nep-hea New Economics Papers
on Health Economics
Issue of 2012‒02‒01
eight papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Mortality transition and differential incentives for early retirement By Hippolyte D'Albis; Paul Lau Sau-Him; Miguel Sanchez-Romero
  2. Dose optimization in HDR brachytherapy: A literature review of quantitative models By De Boeck, Liesje; Belien, Jeroen; Egyed, Wendy
  3. Is it all about Money? A Randomized Evaluation of the Impact of Insurance Literacy and Marketing Treatments on the Demand for Health Microinsurance in Senegal By Jacopo Bonan; Oliver Dagnelie; Philippe LeMay-Boucher; Michel Tenikue
  4. Cash Incentives and Unhealthy Food Consumption By Javier Rivas; Miguel Flores
  5. Health and the Political Agency of Women By Sonia Bhalotra; Irma Clots-Figueras
  6. The Effectiveness of Health Screening By Franz Hackl; Martin Halla; Michael Hummer; Gerald J. Pruckner
  7. Birth weight and family status revisited: evidence from Austrian register data By Wolfgang Frimmel; Gerald J. Pruckner
  8. Child Care Subsidies, Maternal Well-Being, and Child-Parent Interactions: Evidence from Three Nationally Representative Datasets By Chris M. Herbst; Erdal Tekin

  1. By: Hippolyte D'Albis (EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, CES - Centre d'économie de la Sorbonne - CNRS : UMR8174 - Université Paris I - Panthéon Sorbonne); Paul Lau Sau-Him (HKU - School of Economics and Finance - University of Hong Kong); Miguel Sanchez-Romero (mpidr - Max Planck Institute for Demographic Research - Max Planck Institute)
    Abstract: Many studies specify human mortality patterns parametrically, with a parameter change affecting mortality rates at different ages simultaneously. Motivated by the stylized fact that a mortality decline affects primarily younger people in the early phase of mortality transition but mainly older people in the later phase, we study how a mortality change at an arbitrary age affects optimal retirement age. Using the Volterra derivative for a functional, we show that mortality reductions at older ages delay retirement unambiguously, but that mortality reductions at younger ages may lead to earlier retirement due to a substantial increase in the individual's expected lifetime human wealth.
    Keywords: mortality decline; incentive for early retirement; years-to-consume effect; lifetime human wealth effect
    Date: 2012–01
  2. By: De Boeck, Liesje (Hogeschool-Universiteit Brussel (HUB), Belgium); Belien, Jeroen (Hogeschool-Universiteit Brussel (HUB), Belgium); Egyed, Wendy (TriFinance, Zaventem, Belgium)
    Abstract: HDR brachytherapy is a form of internal radiotherapy, in which a tumor receives a temporary high dose of radiation. The treatment is commonly used in clinical practice. We discuss the literature based on the following criteria: scope (interstitial or intracavitary), planning method (forward or inverse planning), objectives (in order to guarantee the right dose for the target area, critical organs and normal tissue), decision process (a priori, a posteriori or interactive), optimization techniques (exact, deterministic heuristic or stochastic heuristic method) and evaluation criteria (to measure the performance of the model results). The review serves three goals. First, we provide an overview of recent developments in the literature regarding the application of quantitative models for HDR dose optimization. Second, the classification allows to indicate recent developments in relation to each criterion and as such, provides an effective overview for researchers who are interested in a particular perspective. Finally, we want to explore opportunities for these quantitative models. We end the paper by revealing the main shortcomings in the current models: a better adaptation of clinical requirements to the mathematical model formulation, and a focus on probabilistic planning.
    Keywords: literature review; quantitative model; dose optimization; HDR brachytherapy
    Date: 2011–12
  3. By: Jacopo Bonan; Oliver Dagnelie; Philippe LeMay-Boucher; Michel Tenikue
    Abstract: In Senegal mutual health organizations (MHOs) have been present in the greater region of Thiès for years. Despite their benefits, in some areas there remain low take-up rates. We offer an insurance literacy module, communicating the benefits from health microinsurance and the functioning of MHOs, to a randomly selected sample of households in the city of Thiès. The effects of this training, and three cross-cutting marketing treatments, are evaluated using a randomized control trial. We find that the insurance literacy module has no impact, but that our marketing treatment has a significant effect on the take up decisions of households.
