nep-hea New Economics Papers
on Health Economics
Issue of 2014‒05‒17
twenty-two papers chosen by
Yong Yin
SUNY at Buffalo

  1. Economic Behavior under Alcohol Influence: An Experiment on Time, Risk, and Social Preferences By L. Corazzini; A. Filippin; P. Vanin
  2. The bi-directional relationship between gambling and addictive substances By A. Bussu; C. Detotto
  3. Electronic Health Records: Cure-all or Chronic Condition? By Chris Kimble
  4. Parental unemployment and child health By Mörk, Eva; Sjögren, Anna; Svaleryd, Helena
  5. Long-Term Impacts of Compensatory Preschool on Health and Behavior: Evidence from Head Start By Pedro Carneiro; Rita Ginja
  6. Outcomes for Teenage Mothers in the First Years after Birth* By Guyonne Kalb; Trinh Le; Felix Leung
  7. Atypical Employment and Health: A Meta-Analysis By Alice Sanwald; Engelbert Theurl
  8. Medicare Advantage 2014 Spotlight: Enrollment Market Update. By Marsha Gold; Gretchen Jacobson; Anthony Damico; Tricia Neuman
  9. How Do Providers Respond to Public Health Insurance Expansions? Evidence from Adult Medicaid Dental Benefits By Thomas C. Buchmueller; Sarah Miller; Marko Vujicic
  10. Disease and Development: A Reply to Bloom, Canning, and Fink By Daron Acemoglu; Simon Johnson
  11. Financial Health Economics By Ralph S.J. Koijen; Tomas J. Philipson; Harald Uhlig
  12. The Effect of Medical Marijuana Laws on Marijuana, Alcohol, and Hard Drug Use By Hefei Wen; Jason M. Hockenberry; Janet R. Cummings
  13. Banning Foreign Pharmacies from Sponsored Search: The Online Consumer Response By Matthew Chesnes; Weijia (Daisy) Dai; Ginger Zhe Jin
  14. The Market for High-Quality Medicine By Daniel Bennett; Wesley Yin
  15. Is Smoking Inferior? Evidence from Variation in the Earned Income Tax Credit By Donald S. Kenkel; Maximilian D. Schmeiser; Carly J. Urban
  16. Effects of Maternal Depression on Family Food Insecurity By Kelly Noonan; Hope Corman; Nancy E. Reichman
  17. The Role of Publication Selection Bias in Estimates of the Value of a Statistical Life By W. Kip Viscusi
  18. Employment status and perceived health condition: longitudinal data from Italy By Minelli, Liliana; Pigini, Claudia; Chiavarini, Manuela; Bartolucci, Francesco
  19. Differences in birth-weight outcomes: A longitudinal study based on siblings By Bacci, Silvia; Bartolucci, Francesco; Chiavarini, Manuela; Minelli, Liliana; Pieroni, Luca
  20. The economics of malaria in Africa By Berthelemy, Jean-Claude; Thuilliez, Josselin
  21. Universal Health Coverage and the Challenge of Informal Employment: Lessons from Developing Countries By Ricardo Bitran
  22. Physician induced demand for C-sections: does the convenience incentive matter? By Lefevre, M.;

  1. By: L. Corazzini; A. Filippin; P. Vanin
    Abstract: We report results from an incentivized laboratory experiment to provide controlled evidence on the causal effects of alcohol consumption on risk preferences, time perception and altruism. Our design allows disentangling the pharmacological effects of alcohol intoxication from those mediated by expectations, as we compare behaviors of three groups of subjects: those participating to an experiment with no reference to alcohol, those exposed to the possibility of consuming alcohol but assigned to a placebo and those having effectively consumed alcohol. Once randomly assigned to one treatment, subjects were administered a series of consecutive economic tasks, being the sequence kept constant across treatments. After controlling for both the willingness to pay and the potential misperception of probabilities as elicited in the experiment, we do not detect any effect of alcohol in depleting subjects’ risk tolerance. On the contrary, we find that alcohol intoxication increases impatience. Moreover, we find that alcohol makes subjects less generous as we detect a negative relationship between the blood alcohol concentration and the amount of money donated to NGOs.
