nep-hea New Economics Papers
on Health Economics
Issue of 2013‒08‒31
fifteen papers chosen by
Yong Yin
SUNY at Buffalo

  1. Intelligence and safe and healthy behavior in a small sample of students By Jan S. Cramer; S.M. Hoogendoorn
  2. Mortality hazard rates and life expectancy By Jan S. Cramer; Rob Kaas
  3. Adult Mortality, AIDS and Fertility in Rural Malawi By Durevall, Dick; Lindskog, Annika
  4. Some Hospitals are Falling Behind in Meeting 'Meaningful Use' Criteria and Could be Vulerable to Penalties in 2015. By Catherine M. DesRoches; Chantal Worzala; Scott Bates
  5. Perspectives on HeA PA from Certified Application Assistants. By Adam Dunn; Dana Petersen; Leslie Foster
  6. Medication Discontinuation and Reinitiation Among Medicare Part D Beneficiaries Taking Costly Medications. By Margaret S. Colby; Dominick Esposito; Seth Goldfarb; Daniel E. Ball; Vivian Herrera; Leslie J. Conwell; Susan B. Garavaglia; Eric S. Meadows; Martin D. Marciniak
  7. State Costs of Excessive Alcohol Consumption, 2006. By Jeffrey J. Sacks; Jim Roeber; Ellen E. Bouchery; Katherine Gonzales; Frank J. Chaloupka; Robert D. Brewer
  8. Association Between Outpatient Visits Following Hospital Discharge and Readmissions Among Medicare Beneficiaries with Atrial Fibrillation and Other Chronic Conditions. By Mai Hubbard; Sloane Frost; Kimberly Siu; Nicole Quon; Dominick Esposito
  9. State Differences in the Vocational Rehabilitation Experiences of Transition-Age Youth with Disabilities. By Todd Honeycutt; Allison Thompkins; Maura Bardos; Steven Stern
  10. Medicaid Analytic Extract Provider Characteristics (MAXPC) Evaluation Report, 2010. By Deo Bencio
  11. Disease Control, Demographic Change and Institutional Development in Africa By Margaret S. McMillan; William A. Masters; Harounan Kazianga
  12. The Heterogeneous Effects of HIV Testing By Sarah Baird; Erick Gong; Craig McIntosh; Berk Ozler
  13. Cost implications of treatment non-completion in a forensic personality disorder service By Sampson, Christopher; James, Marilyn; Huband, Nick; Geelan, Steve; McMurran, Mary
  14. Conspicuous Consumption, Conspicuous Health, and Optimal Taxation By Redzo Mujcic; Paul Frijters
  15. Poverty and transitions in health By Adena, Maja; Myck, Michal

  1. By: Jan S. Cramer; S.M. Hoogendoorn (University of Amsterdam)
    Abstract: There is ample evidence in the epidemiological literature that intelligence (like education and affluence) is related with reduced mortality rates and a longer life. This may be the direct result of safer and healthier behavior of more intelligent people. We have tried to test this hypothesis by a survey among students of the Amsterdam College of Applied Sciences (Hogeschool van Amsterdam) of whom intelligence had been recorded earlier. We find no convincing evidence in support of this hypothesis, in part because of the small sample size of 131 students.
    Date: 2013–02–01
  2. By: Jan S. Cramer; Rob Kaas (University of Amsterdam)
    Abstract: We consider the relation between mortality hazards and life expectancy for men and women in the Netherlands and in England. Halving the lifetime mortality hazards increases life expectancy at birth by only 9%.
    Date: 2013–03–01
  3. By: Durevall, Dick (Department of Economics, School of Business, Economics and Law, Göteborg University); Lindskog, Annika (Department of Economics, School of Business, Economics and Law, Göteborg University)
    Abstract: The impact of HIV/AIDS on fertility in sub-Saharan Africa has received attention recently, since changes in population structure can impact on future economic development. We analyze the effect of AIDS on actual and desired fertility in rural Malawi, using data from Malawi 2004 Demographic and Health Survey and population censuses. Since AIDS was the dominating cause of death during the 1990s and early 2000s, we use prime-age adult mortality as the key explanatory variable. The focus is on heterogeneity in the response of gender-specific mortality rates. By estimating ordered probit models we show that actual fertility responds positively to male mortality but negatively to female mortality, and that the overall fertility response is positive but small. One interpretation of the findings is that the effects of female and male mortality differ because of an old-age security motive for having children. When a woman risks death before her children grow up, she is less likely to need support of children and demand should be low, but when the risk of husband’s death is high, the woman should expect to rely more on children’s support.
