nep-hea New Economics Papers
on Health Economics
Issue of 2011‒06‒11
six papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Child health and mothers’ social capital in Indonesia through crisis By Sujarwoto; Gindo Tampubolon
  2. Are health care payments in Albania catastrophic? Evidence form ALSMS 2002, 2005 and 2008 By Tomini, Sonila; Packard, Truman G.
  3. Mental health promotion and prevention: the economic case. By Knapp, Martin; McDaid, David; Parsonage, Michael
  4. Income-related inequalities in the prevalence of depression and suicidal behaviour: a 10-year trend following economic crisis. By Hong, Jihyung; Knapp, Martin; McGuire, Alistair
  5. Did Vietnam Veterans Get Sicker in the 1990s? The Complicated Effects of Military Service on Self-Reported Health By Joshua D. Angrist; Stacey H. Chen; Brigham R. Frandsen
  6. Hospital Productivity: An analysis at medical-area level (Japanese) By MORIKAWA Masayuki

  1. By: Sujarwoto; Gindo Tampubolon
    Abstract: Social capital has been shown to be positively associated with a range of health outcomes, yet few studies have explored the association between mothers’ social capital and child health. We examine the relationship between mothers' access to social capital via participations in community activities and their children's health. Instrumental variable estimator is used to deal with reverse causality. Data come from the Indonesian Family Life Surveys (IFLS) of 1997, 2000, and 2007. We find strong evidence for the association between mother's social capital and child health before and after the Asian financial crisis. In contrast, there is no relation between mother's social capital and child health during the crisis. The results suggest that the link between mother's social capital and child health is severely ruptured during the period of the crisis, possibly by reducing the number of available community activities and the ability of mothers to participate in such activities.
    Date: 2011
  2. By: Tomini, Sonila (Maastricht Graduate School of Governance, Maastricht University); Packard, Truman G. (Europe and Central Asia Human Development Sector, The World Bank)
    Abstract: The absent or poorly functioning risk pooling mechanisms and high amounts of out-of-pocket payments for health care expose households to financial risks associated with major illnesses or accidents. The aim of this paper is to analyse the extent to which out-of-pocket health spending impoverish the households in Albania. The study augments the existing evidence by analysing the dynamics of such payments over different years and the weight that informal payments have in the total out-of-pocket health spending. The data used in this study come from Albania Living Standard Measurement Survey (ALSMS) for 2002, 2005 and 2008. We measure headcount catastrophic payments using different thresholds and the decomposition of indicators by expenditure quintiles to understand better their effects. We find that out-of-pocket and informal payments have increased in real value throughout the years. Even though their catastrophic effect has gone down (due also to declining trends in absolute poverty), the effect for the poorest expenditure quintiles remains high. Out-of-pocket payments deepen the poverty headcount and also enlarge the poverty gap and again the effect is larger for the poorest quintiles. Future policy interventions should provide better protection mechanisms for the poor by providing exemption criteria or subsidised transport and should seek to address the widespread informal payments in the country.
    Keywords: informal payments, out-of-pocket payments, health care expenditure, impoverishment, Albania LSMS, Albania, living standard, poverty
    JEL: E26 I18 I32 I38 O17
    Date: 2011
  3. By: Knapp, Martin; McDaid, David; Parsonage, Michael
    Date: 2011–01
  4. By: Hong, Jihyung; Knapp, Martin; McGuire, Alistair
    Abstract: The issue of health inequalities has steadily gained attention in South Korea, as income inequality widened and social polarization increased following the country’s economic crisis in the late 1990s. While official figures indicate a general trend of worsening mental health, with rapidly rising rates of suicide and depression in particular, the extent of socio-economic inequality with respect to mental health problems has not been well elucidated. This study aimed to measure income-related inequalities in depression, suicidal ideation and suicide attempts in South Korea and to trace their changes over a 10-year period (1998-2007). The concentration index approach was employed to quantify the degree of income-related inequalities, using four waves of the Korea National Health and Nutrition Examination Survey data. The study found persistent pro-rich inequality in depression, suicidal ideation and suicide attempts over the past decade (i.e., individuals with higher incomes were less likely to have these conditions). The inequalities actually doubled over this period. These findings imply a need for expanded social protection policies for the less privileged in the population.
    Date: 2011
  5. By: Joshua D. Angrist; Stacey H. Chen; Brigham R. Frandsen
    Abstract: The veterans disability compensation (VDC) program, which provides a monthly stipend to disabled veterans, is the third largest American disability insurance program. Since the late 1990s, VDC growth has been driven primarily by an increase in claims from Vietnam veterans, raising concerns about costs as well as health. We use the draft lottery to study the long-term effects of Vietnam-era military service on health and work in the 2000 Census. These estimates show no significant overall effects on employment or work-related disability status, with a small effect on non-work-related disability for whites. On the other hand, estimates for white men with low earnings potential show a large negative impact on employment and a marked increase in non-work-related disability rates. The differential impact of Vietnam-era service on low-skill men cannot be explained by more combat or wartheatre exposure for the least educated, leaving the relative attractiveness of VDC for less skilled men and the work disincentives embedded in the VDC system as a likely explanation.
    Keywords: Public economics, social security and public pensions, health, education, welfare,labour, demographic economics
    JEL: H55 H59 I12 I38 J22
    Date: 2010–12
  6. By: MORIKAWA Masayuki
    Abstract: Medical services have become an important sector in recent years as Japan aims to deal with its aging population. This paper estimates hospital productivity by using panel data of prefectures and secondary medical areas. The major focus of this study is on the economies of scale at medical-area level and hospital level. The average length of stay is used as a measure of medical quality. We avoid effects of case-mix by using data of medical areas instead of hospital-level data. By using panel data, we can control unobservable regional characteristics. Disparity of price among regions is eliminated through the use of quantity data. Results show that hospital size affects productivity-the larger the hospital, the higher the productivity. The magnitude of the hospital size effect is economically significant: hospital productivity increases by more than 10% when the size of hospital doubles. The size effects are absent when we do not control the average length of stay. The policy implication is that the consolidation of hospitals through economies of scale contributes to an improvement in productivity.
    Date: 2010–07

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