    Keywords: Community based health insurance scheme, Randomized control trials, Africa, Senegal
    JEL: C93 O17
    Date: 2012–01
  4. By: Javier Rivas; Miguel Flores
    Abstract: The costs associated to unhealthy food consumption are not only paid by those suffering from overweight but by all members of society in terms of higher costs for the social security system in place. With this in mind, we study the effectiveness of a tax, a subsidy and cash incentives in reducing unhealthy food consumption. We proceed by calibrating and simulating to US and UK data an intertemporal rational choice model with habit. Our findings suggest that cash incentives may be the most effective policy in reducing unhealthy food consumption yet it is the most costly one. Taxes are relatively ineffective in reducing unhealthy food consumption. Subsidies have the best balance between effectiveness and monetary benefits to the society.
    Keywords: Habit; Junk Food; Overweight; Public Policy; Rational Addiction
    JEL: D11 D04 H31
    Date: 2011–10
  5. By: Sonia Bhalotra; Irma Clots-Figueras
    Abstract: We investigate whether politician gender influences policy outcomes in India. We focus upon antenatal and postnatal public health provision since the costs of poor services in this domain are disproportionately borne by women. Accounting for potential endogeneity of politician gender and the sample composition of births, we find that a one standard deviation increase in women’s political representation results in a 1.5 percentage point reduction in neonatal mortality. Women politicians are more likely to build public health facilities and encourage antenatal care, institutional delivery and immunization. The results are topical given that a bill proposing quotas for women in state assemblies is currently pending in the Indian Parliament.
    Keywords: political identity, gender, mortality, health, social preferences, India.
    JEL: H41 I18 O15
    Date: 2011–12
  6. By: Franz Hackl; Martin Halla; Michael Hummer; Gerald J. Pruckner
    Abstract: Using a matched insurant-general practitioner panel data set, we estimated the effect of a general health-screening program on individuals’ health status and health care cost. To account for selection into treatment, we used regional variations in the intensity of exposure to supply-determined screening recommendations as an instrumental variable. We found that screening participation substantially increased inpatient and outpatient health care costs for up to two years after treatment. In the medium term, we found cost savings in the outpatient sector, whereas in the long run, no statistically significant effects of screening on either health care cost component could be discerned. In summary, screening participation increases health care costs. Since we did not find any statistically significant effect of screening participation on insurants’ health status at any point in time, we do not recommend a general health-screening program. However, given that we found some evidence for cost-saving potentials for the sub-sample of younger insurants, we suggest more targeted screening programs.
    Keywords: Health screening, health care costs, sick leave, mortality
    JEL: I10 I18
    Date: 2012–01
  7. By: Wolfgang Frimmel; Gerald J. Pruckner
    Abstract: In this paper, we study the socio-economic determinants of birth weight with a focus on the mother’s family status. We use Austrian birth register data covering all births between 1984 and 2007 and find that a mother’s marriage is associated with a higher birth weight of the newborn in a range between 4 and 6 dekagrams. This result remains stable if we control for time-invariant unobserved mother heterogeneity. A divorce around pregnancy results in birth weight 2 to 8 dekagrams lower as compared to that of newborn babies of single mothers. The family status effects in the 2000s are stronger as they were in the 1980s. A quantile regression suggests that family effects are more pronounced at the lower quantiles of the birth weight distribution and diminish at higher percentiles. Finally, in accordance with several instrumental variable (IV) studies, we find that the significantly positive impact of family status on children’s health outcomes disappears if we confine our sample to mothers, who are below the age of 22 years. We conclude that social and financial stress may have an important influence on the birth weight of newborns, especially at the lower tail of the birth weight distribution.
    Keywords: Low birth weight, family status, newborn health, fixed-effects estimations
    JEL: I12 J12 J13 C21
    Date: 2011–12
  8. By: Chris M. Herbst; Erdal Tekin
    Abstract: A complete account of the U.S. child care subsidy system requires an understanding of its implications for both parental and child well-being. Although the effects of child care subsidies on maternal employment and child development have been recently studied, many other dimensions of family well-being have received little attention. This paper attempts to fill this gap by examining the impact of child care subsidy receipt on maternal health and the quality of child-parent interactions. The empirical analyses use data from three nationally representative surveys, providing access to numerous measures of family well-being. In addition, we attempt to handle the possibility of non-random selection into subsidy receipt by using several identification strategies both within and across the surveys. Our results consistently indicate that child care subsidies are associated with worse maternal health and poorer interactions between parents and their children. In particular, subsidized mothers report lower levels of overall health and are more likely to show symptoms consistent with anxiety, depression, and parenting stress. Such mothers also reveal more psychological and physical aggression toward their children and are more likely to utilize spanking as a disciplinary tool. Together, these findings suggest that work-based public policies aimed at economically disadvantaged mothers may ultimately undermine family well-being.
    JEL: I18 J13
    Date: 2012–01

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