    Keywords: AIDS; demand for children; fertility; HIV; adult mortality; old age security
    JEL: I10 J13 O12
    Date: 2013–08–15
  4. By: Catherine M. DesRoches; Chantal Worzala; Scott Bates
    Abstract: This article cite progress on the adoption of health information technology (HIT) that meets Medicare’s criteria for “meaningful use.†Through an analysis of Medicare data, the study found a substantial increase in the percentage of hospitals receiving electronic health record incentive payments between 2011 (17.4 percent) and 2012 (36.8 percent). However, critical-access, smaller, and publicly owned or nonprofit hospitals appeared to be at risk of failing to meet the criteria.
    Keywords: Meaningful Use, Hospitals, EHR, Health
    JEL: I
    Date: 2013–08–30
  5. By: Adam Dunn; Dana Petersen; Leslie Foster
    Keywords: Health-e-app, Children's Health Care Coverage, California, HeA PA
    JEL: I
    Date: 2013–07–30
  6. By: Margaret S. Colby; Dominick Esposito; Seth Goldfarb; Daniel E. Ball; Vivian Herrera; Leslie J. Conwell; Susan B. Garavaglia; Eric S. Meadows; Martin D. Marciniak
    Keywords: Medication Discontinuation, Medicare Part D Beneficiaries, Health
    JEL: I
    Date: 2013–05–01
  7. By: Jeffrey J. Sacks; Jim Roeber; Ellen E. Bouchery; Katherine Gonzales; Frank J. Chaloupka; Robert D. Brewer
    Abstract: A new study finds excessive alcohol use causes a large economic burden to states and the District of Columbia. The study found that excessive alcohol use cost states and the District a median of $2.9 billion in 2006, ranging from $420 million in North Dakota to $32 billion in California. This means the median cost per state for each alcoholic drink consumed was almost $2.
    Keywords: State Costs, Alcohol Consumption, Substance Abuse, Mental Health
    JEL: I
    Date: 2013–10–30
  8. By: Mai Hubbard; Sloane Frost; Kimberly Siu; Nicole Quon; Dominick Esposito
    Keywords: Care Transitions, Quality of Care, Follow-up Visits, Readmissions, Atrial Fibrillation
    JEL: I
    Date: 2013–07–29
  9. By: Todd Honeycutt; Allison Thompkins; Maura Bardos; Steven Stern
    Keywords: Transition-age youth, Vocational rehabilitation agencies; VR agencies, Youth with disabilities , State comparisons
    JEL: I J
    Date: 2013–08–30
  10. By: Deo Bencio
    Keywords: Medicaid; Medicaid Analytic Extract , MAX, MAX Provider Characteristics 2010, MAXPC 2010
    JEL: I
    Date: 2013–07–31
  11. By: Margaret S. McMillan (Tufts University, IFPRI and NBER); William A. Masters (Tufts University); Harounan Kazianga (Oklahoma State University)
    Abstract: This paper addresses the role of tropical disease in rural demography and land use rights, using data from Onchocerciasis (river blindness) control in Burkina Faso. We combine a new survey of village elders with historical census data for 1975-2006 and geocoded maps of treatment under the regional Onchocerciasis Control Program (OCP). The OCP ran from 1975 to 2002, first spraying rivers to stop transmission and then distributing medicine to help those already infected. Controlling for time and village fixed effects, we find that villages in treated areas acquired larger populations and also had more cropland transactions, fewer permits required for cropland transactions, and more regulation of common property pasture and forest. These effects are robust to numerous controls and tests for heterogeneity across the sample, including time-varying region fixed effects. Descriptive statistics suggest that treated villages also acquired closer access to electricity and telephone service, markets, wells and primary schools, with no difference in several other variables. These results are consistent with both changes in productivity and effects of population size on public institutions.
    Keywords: West Africa, Burkina Faso, Public Health, Land Rights, Rural Infrastructure.
    Date: 2013–06
  12. By: Sarah Baird (Department of Economics, University of Otago, New Zealand); Erick Gong (Department of Economics, Middlebury College); Craig McIntosh (School of International Relations and Pacific Studies, UC San Diego); Berk Ozler (Department of Economics, University of Otago, New Zealand)
    Abstract: An extensive multi-disciplinary literature examines the effects of learning one’s HIV status on subsequent risky sexual behaviors. However, many of these studies rely on nonexperimental designs; use self-reported outcome measures, or both. In this study, we investigate the effects of a randomly assigned Voluntary Counseling and Testing (VCT) intervention on risky sexual behaviors and schooling investments among school-age females in Malawi. We find no overall effects on HIV, Herpes Simplex Virus (HSV-2), or test scores at follow-up. However, receiving a HIV-positive test result causes a large increase in the probability of contracting HSV-2, with stronger effects among those surprised by the HIV-positive test results. Similarly, those surprised by HIV-negative test results see a significant improvement in achievement test scores, consistent with increased returns to investments in human capital. We view the finding on increased HSV-2 prevalence among HIV-positive individuals as a caution to the conventional wisdom that those who learn they are HIV-positive will adopt safer sexual practices.
