicit individuals hypothetical willingness to pay for a reduced risk of dying from OHCA. Results: VSL values are found to be higher than for comparable VSL estimates from the transport sector. A lower-bound estimate of VSL for OHCA would be around SEK 20-30 million. Conclusions: The results in this paper indicates that it is not an overestimation to use the „baseline VSL value from the transport sector (SEK 22 million) in cost-benefit analysis of OHCA policy decisions. We do not support a senior death discount for this cause of death.
    Keywords: Contingent valuation; Value of a statistical life; Cardiac arrest
    JEL: H43 I18
    Date: 2010–06–16
  3. By: Rehn, Eric (Department of Economics, Lund University)
    Abstract: Hospital care is a joint production involving a wide range of services; ranging from medical services to support services to hotel services. This paper, focusing on the cooperation between these services, models the internal organization of public hospitals. The analysis is based on the property rights approach to organization (aka the Grossman-Hart-Moore model) and adopts it to the realities of public hospitals. Some institutional features from the Swedish hospital sector are presented to support the analysis, but the results are general. It is found that support services should be integrated into the medical specialities and that hotel services should be outsourced by the hospital. Moreover, it is found that cooperating medical specialities should be integrated, giving support to the use of multi-skilled teams suggested by the advocates of lean health care.
    Keywords: Public Hospitals; Property Rights Approach; Joint Production; Integration; Bargaining; Lean Health Care
    JEL: D23 I11 I18
    Date: 2010–06–14
  4. By: Crescenzio Gallo; Lorenzo Cola; Fernando Triggiani
    Abstract: Efficient and generalized deployment of rich multimedia contents is a challenging target that is becoming more and more important in the modern information society. In this work we first examine the technical background behind the general problem of multimedia content deployment. Then we study the architectural and technical choices and legal implications to be considered in order to build an effective client/server multimedia content deployment platform for the implementation and spreading of a series of services related both to the specific health environment (integration with the health information system) and the general educational (classroom lessons, on line participation and deferred streaming) and recreational facilities (such as TV and radio live and on demand streaming) and support activities (i.e. phone and video calls).
    Keywords: multimedia content, streaming platform, e-health information system.
    Date: 2010–03
  5. By: Karma Jigme Tobgay
    Abstract: The objective of this paper is to study the health seeking behaviour in patients reporting with cough of 3 weeks or more to Tuberculosis Units & Microscopy Centres in East District of Sikkim and to ascertain delays if any in diagnosis and treatment, and to examine the associated factors. A cross sectional survey that included 2 Tuberculosis Units and 4 Microscopy Centres was conducted in East Sikkim from 1.1.2003 to 15.3.2003. A total of 323 patients, reporting to the health facilities, were interviewed using a pre-tested interview schedule.[Working Paper No. 6]
    Keywords: health seeking behaviour, Tuberculosis Units, Microscopy Centres, Sikkim, diagnosis, treatment, East Sikkim, reporting, health facilities
    Date: 2010
  6. By: Lindsey N. Kingston; Christopher P. Morley; Elizabeth F. Cohen
    Abstract: The fact that statelessness as a concept is largely absent from the medical literature has been on e of the central motivatin factor for this essay which aims for a discussion, primarily to illustrate the need for further monitoring of health access issues by the medical community, and for a great deal more research into the effects of statelessness upon access to healthcare. This is important both as a theoretical issue, in light of the recognition by many of healthcare as a universal right, as well as an empirical fact that requires further exploration and amelioration.
    Keywords: right to health, healthcare, international, individuals, accessible, globe, central, motivating factor, medical literature, community, empirical, exploration, amelioration
    Date: 2010
  7. By: Raghav Gaiha; Raghbendra Jha; Vani S. Kulkarni
    Abstract: We have constructed a composite indicator of anthropometric failure (CIAF) that refines the Waterlow-3 tier classification, using a recent nation-wide household survey. The CIAF and its disaggregation into subcategories of undernourished 5 years old children reveal a grimmer story of child undernutrition than conventional anthropometric indicators do. Besides, simultaneous occurrence of anthropometric failures (e.g. stunting and underweight, and stunting, wasting and underweight) is pervasive. Our analysis of determinants of CIAF yields some new insights-specifically, the important role of food prices. Investigation of the links between different anthropometric failures and prevalence of infectious diseases (viz. Diarrhoea and acute respiratory infection), however, offers some justification for the disaggregated classification of undernourished children used here. Specifically, those with more than one failure were worse-off in this respect than children with no failure. There is a strong case for income growth together with food price stabilisation in curbing child undernutrition. Education has the desired effect but it is less strong than expected. Improvement in the quality of home environment makes a difference too but it is not conditional on income or wealth alone.
    Keywords: stunting, wasting, underweight, poverty, infectious diseases, and mortality
    JEL: D12 D60 I10 I31
    Date: 2010
  8. By: Madden, D.
    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
  9. By: Sebnem Kalemli-Ozcan; Belgi Turan
    Abstract: Young (2005) argues that HIV related population declines reinforced by the fertility response to the epidemic will lead to higher capital-labor ratios and to higher per capita incomes in the affected countries of Africa. Using household level data on fertility from South Africa and relying on between cohort variation in country level HIV infection, he estimates a large negative effect of HIV prevalence on fertility. However, the studies that utilize the recent rounds of Demographic Health Surveys, where fertility outcomes are linked to HIV status based on testing, find no effect of the disease on the fertility behavior. This paper tries to bridge this gap by revisiting Young's findings. Young (2005) includes data before 1990, when no data are available on HIV prevalence rates. He assigns all the fertility observations before 1990 with HIV prevalence rates of zero, and this appears to drive the significant negative effect found in his study. When one restricts the sample to the period 1990-1998, where actual HIV data are available, the effect of HIV prevalence on fertility turns out to be positive for South Africa. Simulating Young's model utilizing these new estimates shows that the future generations of South Africa are worse off.
    JEL: I12 J11 J13 O11
    Date: 2010–06
  10. By: John C. Ham; I. Serkan Ozbeklik; Lara Shore-Sheppard
    Abstract: Economists have devoted considerable resources to estimating local average treatment effects of expansions in Medicaid eligibility for children. In this paper we use random coefficients linear probability models and switching probit models to estimate a more complete range of effects of Medicaid expansion on Medicaid take-up and crowd-out of private insurance. We demonstrate how to estimate, for Medicaid expansions, the average effect among all of those eligible, the average effect for a randomly chosen person, the effect for a marginally eligible child, and the average effect for those affected by a nonmarginal counterfactual policy change. We then estimate the average effect of Medicaid expansions among all eligible children and the average effect for those affected by a nonmarginal counterfactual Medicaid expansion since these are likely to be the most useful for policy analysis. Estimated take-up rates among average eligible children are substantially larger than take-up rates for those made eligible by a counterfactual Medicaid expansion, moreover both of these effects vary widely across demographic groups. In terms of crowd-out, we find statistically significant, though small, effects for all eligible children, but not for those affected by a counterfactual policy change.
    JEL: H42 I1 I38
    Date: 2010–06

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