nep-hea New Economics Papers
on Health Economics
Issue of 2012‒03‒14
eight papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Willingness to pay and QALYs: What can we learn about valuing foodborne risk? By Andersson, Henrik; Hammitt, James; Sundström, Kristian
  2. Child malnutrition and antenatal care: Evidence from three Latin American countries By Ramirez, N.F.; Gamboa, L.F.; Bedi, A.S.; Sparrow, R.A.
  3. Effects of Medicare Payment Reform: Evidence from the Home Health Interim and Prospective Payment Systems By Huckfeldt, Peter J.; Sood, Neeraj; Escarce, Jose J.; Grabowski, David C.; Newhouse, Joseph P.
  4. Socioeconomic Gradient in Health: How Important is Material Deprivation? By Blázquez, Maite; Cottini, Elena; Herrarte, Ainhoa
  5. Health in the cities: when the neighborhood matters more than income By Bilger, M.; Carrieri.;
  6. Measuring the effects of removing subsidies for private insurance on public expenditure for health care By Chai Cheng, T.
  7. FDI and health in developed economies: a panel cointegration analysis By Dierk Herzer, Peter Nunnenkamp
  8. Does Universal Coverage Improve Health? The Massachusetts Experience By Charles J. Courtemanche; Daniela Zapata

  1. By: Andersson, Henrik; Hammitt, James; Sundström, Kristian
    Abstract: This study examines the value of reducing foodborne risk. Research on the valuation of health risk has been dominated by the study of mortality risk. Foodborne risk is, however, in most cases non-fatal and this study therefore focuses on individuals' preferences for reducing morbidity risk related to food consumption. We obtain estimates of the value of a statistical case (VSC) for morbidity risk and the value of a statistical life (VSL) for mortality risk in line with previous findings in the literature. However, we also examine whether WTP is proportional to the expected change in QALYs and estimate a WTP per QALY. We find that WTP is increasing with but not proportional to the change in QALYs. Our monetary estimates are significantly higher than expected and suggest that respondents may have found it dificult to evaluate both a change in risk and health level.
    Keywords: Contingent valuation, Food safety, QALY, Willingness to pay
    Date: 2011–11
  2. By: Ramirez, N.F.; Gamboa, L.F.; Bedi, A.S.; Sparrow, R.A.
    Abstract: The importance of ever-earlier interventions to help children reach their physical and cognitive potential is increasingly being recognized. In part, as a result of this, in developing countries, antenatal care is becoming an important element of strategies to prevent child stunting in utero and later. Notwithstanding their policy relevance and substantial expansion, empirical evidence on the role of antenatal care (ANC) programs in combating stunting is scarce. This study analyzes the role of ANC programs in determining the level and distribution of child stunting in three Andean countries - Bolivia, Colombia, and Peru - where since the 1990s, expanding access to such care has been an explicit policy intervention to tackle child malnutrition. We find that the use of such services is associated with a reduction in the level of malnutrition and at the same time access to such services is relatively equally distributed. While this is a positive sign, it also suggests that further expansion of ANC programs is unlikely to play a large role in reducing inequalities in malnutrition.
    Keywords: antenatal care;child malnutrition;inequality decomposition;height for age
    Date: 2012–03–06
  3. By: Huckfeldt, Peter J. (RAND Corporate, Santa Monica, CA); Sood, Neeraj (University of Southern CA); Escarce, Jose J. (UCLA); Grabowski, David C. (Harvard University); Newhouse, Joseph P. (Harvard University)
    Abstract: Medicare continues to implement payment reforms that shift reimbursement from fee-for-service towards episode-based payment, affecting average and marginal reimbursement. We contrast the effects of two reforms for home health agencies. The Home Health Interim Payment System in 1997 lowered both types of reimbursement; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The Home Health Prospective Payment System in 2000 raised average but lowered marginal reimbursement with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality.
