nep-hea New Economics Papers
on Health Economics
Issue of 2011‒03‒12
thirteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Work Absenteeism Due to a Chronic Disease By Guy Lacroix; Marie-Ève Brouard
  2. Medical Technology and the Production of Health Care By Baltagi, Badi H.; Moscone, Francesco; Tosetti, Elisa
  3. The Poor Health Status of the Hungarians; Comparative Macro-Analysis of the Likely Explanatory Factors onHungarian and Austrian Data, 1960-2004 By M ria Lack¢
  4. How efficient is the Italian hospitality sector? A window DEA and truncated-Tobit analysis By JG. Brida; Claudio Detotto; Manuela Pulina
  5. Pro-social preferences and self-selection into the public health sector: evidence from economic experiments By Kolstad, Julie Riise; Lindkvist, Ida
  6. Diminishing Willingness to Pay per Quality-Adjusted Life Year: Valuing Acute Foodborne Illness By Hammitt, James; Haninger, Kevin
  7. Infectious Diseases and Economic Growth By Aditya Goenka; Lin Liu; Manh-Hung Nguyen
  8. Consumer Response to Cigarette Excise Tax Changes By Chiou, Lesley; Muehlegger, Eric
  9. Chronic diseases and labor market outcomes in Egypt By Rocco, Lorenzo; Tanabe, Kimie; Suhrcke, Marc; Fumagalli, Elena
  10. Social Capital and Health of Older Europeans By Nicolas Sirven; Thierry Debrand
  11. Why is Medical Care Expensive in the U.S.? By Kaz Miyagiwa; Paul Rubin
  12. Behavioural Factors as Emerging Main Determinants of Child Mortality in Middle-Income Countries: A Case Study of Jordan By Cornelia Kaldewei; Ingo Pitterle
  13. How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Sixth Version By Aureo de Paula; Gil Shapira; Petra E. Todd

  1. By: Guy Lacroix; Marie-Ève Brouard
    Abstract: Research on health-related work absenteeism focuses primarily on moral hazard issues but seldom discriminates between the types of illnesses that prompt workers to stay home or seek care. This paper focuses on chronic migraine, a common and acute illness that can prove to be relatively debilitating. Our analysis is based upon the absenteeism of workers employed in a large Fortune-100 manufacturing firm in the United States. We model their daily transitions between work and absence spells between January 1996 up until December 1998. Only absence due to migraine and depression, its main comorbidity, are taken into account. Our results show that there is considerable correlation between the different states we consider. In addition, workers who are covered by the Blue Preferred Provided Organization tend to have shorter employment spells but also shorter migraine spells.
    Keywords: Migraine, absenteeism, insurance policies, transition models, unobserved heterogeneity
    JEL: I10 J32
    Date: 2011
  2. By: Baltagi, Badi H. (Syracuse University); Moscone, Francesco (Brunel University); Tosetti, Elisa (University of Cambridge)
    Abstract: This paper investigates the factors that determine differences across OECD countries in health outcomes, using data on life expectancy at age 65, over the period 1960 to 2007. We estimate a production function where life expectancy depends on health and social spending, lifestyle variables, and medical innovation. Our first set of regressions include a set of observed medical technologies by country. Our second set of regressions proxy technology using a spatial process. The paper also tests whether in the long-run countries tend to achieve similar levels of health outcomes. Our results show that health spending has a significant and mild effect on health outcomes, even after controlling for medical innovation. However, its short-run adjustments do not seem to have an impact on health care productivity. Spatial spill overs in life expectancy are significant and point to the existence of interdependence across countries in technology adoption. Furthermore, nations with initial low levels of life expectancy tend to catch up with those with longer-lived populations.
    Keywords: life expectancy, health care production, health expenditure, spatial dependence
    JEL: C31 C33 H51
    Date: 2011–03
  3. By: M ria Lack¢ (Institute of Economics Hungarian Academy of Sciences)
    Abstract: In Hungary, the health status of working age men is extremely bad in comparison with both the developed market economies and the neighboring transition countries. The study based on data between 1960 and 2004 investigates the health status of population in Hungary and Austria by health-production functions on macro level and makes comparisons. The rationale for comparison of these very countries is the territorial closeness and the mutual long past. The mortality rate of working age population (15-60 years old) is considered the proxy variable for the health status. According to this indicator the health status in the two countries was at the same level in 1960's, but they started to diverge at the beginning in the 1970's. As explanatory variables for the mortality rate of the working age population the following variables are taken into account: the indicators of the life style (consumption of alcohol, smoking, the extra work in the "second" and "hidden economy"), the long- term economic development (the development of the GDP per capita), health-care resources (the relative share of physicians) and the situation in the labor market (unemployment rate). The estimations of the health production functions turn out approximating well real world developments in both countries.
