nep-hea New Economics Papers
on Health Economics
Issue of 2010‒07‒03
twelve papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Scaling methods for categorical self-assessed health measures By Patricia Cubí Mollá
  2. The Effect of Private Health Insurance on Medical Care Utilization and Self-Assessed Health in Germany By Hullegie, Patrick; Klein, Tobias J.
  3. Does Schooling Affect Health Behavior? Evidence from Educational Expansion in Western Germany By Steffen Reinhold
  4. Association of smoking and drinking with socioeconomic factors: A comparative study based on bivariate probit model analysis By Oshio, Takashi; Kobayashi, Miki
  5. Benefiting Without Receiving Money? Externalities of Conditional Cash Transfer Programmes on Schooling, Health and the Village Economy By Christian Lehmann
  6. Scandinavian long-term care financing By Karlsson, Martin; Iversen, Tor; Øien, Henning
  7. Time Discounting and Smoking Behavior under Tax Hikes By Myong-Il Kang; Shinsuke Ikeda
  8. Economic and financial analysis of scaling up child, newborn and maternal health By Giulia Greco; Anne Mills; Jo Borghi; Tim Powell Jackson
  9. The social determinants of HIV testing in Botswana: a keystone for addressing the epidemic By Divya Rajaraman; S Jody Heymann
  10. Estimating human resource requirements for scaling up priority health interventions in Lowincome countries of Sub-Saharan Africa: A methodology based on service quantity, tasks and productivity (THE QTP METHODOLOGY) By Christoph Kurowski; Anne Mills
  11. The effect of waiting time and distance on hospital choice for English cataract patient By Peter Sivey
  12. Better Health and Ambient Assisted Living (AAL) from a global, regional and local economic perspective By Eberhard, Birgid; Fachinger, Uwe; Henke, Klaus-Dirk

  1. By: Patricia Cubí Mollá (Universidad de Alicante)
    Abstract: The lack of a continuous health valuation is a major drawback in health analyses over broad populations. The use of categorical health variables to estimate a continuous health variable is an usual procedure in healthstudies. The most common approaches (ordered probit/logit model and interval regression model) do not admit any skewness in the distribution of health. In the present study a new procedure is suggested, that is attaching a log-normal distribution to health values. Different scaling procedures have been compared, with data obtained from the Catalan Health Survey (2006). The validity of the scaling approaches is assessed by measuring to what extent the health values derived from categorical health variables suit the actual health values. Two different health tariffs have been used for each procedure (VAS tariff and TTO tariff), so that the results are robust to the selection of a metric. In general, models under log normality outperform the other approaches.
    Keywords: Health-Related Quality of Life, Health Measurement, Interval
    JEL: C01 I10
    Date: 2010–01
  2. By: Hullegie, Patrick (Tilburg University); Klein, Tobias J. (Tilburg University)
    Abstract: In Germany, employees are generally obliged to participate in the public health insurance system, where coverage is universal, co-payments and deductibles are moderate, and premia are based on income. However, they may buy private insurance instead if their income exceeds the compulsory insurance threshold. Here, premia are based on age and health, individuals may choose to what extent they are covered, and deductibles and co-payments are common. In this paper, we estimate the effect of private insurance coverage on the number of doctor visits, the number of nights spent in a hospital and self-assessed health. Variation in income around the compulsory insurance threshold provides a natural experiment that we exploit to control for selection into private insurance. We document that income is measured with error and suggest an approach to take this into account. We find negative effects of private insurance coverage on the number of doctor visits, no effects on the number of nights spent in a hospital, and positive effects on health.
