nep-hea New Economics Papers
on Health Economics
Issue of 2010‒07‒17
fifteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Income and the use of prescription drugs for near retirement individuals By Søren Leth-Petersen; Niels Skipper
  2. The Wage Elasticity of Informal Care Supply: Evidence from the Health and Retirement Study By Olena Nizalova
  3. Stronger sex but earlier death: A multi-level socioeconomic analysis of gender differences in mortality in Austria By Martin Gächter; Peter Schwazer; Engelbert Theurl
  4. Medical Consumption Over the Life Cycle: Facts from a U.S. Medical Expenditure Panel Survey By Juergen Jung; Chung Tran
  5. Hospital competition when patients have different willingness to pay for quality By Mario Pezzino
  6. Older people's participation in disability benefits: targeting, timing and financial wellbeing By Zantomio F
  7. Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets. By Bärnighausen, Till; Diedrichsen, Ellen; Hochstadt, Jenny; Kyle, Margaret; Moon, Suerie; Soucy, Lyne; Waning, Brenda
  8. Economic evaluation and the postponement of health care costs. By Baal, P.H. van; Feenstra, T.L.; Polder, J.J.; Hoogenveen, R.T.; Brouwer, W.
  9. Patterns of organization in the development of medical know-how: the case of glaucoma research By Consoli, Davide; Ramlogan, Ronnie
  10. Effects on the U.S. of an H1N1 epidemic: analysis with a quarterly CGE model By Peter B. Dixon; Bumsoo Lee; Todd Muehlenbeck; Maureen T. Rimmer; Adam Z. Rose; George Verikios
  11. Testing sensitivity of willingness to pay for mortality risk reduction By Marek Giergiczny
  12. Public expenditure on health and private old-age insurance in an OLG growth model with endogenous fertility: chaotic cycles under perfect foresight By Fanti, Luciano; Gori, Luca
  13. Health Expenditure Models: a Comparison of Five Specifications using Panel Data By V. ALBOUY; L. DAVEZIES; T. DEBRAND
  14. Retirement Decisions of People with Disabilities: Voluntary or Involuntary By Margaret Denton; Jennifer Plenderleith; James Chowhan
  15. Older Adults’ Awareness of Community Health and Support Services for Dementia Care By Jenny Ploeg; Margaret Denton; Joseph Tindale; Brian Hutchison; Kevin Brazil; Noori Akhtar-Danesh; Jean Lillie; Jennifer Millen Plenderleith

  1. By: Søren Leth-Petersen (Department of Economics, University of Copenhagen); Niels Skipper (School of Economics and Management, Aarhus University, Denmark)
    Abstract: Understanding how demand for prescription drugs responds to changes in income is important for assessing the welfare consequences of reforms affecting income. This becomes more imminent as age progresses, because the use of prescription drugs and the associated budgetary burden increases dramatically from about age 55. In this paper we estimate how demand for prescription drugs varies with income for a sample of near retirement individuals. Estimating the prescription drug demand response to income changes is complicated because an important explanatory variable, the health capital, is unobserved, and because demand is potentially dynamic, for example because some drugs are habitual. The analysis is based on a novel panel data set with information about purchase of prescription drug demand for a very large number of Danish individuals over the period 1995-2003. Our preferred model that takes into account the aforementioned complications performs better in an external validation test than models that can be estimated on cross section data. Results indicate that demand does respond to variations in income and that reforms affecting income therefore will affect the use of prescription drugs.
    Keywords: Prescription drugs demand, income, near retirement
    JEL: I11 I18
    Date: 2010–07–08
  2. By: Olena Nizalova (Kyiv School of Economics, Kyiv Economics Institute)
    Abstract: This paper focuses on the relationship between wages and supply of informal care to elderly parents. Unlike most of the previous research estimating wage elasticities of informal care supply, this study employs instrumental variable technique to account for the fact that the wage rate is likely to be correlated with omitted variables. Based on the data from the 1998 wave of the Health and Retirement Study, the results show that the wage elasticity of informal care supply is negative and larger in magnitude than has been found previously. The lower bound of this elasticity is estimated to be -1.8 for males and -3.6 for females. Additional findings suggest that the wage elasticity of informal care supply differs by the type of care provided to elderly parents, and that it is larger in magnitude among individuals with siblings and those with independently living parents. The analysis also indicates that the reductions in the informal care constitute about 18% of the labor supply response for men and about 56% of the labor supply response for women, which are not compensated by monetary transfers.