    Keywords: health status, health production function, mortality, Hungary, Austria
    JEL: I12
    Date: 2011–02
  4. By: JG. Brida; Claudio Detotto; Manuela Pulina
    Abstract: This paper analyses the Italian regional efficiency of the hospitality sector using a data envelopment analysis (DEA), for the time span 2000-2004. Via a window DEA, pure technical efficiency is computed. The Lombardy region presents the best relative performance. Overall Italian regions denote important sources of inefficiency mostly related to their inputs. Via a truncated-Tobit analysis, the rate of utilisation and regional intrinsic features positively are found to affect hospitality efficiency. Nevertheless, empirical evidence does not support spill-over effects amongst Italian regions.
    Keywords: Regional hospitality sector; window DEA; double bootstrap; spatial heterogeneity.
    JEL: C14 C24 L83 R11
    Date: 2011
  5. By: Kolstad, Julie Riise (University of Bergen); Lindkvist, Ida (CMI (Chr. Michelsen Institute)
    Abstract: There is growing interest in the role of pro-social motivation in public service delivery. In general, economists no longer question whether people have social preferences, but ask how and when such preferences will influence their economic and social decisions. Apart from revealing that individuals on average share and cooperate even when such actions lower their own material pay-off, economic experiments have documented substantial individual heterogeneity in the strength and structure of social preferences. In this paper we study the extent to which these differences are related to career choices, by testing whether preferences vary systematically between Tanzanian health worker students who prefer to work in the private health sector and those who prefer to work in the public health sector. Despite its important policy implications, this issue has received hardly any attention to date. By combining data from a questionnaire and two economic experiments, we find that students who prefer to work in the public health sector have stronger pro-social preferences than those who prefer to work in the private sector. We also show that the extent to which these students care about others can be conditional and linked to inequality aversion. A systematic selfselection of pro-socially motivated health workers into the public sector suggests that it is a good idea to have two sectors providing health services: this can ensure efficient matching of individuals and sectors by allowing employers in the two sectors to use different payment mechanisms tailored to attract and promote good performance from different types of health workers.
    Keywords: pro-social preferences; career choice; economic experiments; health workers
    JEL: H40 I18 J33 J45
    Date: 2010–04–01
  6. By: Hammitt, James; Haninger, Kevin
    Date: 2010–08
  7. By: Aditya Goenka; Lin Liu; Manh-Hung Nguyen
    Date: 2011–02
  8. By: Chiou, Lesley (Occidental College); Muehlegger, Eric (Harvard University)
    Abstract: We use a rich dataset of weekly cigarette sales to examine how consumers adapt their behavior before and after excise tax increases--whether by reducing demand, stockpiling, traveling to low-tax jurisdictions, or substituting towards lower-cost brands. Consumer response varies substantially for different types of cigarettes. Stockpiling primarily occurs for discount cigarettes and is most pronounced at stores far from lower-tax jurisdictions. Border-crossing is greatest at stores close to low-tax jurisdictions and occurs primarily for cigarettes sold by the carton. Finally, we find modest short-run substitution towards lower-cost brands following a tax-increase, consistent with consumers smoothing the transition to higher cigarette taxes. These differences in consumer behavior lead to meaningful differences in tax incidence--pass-through is higher for discount cigarettes which have more inelastic demand. Pass-through is lower near low-tax borders, especially for cigarettes sold by the carton for which cross-border evasion is greatest.
    JEL: D10 D40 H20 H70
    Date: 2010–06
  9. By: Rocco, Lorenzo; Tanabe, Kimie; Suhrcke, Marc; Fumagalli, Elena
    Abstract: By causing a sizeable reduction in employment 6 percent and labor supply 19 percent, chronic diseases are responsible for a major efficiency loss in the Egyptian economy. Furthermore the impact of chronic diseases on the labor market is not uniformly distributed. The older and the less educated suffer a larger drop in the probability of being employed and in their supply of working hours. The authors estimate the reduced form equations of individual employment status, labor supply and the usual wage equation. They control for unobserved ability and individual preferences by means of a within-siblings estimator. Measurement errors in our self-reported health variable have been accounted for.