    Date: 2012–03
  4. By: Blázquez, Maite (Departamento de Análisis Económico (Teoría e Historia Económica). Universidad Autónoma de Madrid.); Cottini, Elena (Università Cattolica del Sacro Cuore); Herrarte, Ainhoa (Departamento de Análisis Económico (Teoría e Historia Económica). Universidad Autónoma de Madrid)
    Abstract: In this paper we use the Spanish Living Conditions Survey (2005-2008) to investigate whether there is a socioeconomic gradient in health when alternative measures of socioeconomic status, apart from income, are considered. In particular we construct a material deprivation index that reflects some minimum standards of quality of life, and we analyze its impact on self-reported health. To address this issue, we use a deprivation index that incorporates comparison effects with societal peers and we estimate health equations using a random effects model. Furthermore, the model is extended to include a Mundlak term that corrects for the potential correlation between the error term and the regressors. Our results reveal that the relationship between health and income operates through comparison information with respect to societal peers. In contrast, material deprivation in terms of financial difficulties, basic necessities and housing conditions exerts a direct effect on individual health.
    Keywords: Material deprivation, Mundlak correction, random effects model, self-assessed health.
    JEL: C23 D63 I10
    Date: 2012–03
  5. By: Bilger, M.; Carrieri.;
    Abstract: Using a rich Italian cross-sectional data set, we estimate the effect of a neighborhood quality index based on pollution, crime, and noise on self-assessed health, presence of chronic conditions and limitations in daily activities. We address the self-selection of the residents in their neighborhoods, as well as the possible endogeneity of income with respect to health, through instrumental variable methods and several endogeneity tests. The main novelty is the sound estimation of the neighborhood effect on health using observational data, which has the advantage of providing general results that are not dependent on any experimental design. This allows us to fully compare the neighborhood effect with the traditional socioeconomic determinants of health. Our main findings are that low quality neighborhoods are strongly health damaging. This effect is comparable to the primary/upper secondary education health differential and is even higher than the impact that poor economic circumstances have on health.
    Keywords: Neighborhood quality; Health; Endogeneity; Instrumental Variables;
    JEL: I10 R23 C31
    Date: 2011–12
  6. By: Chai Cheng, T.
    Abstract: This paper investigates the effects of removing subsidies for private health insurance on public sector expenditure for hospital care. An econometric framework using simultaneous equation models is developed to analyse the interrelated decisions on the intensity and type of health care use and insurance. The results indicate that while privately insured individuals are more likely to seek hospital care as a private patient, they do not differ in their intensity of hospital care use compared with those without private insurance. The simulation results suggest that eliminating subsides could potentially yield substantial public sector savings.
    Keywords: Demand for Hospital Care; Private Insurance; Bivariate count data models; Simultaneous equation models; Policy simulation;
    JEL: I11 H42 C31 C15
    Date: 2011–10
  7. By: Dierk Herzer, Peter Nunnenkamp
    Abstract: This paper examines the long-run effect of FDI on health in developed countries. Using panel cointegration techniques, we find a significant and negative long-run effect
    Keywords: FDI, health, panel cointegration
    JEL: I10 F21 C23
    Date: 2012–02
  8. By: Charles J. Courtemanche; Daniela Zapata
    Abstract: In 2006, Massachusetts passed health care reform legislation designed to achieve nearly universal coverage through a combination of insurance market reforms, mandates, and subsidies that later served as the model for national health care reform. Using individual-level data from the Behavioral Risk Factor Surveillance System, we provide evidence that health care reform in Massachusetts led to better overall self-assessed health. An assortment of robustness checks and placebo tests support a causal interpretation of the results. We also document improvements in several determinants of overall health, including physical health, mental health, functional limitations, joint disorders, body mass index, and moderate physical activity. The health effects were strongest among women, minorities, near-elderly adults, and those with incomes low enough to qualify for the law’s subsidies. Finally, we use the reform to instrument for health insurance and estimate a sizeable impact of coverage on health. The effects on coverage were strongest for men, non-black minorities, young adults, and those who qualified for the subsidies, while the effects of coverage were strongest for women, blacks, the near-elderly, and middle-to-upper income individuals.
    JEL: I12 I18
    Date: 2012–03

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