    Keywords: wage elasticity, informal care supply, labor supply, elderly care, family obligations
    JEL: J22 J18 J14
    Date: 2010–07
  3. By: Martin Gächter; Peter Schwazer; Engelbert Theurl
    Abstract: Gender inequalities in mortality/life expectancy have been a major area of research in the social sciences since the 1970s. However, the questions posed and the research strategies used are still in a state of flux. In the present paper we shed some light on two related questions: (i) Which socioeconomic variables determine the gender gap in mortality? (ii) Are male and female mortality rates determined by different socioeconomic factors and in different shapes? We use aggregated data from Austria both at the community and district level covering the time period 1969 - 2004. Our two-level empirical design combined with a panel structure at the districts level reveals additional evidence on these questions compared to previous studies at the regional level. By using weighted regression analysis (panel fixed effects, pooled and cross section) we find that the gender gap is negatively associated with higher average net income, a higher educational level, a higher share of immigrants and better familial integration. In general, males are more sensitive with respect to social and economic conditions compared to females, leading to a narrowing gap in mortality when living conditions improve. These results are also confirmed by our Blinder-Oaxaca Decomposition.
    Keywords: mortality, gender mortality gap, life expectancy, Austria
    JEL: I12 I18 J16
    Date: 2010–07
  4. By: Juergen Jung (Department of Economics, Towson University); Chung Tran (School of Economics, University of New South Wales)
    Abstract: In this paper we construct life-cycle profiles of U.S. health care spending using data from the Medical Expenditure Panel Survey (MEPS). We separate pure age effects on health expenditure from time effects (i.e. productivity effects, business cycle effects, etc.) and cohort effects (i.e. initial condition effects) by estimating a seminonparametric partial linear model. After controlling for time and cohort effects, we find that medical expenditure-age profiles follow an upward trend. Time and cohort effects introduce a significant estimation bias into predictions of health expenditures per age group. It is demonstrated that failing to adequately control for time and cohort effects results in an overprediction of the effect of age on health expenditures, especially for agents older than 60. Cohort effect biases dominate time effect biases in estimates of health expenditures that do not adequately control for both effects. Estimation biases introduced by cohort effects increase monotonically with age while time effects are non-monotone.
    Keywords: life-cycle profiles; time and cohort effects; partial linear seminonparametric models; pseudo panels; medical expenditure panel survey (MEPS)
    JEL: I10 I11 C14 C23 D12 D91 J10
    Date: 2010–08
  5. By: Mario Pezzino
    Date: 2010
  6. By: Zantomio F (Research Institute for the Evaluation of Public Policies)
    Abstract: This paper evaluates the effectiveness of disability benefits for the elderly. Using seventeen waves of panel data, it first analyses the extent to which receipt is responsive to changes in disability status. Second, it investigates the extent of delays in first receipt. Third, it compares later outcomes of recipients and non recipients, accounting for selection into the program. Results indicate that entry is highly responsive to previous changes in disability, and that the program enhances persistently recipients' financial wellbeing. However, considerable delays in receipt are also found. Beside, the evidence of characteristics unrelated to eligibility influencing the assignment mechanism raises horizontal equity concerns.
    Date: 2010–07–06
  7. By: Bärnighausen, Till; Diedrichsen, Ellen; Hochstadt, Jenny; Kyle, Margaret; Moon, Suerie; Soucy, Lyne; Waning, Brenda
    Date: 2010
  8. By: Baal, P.H. van; Feenstra, T.L. (Tilburg University); Polder, J.J. (Tilburg University); Hoogenveen, R.T.; Brouwer, W.
    Date: 2010
  9. By: Consoli, Davide; Ramlogan, Ronnie
    Abstract: This paper focuses on the longitudinal development of the glaucoma medical specialty with a view to capture the configurations of division of labor that contributed to or followed from novel understanding of the disease. The historical background is corroborated by an analysis of collaborative scholarly research over the period 1973-2003 to illustrate how successive clinical and scientific modalities co-existed and influenced each other.
    JEL: O33 I12
    Date: 2010–07–06
  10. By: Peter B. Dixon; Bumsoo Lee; Todd Muehlenbeck; Maureen T. Rimmer; Adam Z. Rose; George Verikios
    Abstract: We simulate the effects of a hypothetical H1N1 epidemic in the U.S. using a quarterly CGE model. Quarterly periodicity allows us to capture the short-run nature of an epidemic. We find potentially severe economic effects in the peak quarter. Averaged over the epidemic year the effects are considerably damped. Our results indicate that the macroeconomic consequences of an epidemic are more sensitive to demand-side effects such as reductions in international tourism and leisure activities than to supply-side effects such as reductions in productivity. This suggests that demand stimulus policies might be an appropriate economic response to a serious epidemic.
    Keywords: Influenza epidemic Quarterly CGE modelling
    JEL: I18 C68
    Date: 2010–06
  11. By: Marek Giergiczny (Warsaw Ecological Economics Center, University of Warsaw)
    Abstract: Contingent valuation method was used in this study to elicit willingness to pay for risk reduction of dying because of cardiovascular or respiratory diseases. The survey was conducted on a sample of 408 citizens of Warsaw between 50 and 80 years of age. Obtained results did not pass external scope test, even in its weak form. The magnitude of risk reduction did not have statistical influence on the probability of accepting the bid.