    JEL: D03 I10 C91
    Date: 2014–05
  2. By: A. Bussu; C. Detotto
    Abstract: The aim of this study is to measure the impact of gambling activity on health among a sample of 709 gamblers in Sardinia (Italy). In fact, gambling is often associated with other lifestyle risk factors that increase the negative effect of such activity. In this paper a multivariate probit approach is proposed in order to document the relationship between gambling expenditures and other addictive behaviours, namely smoking, alcohol and drugs consumption, controlling for a set of individual and gambling characteristics along with emotional and psychological factors. The findings show a bidirectional effect between gambling involvement and alcohol and drugs consumption. Moreover, betting more money leads to an increase in the propensity to consume tobacco in the middle of the game. Then, the co-occurrence of two and/or three of the addictive substances under study drives up the probability to get more involved in gambling activity.
    Keywords: risk factors, health, gambling, addictions, co-occurrence
    JEL: C35 C91 D01 D12 I30
    Date: 2014
  3. By: Chris Kimble (Euromed Marseille - École de management - Association Euromed Management - Marseille, MRM - Montpellier Recherche en Management - Université Montpellier II - Sciences et techniques : EA4557 - Université Montpellier I - Université Paul Valéry - Montpellier III - Groupe Sup de Co Montpellier (GSCM) - Montpellier Business School)
    Abstract: Computer-based information systems feature in almost every aspect of our lives, and yet most of us receive handwritten prescriptions when we visit our doctors and rely on paper-based medical records in our healthcare. Although electronic health record (EHR) systems have long been promoted as a cost-effective and efficient alternative to this situation, clear-cut evidence of their success has not been forthcoming. An examination of some of the underlying problems that prevent EHR systems from delivering the benefits that their proponents tout identifies four broad objectives - reducing cost, reducing errors, improving coordination and improving adherence to standards - and shows that they are not always met. The three possible causes for this failure to deliver involve problems with the codification of knowledge, group and tacit knowledge, and coordination and communication. There is, however, reason to be optimistic that EHR systems can fulfil a healthy part, if not all, of their potential.
    Keywords: EHR; Electronic Health Records; Electronic Health Records; Electronic Medical Records; Electronic Patient Records; Healthcare; Information Systems; Knowledge Management
    Date: 2014–04–23
  4. By: Mörk, Eva (Department of Economics); Sjögren, Anna (IFAU); Svaleryd, Helena (Department of Economics)
    Abstract: We analyze to what extent health outcomes of Swedish children are worse among children whose parents become unemployed. To this end we combine Swedish hospitalization data for 1992-2007 for children 3-18 years of age with register data on parental unemployment. We find that children with unemployed parents are 17 percent more likely to be hospitalized than other children, but that most of the difference is driven by selection. A child fixed-effects approach suggests a small effect of parental unemployment on child health.
    Keywords: Parental unemployment; child Health; human capital
    JEL: I12 J13
    Date: 2014–03–03
  5. By: Pedro Carneiro (University College London); Rita Ginja (Uppsala Universitet)
    Abstract: This paper provides new estimates of the medium and long-term impacts of Head Start on health and behavioral problems. We identify these impacts using discontinuities in the probability of participation induced by program eligibility rules. Our strategy allows us to identify the effect of Head Start for the set of individuals in the neighborhoods of multiple discontinuities, which vary with family size, state and year. Participation in the program reduces the incidence of behavioral problems, health problems and obesity of male children at ages 12 and 13. It lowers depression and obesity among adolescents, and reduces engagement in criminal activities and idleness for young adults.
    Keywords: Head Start, Regression Discontinuity, poverty
    JEL: C26 I28 J13
    Date: 2014
  6. By: Guyonne Kalb (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne); Trinh Le (The University of Waikato; and Motu Economic and Public Policy Research); Felix Leung (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne)
    Abstract: This study uses data from the LSAC and HILDA surveys to examine educational, labour market, health and partnership outcomes of young women who became a mother during their teenage years and compares them with outcomes of women who became a mother in their twenties and those who do not have children yet. We find that while teenage motherhood is strongly associated with poorer outcomes in the first years after birth, a large part of the observed associations is due to selection bias. However, although not all of the observed associations can be attributed to the causal impact of teenage motherhood, the indication is that some of the associations are causal, of nontrivial size, and significant. Propensity score matching analysis suggests that relative to childless women with similar characteristics, teenage mothers are 39 percentage points less likely to complete Year 12, 54 percentage points less likely to be employed and 34 percentage points more likely to be a smoker. Relative to childless women, teenage mothers have $100 less in weekly personal income and are 8 percentage points less likely to be in good health or better than good health.