    Keywords: private health insurance, medical care utilization, selection into insurance, measurement error, natural experiment, regression discontinuity design
    JEL: I11 I12 C31
    Date: 2010–06
  3. By: Steffen Reinhold (Mannheim Research Institute for the Economics of Aging (MEA))
    Abstract: During the postwar period German states pursued policies to increase the share of young Germans obtaining a university entrance diploma (Abitur) by building more academic track schools, but the timing of educational expansion differed between states. This creates exogenous variation in the availability of higher education, which allows estimating the causal effect of education on health behaviors. Using the number of academic track schools in a state as an instrumental variable for years of schooling, we investigate the causal effect of schooling on health behavior such as smoking and related outcomes such as obesity. We find large negative effects of education on smoking. These effects can mostly be attributed to reductions in starting rates rather than increases in quitting rates. We find no causal effect of education on reduced overweight and obesity.
    JEL: I12 I20
    Date: 2009–08–21
  4. By: Oshio, Takashi; Kobayashi, Miki
    Abstract: In this study, we examined the differences between smoking and drinking in regard to their associations with socioeconomic factors among about 7,000 Japanese workers. Using microdata from nationwide surveys in Japan, we estimated bivariate probit models to jointly explore how smoking and drinking are related to a wide variety of socioeconomic factors. We found that only educational attainment is consistently and negatively associated with both smoking and drinking for both genders. The associations with other socioeconomic factors are not uniform between smoking and drinking and between men and women. A notable finding is that smoking is more sensitive than drinking to daily or continuous stress related to one's jobs and perceptions of one's income class, especially among men.
    Keywords: Smoking, Drinking, Bivariate probit model
    Date: 2010–06
  5. By: Christian Lehmann (International Policy Centre for Inclusive Growth)
    Abstract: Although cash transfer programmes have been implemented and evaluated for more almost a decade, very little is known about how they affect households that are located in communities where the programme is implemented but that are not officially registered for the programme (either because they are ineligible or are unwilling to participate). The vast majority of evaluations focus on households that are officially registered. Cash transfer programmes, however, are likely to affect all households living in a community, even those that are not participating.
    Keywords: Benefiting Without Receiving Money? Externalities of Conditional Cash Transfer Programmes on Schooling, Health and the Village Economy
    Date: 2010–03
  6. By: Karlsson, Martin (Technische Universität Darmstadt); Iversen, Tor (Institute of Health Management and Health Economics); Øien, Henning (Institute of Health Management and Health Economics)
    Abstract: In this paper, we compare and analyse the systems for financing long-term care for older people in the Scandinavian countries – Denmark, Norway and Sweden. The three countries share common political traditions of local autonomy and universalism, and these common roots are very apparent when the financing of long-term care is concerned. Nevertheless, the Scandinavian systems for long- term care (LTC) exhibit some important deviations from the idealized “universal welfare state” to which these countries are normally ascribed. For example, user charges tend to be strongly dependent on earnings, which is incoherent with the general norm of flat-rate public services. Also, there is significant regional variation in the level of services provided, which is in direct contrast with the universalist ambitions. Overall, the Scandinavian countries distinguish themselves through their very high reliance on public spending in long-term care. It is unclear to what extent the Scandinavian model for financing of long term care will be sustainable as demographic change progresses in the next few decades.
    Keywords: long term care; financing; welfare state; Scandinavia
    JEL: H42 H51 I11 I18 J14
    Date: 2010–06–22
  7. By: Myong-Il Kang; Shinsuke Ikeda
    Abstract: By combining our broad panel survey of Japanese adults from 2005 to 2008 and actual cigarette tax data, we investigate how smoking behavior including responses to tax hikes depends on time discounting and its biases, such as hyperbolic discounting and the sign effect. Cigarette consumption displays significantly positive correlations with discount rates and the procrastinating tendency, and negative correlations with the sign effect. Hyperbolic, procrastinating, andnaïve respondents decrease their after-tax-hike cigarette consumption more than the others, implying that, irrespective of the preannouncement of a future tax hike, they postpone smoking moderation until the tax hike actually takes place. Finally, the government's revenue from cigarette tax peaks at a JPY 29.92 (around USD 0.28 using the conversion rate [107.16] in February 2008) higher tax per cigarette than the present actual level.