    Keywords: Health Monitoring&Evaluation,Labor Markets,Disease Control&Prevention,Labor Policies,Population Policies
    Date: 2011–02–01
  10. By: Nicolas Sirven (IRDES institut for research and information in health economics); Thierry Debrand (IRDES institut for research and information in health economics)
    Abstract: This research uses a time-based approach of the causal relationship (Granger-like)between health and social capital for older people in Europe. We use panel data from waves 1 and 2 of SHARE (the Survey of Health, Ageing, and Retirement in Europe)for the analysis. Additional wave 3 data on retrospective life histories (SHARELIFE)are used to model the initial conditions in the model. For each of the first 2 waves, a dummy variable for involvement in social activities (voluntary associations, church, social clubs, etc.) is used as a proxy for social capital as involvement in Putnamesque associations; and seven health dichotomous variables are retained, covering a wide range of physical and mental health measures. A bivariate recursive Probit model is used to simultaneously investigate (i) the influence of baseline social capital on current health - controlling for baseline health and other current covariates, and (ii)the impact of baseline health on current participation in social activities - controlling for baseline social capital and other current covariates. As expected, we account for a reversed causal effect: individual social capital has a causal beneficial impact on health and vice versa. However, the effect of health on social capital appears to be significantly higher than the social capital effect on health. These results indicate that the sub-population reaching 50 years old in good health has a higher propensity to take part in social activities and to benefit from it (social support, etc.). Conversely, the other part of the population in poor health at 50, may see its health worsening faster because of the missing beneficial effect of social capital. Social capital may therefore be a potential vector of health inequalities.
    Keywords: Healthy Ageing, Social Capital, Health Inequality, Granger Causality, Panel Data.
    JEL: C33 I12 Z13
    Date: 2011–02
  11. By: Kaz Miyagiwa; Paul Rubin
    Abstract: One impetus for reform of the health care system in the United States is that in the U.S. more is spent on medical care than in other countries, with no noticeable difference in results. It is commonly thought that this is a result of a defect in the organization of medicine in the U.S. which can be repaired by “reform.” However, medicine is a labor intensive good and labor is more expensive in the U.S. We show that in a simple general equilibrium model these conditions will invariably lead to a higher price and a higher percentage of GDP spent on the labor intensive good. While reforms may improve the functioning of the health care sector, they are unlikely to have a major effect on spending levels (unless they artificially reduce usage of medical care.)
    Date: 2011–03
  12. By: Cornelia Kaldewei; Ingo Pitterle
    Abstract: This paper uses data from Jordan’s 2007 Demographic and Health Survey to reassess the main determinants of child mortality in this middle-income country. Running different logit estimations to allow for different time windows and sets of variables, we find that behavioural factors have gained importance, compared to the household and community factors that were found to be important in earlier studies. We conclude that once a country has passed a certain threshold in household income, education and access to health care and safe drinking water, policies targeting behavioural changes are the most promising for achieving further reductions in mortality rates.
    Keywords: child mortality; infant mortality; emerging determinants; behavioural factors; middle-income countries; Jordan
    JEL: I12 I18 J13 O29
    Date: 2011–02
  13. By: Aureo de Paula (Department of Economics, University of Pennsylvania); Gil Shapira (Department of Economics, University of Pennsylvania); Petra E. Todd (Department of Economics, University of Pennsylvania)
    Abstract: This paper examines how beliefs about own HIV status affect decisions to engage in risky sexual behavior (as measured by extramarital affairs) and analyzes the potential for interventions that influence beliefs, such as HIV testing and informational campaigns, to reduce transmission rates. The empirical analysis is based on a panel survey of married males for years 2006 and 2008 from the Malawi Diffusion and Ideational Change Project (MDICP). In the data, beliefs about HIV status vary significantly geographically and over time, in part because of newly available testing opportunities and because of cultural differences. We estimate the effect of beliefs on risky behavior using Arellano and Carrasco’s (2003) semiparametric panel data estimator, which accommodates unobserved heterogeneity and belief endogeneity. Results show that changes in the belief of being HIV positive induce changes in risky behavior. Downward revisions in beliefs increase risky behavior and upward revisions decrease it. We modify Arellano and Carrasco’s (2003) estimator to allow for underreporting of extramarital affairs and find the estimates to be robust. Using the estimates and a prototypical epidemiological model of disease transmission, we show that better informing people about their HIV status on net reduces the population HIV transmission rate.
    Keywords: Malawi,HIV,beliefs
    JEL: I12
    Date: 2010–07–26

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