    Keywords: Teenage mothers, educational outcomes, health outcomes, labour market
    JEL: J12 J13
    Date: 2014–03
  7. By: Alice Sanwald; Engelbert Theurl
    Abstract: In this meta-analysis we provide new quantitative evidence on the relationship between the characteristics of working contracts and worker's health. We examine 52 studies covering 26 countries in the time period 1984 - 2010 with a combined sample size of 192. We apply a random effects model using odds ratios and their 95\% confidence intervals as measures for the effect size. We distinguish between six types of employment contracts with decreasing security levels (fixed-term, temporary, casual, on-call, daily, no formal contract) and classify the health outcomes into five subgroups (sickness absence, occupational injuries, health-related behavior, mental health and physical health). Furthermore, we control for selected dimensions of the socioeconomic environment of the studies, e.g. the unemployment rate and GDP growth rate. Summary findings show a higher risk of occupational injuries for atypical employees compared to the reference group. Atypical employment increases complaints about mental and physical health and has a negative impact on health-related behavior. Sickness absence works in the opposite direction and permanent employees are more likely to be absent from work. The heterogeneity of the effect sizes between different contracts of atypical employment is low. Effect sizes are country specific and depend on the health outcome indicators. The macroeconomic surrounding - unemployment rate and GDP growth rate - don't cause variation in study results. The 'healthy worker effect' may lead to an overestimation of the impact of workers' atypical employment contract on the health status. More research work which explicitly focuses on the problems of endogeneity, reverse causality and the selection bias is necessary. Furthermore, additional control groups and the employment biography of workers have to be taken into account.
    Keywords: Meta-Analysis, Atypical Employment, Health Outcomes, Employment Contracts
    JEL: I1 J3 J5
    Date: 2014–05
  8. By: Marsha Gold; Gretchen Jacobson; Anthony Damico; Tricia Neuman
    Keywords: Medicare Advantage, Enrollment Market, 2014 Update, Health
    JEL: I
    Date: 2014–04–30
  9. By: Thomas C. Buchmueller; Sarah Miller; Marko Vujicic
    Abstract: A large and growing number of adults are covered by public insurance, and the Affordable Care Act is predicted to dramatically increase public coverage over the next several years. This study evaluates how such large increases in public coverage affect provider behavior and patient wait times by analyzing a common type of primary care: dental services. We find that when states add dental benefit to adult Medicaid coverage, dentists' participation in Medicaid increases and dentists see more publicly insured patients without decreasing the number of visits provided to privately insured patients. Dentists increase the total number of visits they supply each week while only modestly increasing the amount of time they spend working. They achieve this primarily by making greater use of dental hygienists. As a result, dentists' income increases. Wait times increase modestly, with the largest increases in wait times observed in states with restrictive scope of practice laws governing dental hygienists. These changes are most pronounced among dentists who practice in poor areas where Medicaid coverage is greatest.
    JEL: I11 I13 I18
    Date: 2014–04
  10. By: Daron Acemoglu; Simon Johnson
    Abstract: Bloom, Canning, and Fink (2014) argue that the results in Acemoglu and Johnson (2006, 2007) are not robust because initial level of life expectancy (in 1940) should be included in our regressions of changes in GDP per capita on changes in life expectancy. We assess their claims controlling for potential lagged effects of initial life expectancy using data from 1900, employing a nonlinear estimator suggested by their framework, and using information from microeconomic estimates on the effects of improving health. There is no evidence for a positive effect of life expectancy on GDP per capita in this important historical episode.
    JEL: I15 N40 O15
    Date: 2014–04
  11. By: Ralph S.J. Koijen; Tomas J. Philipson; Harald Uhlig
    Abstract: We provide a theoretical and empirical analysis of the link between financial and real health care markets. We document a “medical innovation premium” of 4-6% annually for equity of medical firms and analyze the implications it has for the growth of the health care sector. We interpret the premium as compensating investors for government-induced proft risk. We provide supportive evidence for this hypothesis through company filings and abnormal return patterns surrounding threats of government intervention. We quantify the implications of the premium for growth in real health care spending by calibrating our model to match historical trends. Policies that had removed government risk would have lead to more than a doubling of medical R&D and would have increased the current share of health care spending by 4% of GDP, with a predicted long run share of 38%.