    Date: 2013–07
  13. By: Sampson, Christopher; James, Marilyn; Huband, Nick; Geelan, Steve; McMurran, Mary
    Abstract: Background: A high proportion of individuals admitted to specialist secure hospital services for treatment of personality disorder do not complete treatment. Non-completion has been associated with poorer treatment outcomes and increased rates of recidivism and hospital readmission, when compared with individuals who do complete treatment or who do not receive treatment at all. Aims: In this study, we sought to determine the economic consequences of non-completion of treatment, using case study data from a secure hospital sample. Both health and criminal justice service perspectives were taken into account. Methods: Data were collected from a medium secure hospital personality disorder unit. A probabilistic decision-analytic model was constructed, using a Markov cohort simulation with 10,000 iterations. The expected cost differential between those who do and those who do not complete treatment was estimated, as was the probability of a cost differential over a 10-year post-admission time horizon. Results: On average, in the first 10 years following admission, those who do not complete treatment go on to incur £52,000 more in costs to the National Health Service and criminal justice system than those who complete treatment. The model estimates that the probability that non-completers incur greater costs than completers is 78%. Conclusion: It is possible that an improvement in treatment completion rates in secure hospital personality disorder units would lead to some cost savings. Thismight be achievable through better selection into treatment or improved strategies for engagement and retention. Our study highlights a financial cost to society of individuals discharged from secure hospital care when incompletely treated. We suggest that it could, therefore, be useful for secure hospitals to introduce routine monitoring of treatment completion.
    Keywords: personality disorder, treatment completion, Markov model
    JEL: I19 K49
    Date: 2013–07–23
  14. By: Redzo Mujcic (School of Economics, The University of Queensland); Paul Frijters (School of Economics, The University of Queensland)
    Abstract: We present a simple model of status-seeking over multiple socioeco- nomic domains by introducing the concept of conspicuous health as an argument in the utility function, in addition to the well-established conspicuous consumption term. We explore the implications of such a utility function for optimal income taxation, where we show an in- crease in concerns for conspicuous health to have an opposite effect on the marginal tax rate, compared to an increase in concerns for conspic- uous consumption. Using life satisfaction panel data from Australia, along with an improved measure of exogenous reference groups (that accounts for the ‘time era’ of respondents), we find evidence of a com- parison health effect.
    Date: 2013–08–20
  15. By: Adena, Maja; Myck, Michal
    Abstract: Using a sample of Europeans aged 50+ from twelve countries in the Survey of Health, Ageing and Retirement in Europe (SHARE) we analyse the role of poor material conditions as a determinant of changes in health over a four-year period. We find that poverty defined with respect to relative incomes has no effect on changes in health. However, broader measures of poor material conditions such as subjective poverty or low relative value of wealth significantly increase the probability of transition to poor health among the healthy and reduce the chance of recovery from poor health over the time interval analysed. In addition to this the subjective measure of poverty has a significant effect on mortality, increasing it by 40.3% among men and by 58.3% among those aged 50-64. Material conditions matter for health among older people. We suggest that if monitoring of poverty in old age and corresponding policy targets are to focus on the relevant measures, they should take into account broader definitions of poverty than those based only on relative incomes. -- Wir untersuchen den Einfluss materieller Umstände auf die Gesundheit der Bevölkerung 50+ in Europa. Dafür analysieren wir die Ergebnisse des Survey of Health, Ageing and Retirement in Europe (SHARE), einer repräsentativen Befragung von Personen im Alter 50+ aus 12 europäischen Ländern über einen Zeitraum von vier Jahren. Unsere Ergebnisse zeigen, dass das Leben in Armut, definiert über das relative Einkommen, keinen Einfluss auf die Gesundheit ausübt. Bei weiter gefassten Definitionen von Armut, wie der subjektiven Armut oder einem niedrigen relativen Vermögen, erhöht sich hingegen die Wahrscheinlichkeit, einen schlechteren Gesundheitszustand zu erreichen, die Genesungswahrscheinlichkeit im analysierten Zeitraum reduziert sich. Des Weiteren ergeben unsere Untersuchungen, dass das subjektive Armutsempfinden die Sterblichkeitsrate signifikant erhöht. Diese Wahrscheinlichkeit ist für Männer um 40,3 Prozent höher, bei den 50- bis 64-Jährigen sogar 58,3 Prozent höher. Solche Ergebnisse weisen darauf hin, dass die materiellen Lebensumstände entscheidend für die Gesundheit der älteren Generation sind. Wir empfehlen, dass sich die Messung von Armut innerhalb der älteren Generation sowie die Zielsetzung in der Politik auf weiter gefasste Armutsdefinitionen stützen sollte als lediglich über das Einkommen definierte.
    Keywords: health transitions,material conditions,poverty,mortality
    JEL: I14 I32 J14
    Date: 2013

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