    Date: 2010–06
  8. By: Giulia Greco; Anne Mills; Jo Borghi; Tim Powell Jackson
    Abstract: Little attention has been paid to the question of how to finance the costs of scaling up MNCH care and the likely availability of funds. Methods Past health expenditure (2000 – 2005) was analysed through the National Health Accounts of 57 high priority countries. They projected likely availability of funding for the period 2006 – 2015 under two scenarios (business as usual and public commitments). We estimated the financing gap by comparing the share of projected total health expenditure dedicated to MNCH with the WHO costing model for scaling MNCH interventions.[HEFP Working paper 01/07, LSHTM, 2007]
    Keywords: MNCH, Methods Past health expenditure, financing gap, public commitments
    Date: 2010
  9. By: Divya Rajaraman; S Jody Heymann
    Abstract: This paper considers the distribution of HIV testing in Botswana in 2002 and 2004. Botswana is a country with a high prevalence of HIV in the general population and HIV testing is considered to be a critical component of prevention and care efforts. The study found that people who had a higher level of education, had become parents since the establishment of the Prevention of Mother to Child Transmission of HIV (PMTCT) programme, and who had provided care for someone they suspected was HIV positive/ had known someone who was HIV positive were more likely to have taken an HIV test. In a population-based sample, women were more likely to have taken an HIV test. The findings indicate the effectiveness of a routine health intervention such as PMTCT in increasing knowledge of HIV status. They also provide empirical evidence of a socio-economic differential in HIV testing, underscoring the need to design and implement health care programmes in such a way as to reduce the socio-economic gap in health protective behaviour and health outcomes.[HEFP Working Paper 02/07, LSHTM, 2007]
    Keywords: HIV testing, Botswana, VCT, PMTCT, SES, Poverty
    Date: 2010
  10. By: Christoph Kurowski; Anne Mills
    Abstract: This study was carried out under the auspices of the LSHTM Health Economics and Financing Program, which, at the time of the work, received a research programme grant from DFID. The findings, conclusions and interpretations expressed in this report, however, are those of the authors and do not necessarily reflect those of DFID or the WB, its Executive Directors or the countries they represent. The version of the QTP model presented here benefited from the experiences gathered in two case studies carried out in Tanzania and Chad. Kaspar Wyss and N’Diekhor Yemadji led the case study in Chad and Salim Abdulla participated in the Tanzania team.[HEFP working paper 01/06, LSHTM, 2006]
    Keywords: LSHTM, Health Economics and Financing Program, DFID, interpretations, WB, Executive Directors, Kaspar Wyss, N’Diekhor Yemadji, Tanzania, Chad, Salim Abdulla
    Date: 2010
  11. By: Peter Sivey
    Abstract: This paper applies latent-class and multinomial logit models to the choice of hospital for cataract operations in the UK NHS. We concentrate on the effects of travel time and waiting time and especially on the waiting time elasticity of demand. Models including hospital fixed effects rely on changes over time in waiting time to indentify coefficients. We show how using latent-class multinomial logit models characterises the unobserved heterogeneity in GP practices' choice behaviour and affects the estimated waiting time elasticities of demand. The models estimate waiting time elasticities of demand of approximately -0.1, comparable with previous waiting time-demand models. For the average waiting time elasticity, the simple multinomial logit models are good approximations of the latent-class logit results.
    Keywords: Hospital Choice; Waiting Time; Latent Class Model
    JEL: I11
    Date: 2010–06
  12. By: Eberhard, Birgid; Fachinger, Uwe; Henke, Klaus-Dirk
    Abstract: Assisting technologies aim to provide more support in the meeting of one's daily needs and the preservation of one's autonomy and quality of life. Continual developments in medicine, medical equipment, nursing and medical care are assumed to lead to new types of care being created. A high degree of social and economic relevance has been attributed to assisting technologies, as well as information and communication systems, by scientists and politicians alike, particularly in connection with the development, promotion and organization of so-called senior-friendly environments and with ambient assisted living (AAL).
    Keywords: economic development; ambient assisted living; health care system; assisting technologies; health care; new technologies; health economy
    JEL: I10
    Date: 2009–07

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