    JEL: G0 I0
    Date: 2014–04
  12. By: Hefei Wen; Jason M. Hockenberry; Janet R. Cummings
    Abstract: 21 states and the District of Columbia currently have laws that permit marijuana use for medical purposes, often termed medical marijuana laws (MMLs). We tested the effects of MMLs adopted in seven states between 2004 and 2011 on adolescent and adult marijuana, alcohol, and hard drug use. We employed a restricted-access version of the National Survey on Drug Use and Health (NSDUH) micro-level data with geographic identifiers. For those 21 and older, we found that MMLs led to a relative increase in the probability of marijuana use of 16 percent, an increase in marijuana use frequency of 12-17 percent, and an increase in the probability of marijuana abuse/dependence of 15-27 percent. For those 12-20 years old, we found a relative increase in marijuana use initiation of 5-6 percent. Among those aged 21 or above, MMLs increased the frequency of binge drinking by 6-9 percent, but MMLs did not affect drinking behavior among those 12-20 years old. MMLs had no discernible impact on hard drug use in either age group. Taken together, MML implementation increases marijuana use mainly among those over 21, where there is also a spillover effect of increased binge drinking, but there is no evidence of spillovers to other substance use.
    JEL: I18 K32
    Date: 2014–05
  13. By: Matthew Chesnes; Weijia (Daisy) Dai; Ginger Zhe Jin
    Abstract: Increased competition from the Internet has raised a concern of product quality for online prescription drugs. The Food and Drug Administration (FDA) prohibits the importation of unapproved drugs into the US and the National Association of Boards of Pharmacy (NABP) emphasizes their illegality and cites examples of unsafe drugs from rogue pharmacies. An investigation by the Department of Justice (DOJ) revealed that Google was allowing unapproved Canadian pharmacies to advertise on their search engine and target US consumers. Because of heightened concern to protect consumers, Google agreed to ban non-NABP-certified pharmacies from their sponsored search listings in February 2010 and settled with the DOJ in August 2011. We study how the ban on non-NABP-certified pharmacies from sponsored search listings affects consumer search on the Internet. Using click-through data from comScore, we find that non-NABP-certified pharmacies receive fewer clicks after the ban, and this effect is heterogeneous. In particular, pharmacies not certified by the NABP, but certified by other sources (other-certified sites), experience a reduction in total clicks, and some of their lost paid clicks are replaced by organic clicks. These effects do not change significantly after the DOJ settlement. In contrast, pharmacies not certified by any of the four major certification agencies suffer a greater reduction in both paid and organic clicks, and the reduction was exacerbated after the DOJ settlement. These results suggest that the ban has increased the search cost for other-certified sites, but at least some consumers overcome the search cost by switching from paid to organic links. In addition to search cost, the ban may have increased concerns for uncertified sites and discouraged consumers from reaching them via both paid and organic links.
    JEL: D83 I18 K32 L81
    Date: 2014–05
  14. By: Daniel Bennett; Wesley Yin
    Abstract: This study examines the effect of chain store entry on drug quality and prices in the retail pharmacy market in Hyderabad, India. In contrast to prevailing mom-and-pop pharmacies, chains exploit scale economies to offer high-quality drugs at lower cost. With a unique data set and a natural experiment methodology, we show that chain entry leads to a relative 5 percent improvement in drug quality and a 2 percent decrease in prices at incumbent retailers. These changes do not depend on the socioeconomic status of consumers, suggesting that chain entry improves consumer welfare throughout the market. Despite the likely role of asymmetric information in this market, we show that consumers partially infer these quality improvements. Our findings suggest that in markets with asymmetric information, organizational technologies such as chains may play an important role translating greater demand into higher quality.
    JEL: I1 L15 O1
    Date: 2014–05
  15. By: Donald S. Kenkel; Maximilian D. Schmeiser; Carly J. Urban
    Abstract: In this paper we estimate the causal income elasticity of smoking participation, cessation, and cigarette demand conditional upon participation. Using an instrumental variables (IV) estimation strategy we find that smoking appears to be a normal good among low-income adults: higher instrumented income is associated with an increase in the number of cigarettes consumed and a decrease in smoking cessation. The magnitude and direction of the changes in the income coefficients from our OLS to IV estimates are consistent with the hypothesis that correlational estimates between income and smoking related outcomes are biased by unobservable characteristics that differentiate higher income smokers from lower income smokers.