    Keywords: value of a statistical life, contingent valuation, scope test, robustness
    JEL: H41 H51 I18 I31 J17
    Date: 2010
  12. By: Fanti, Luciano; Gori, Luca
    Abstract: This paper analyses the dynamics of a simple overlapping generations economy with endogenous longevity, endogenous fertility and private transfers from children to parents. In this context, it is shown that both the public provision of health care services, which determines the individual length of life, and the size of the intra-family transfer may be a source of chaotic cycles when individuals are perfect foresighted. However, such economic factors also have the potential to ultimately suppress undesirable chaotic fluctuations. This suggests that the equilibrium dynamics of an OLG growth model may endogenously reconcile the existence of both irregular business cycles and the global stability of the economic system.
    Keywords: Endogenous fertility; OLG model; Perfect foresight; Private old-age support; Public health care services
    JEL: J14 H55 I18 J18 C62
    Date: 2010–07–06
  13. By: V. ALBOUY (Insee); L. DAVEZIES (Insee); T. DEBRAND (Irdes)
    Abstract: In this article, we focus on the estimation of outpatient expenditures with panel data. We model the logarithm of expenditures and consider five different models. The first two models are cross section two part and sample selection models. The two-part approach appears inappropriate when moving to panel data. We therefore focus on panel data models with sample selection. Our third model is a model without lagged dependent variables, and the last two ones include such lagged variables. These two latter models differ in their assumptions on the variance of the residuals. Modeling heteroskedasticity may indeed be important to avoid the bias due to the retransformation problem. We show that lagged dependent variables are important factors of heteroskedasticity. For the models with state dependence we provide a new solution to the initial conditions problem by using generalized residuals. We establish that panel data models highly improve the correlation explained by the model in the time-series dimension without damaging the fit in the cross-section dimension. For all indicators of fit, the model with state dependence and heteroskedasticity seems to dominate the others.
    Keywords: Health econometrics, health expenditures, panel data, selection models, state dependence
    JEL: I0 C1 C5
    Date: 2010
  14. By: Margaret Denton; Jennifer Plenderleith; James Chowhan
    Abstract: While some retirement is welcomed and on-time, other retirements are involuntary or forced due to the loss of a job, an early retirement incentive, a health problem, mandatory retirement, lack of control with too many job strains, or to provide care to a family member. An analysis of the 2002 Canadian General Social Survey reveals that 27% of retirees retired involuntarily. This research focuses on the disabled population in Canada and considers factors that influence voluntary and involuntary retirement. Further, consideration is given to the economic consequences of retiring involuntarily. This research will examine issues surrounding retirement and disability through statistical analysis of the Canadian Participation and Activity Limitations Survey (PALS) 2006 data. Methods include the use of descriptive statistics and logistic regression analysis to determine the characteristics associated with involuntary retirement. This study found that those who retired involuntarily were more likely to have the following socio-demographic and socioeconomic characteristics -- age 55 or less, less than high-school education, live in Quebec, rent their home, and have relatively low income. They were also more likely to be worse off financially after retirement and to be receiving social assistance or a disability benefit. In terms of disability, the likelihood of retiring involuntarily was greater for those with poor health at retirement, the age of onset was over 55, higher level of severity, and multiple types of disability. For the discussion, a social inequalities framework is used, where health selection into involuntary retirement depends on social location defined by age and education. Policy initiatives that reduce the effects of disability, and allow individuals to remain in or return to the labour force such as workplace accommodations are discussed.
    Keywords: Retirement, Disabled, Health, Labour Force
    JEL: J14
    Date: 2010–06
  15. By: Jenny Ploeg; Margaret Denton; Joseph Tindale; Brian Hutchison; Kevin Brazil; Noori Akhtar-Danesh; Jean Lillie; Jennifer Millen Plenderleith
    Abstract: The article examines where older adults seek help in caring for a parent with dementia and the factors associated with their identification of community health and support services as sources of assistance. The authors conducted telephone interviews, using random digit dialing, of 1,152 adults aged 50 and over in the city of Hamilton. Respondents received a vignette that raised issues related to parental dementia. In identifying support sources, over 37 per cent of respondents identified their physician, 33 per cent identified informal support such as family and neighbors, and 31 per cent identified home health services. Only 18 per cent identified community support services. Female participants having higher levels of education were more likely to identify their physician as a source of support. Knowing where to find information about community support services was associated with an increased likelihood of mentioning physicians and home health services as sources of assistance.
    Keywords: community support services , awareness , dementia , caregivers , vignette methodology
    JEL: I18
    Date: 2010–06

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