    JEL: H2 I1
    Date: 2014–05
  16. By: Kelly Noonan; Hope Corman; Nancy E. Reichman
    Abstract: Theory suggests that adverse life events—such as unemployment or health shocks—can result in food insecurity, which has increased substantially in the U.S. over the past decade alongside the obesity epidemic. We test this proposition by estimating the effects of a specific and salient mental health event—maternal depression during the postpartum year—on child and family food insecurity. Using data from the Early Childhood Longitudinal Study—Birth Cohort, we estimate the effects of maternal depression on food insecurity using both single- and two-stage models, and explore potential buffering effects of relevant public assistance programs and supports. We find that moderate to severe maternal depression increases the likelihood that children and households experience any food insecurity—by between 50 and 80%, depending on the measure of food insecurity. We also find that maternal depression increases the likelihood of reliance on the Supplemental Nutrition Assistance Program; Supplemental Nutrition Program for Women, Infants, and Children; Medicaid; and the Temporary Assistance to Needy Families program, suggesting that these programs play a buffering role.
    JEL: H53 I1 I3
    Date: 2014–05
  17. By: W. Kip Viscusi
    Abstract: Meta-regression estimates of the value of a statistical life (VSL) controlling for publication selection bias yield bias-corrected estimates of VSL that are higher for labor market studies using the more recent Census of Fatal Occupational Injuries (CFOI) data. These results are borne out by the findings for four meta-analysis data sets and different formulations of the variable used to capture publication bias effects. Meta-regression estimates for a large sample of VSL estimates consisting only of results of labor market studies using the CFOI fatality data indicate publication selection bias effects that are not statistically significant in either fixed effects or random effects models with clustered standard errors. The confidence intervals of the publication bias-corrected estimates of the value of a statistical life sometimes include the sample mean estimates and always include the values that are currently used by government agencies.
    JEL: I18 J17 J31 K32
    Date: 2014–05
  18. By: Minelli, Liliana; Pigini, Claudia; Chiavarini, Manuela; Bartolucci, Francesco
    Abstract: The considerable increase of non-standard labor contracts, unemployment and inactivity rates raises the question of whether job insecurity and the lack of job opportunities affect physical and mental well-being differently from being employed with an open-ended contract. In this paper we offer evidence on the relationship between Self Reported Health Status (SRHS) and the employment status in Italy using the Survey on Household Income and Wealth; another aim is to investigate whether these potential inequalities have changed with the recent economic downturn (time period 2006-2010). We estimate an ordered logit model with SRHS as response variable based on a fixed-effects approach which has certain advantages with respect to the random-effects formulation and has not been applied before with SRHS data. The fixed-effects nature of the model also allows us to solve the problems of incidental parameters and non-random selection of individuals into different labor market categories. We find that temporary workers, unemployed and inactive individuals are worse off than permanent employees, especially males, young workers, and those living in the center and south of Italy. Health inequalities between unemployed/inactive and permanent workers widen over time for males and young workers, and arise in the north of the country as well.
    Keywords: self-reported health status, employment status, economic crisis, fixed-effects ordered logit model
    JEL: I10 J60 J70
    Date: 2014–03
  19. By: Bacci, Silvia; Bartolucci, Francesco; Chiavarini, Manuela; Minelli, Liliana; Pieroni, Luca
    Abstract: Objectives We investigate about the differences in birthweight between firstand second-borns, evaluating the impact of changes in pregnancy (e.g., gestational age), demographic (e.g., age), and social (e.g., education level, marital status) maternal characteristics. Data and Methods All analyses are performed on data collected in Umbria (Italy) taking into account a set of 792 women who delivered twice from 2005 to 2008. Firstly, we use a univariate paired t-test for the comparison between weights of first- and second-borns. Secondly, we use linear and nonlinear regression approaches in order to: (i) evaluate the effect of demographic and social maternal characteristics and (ii) predict the odds-ratio of low and high birthweight infants, respectively. Results We find that the birthweight of second-borns is significantly higher than that of first-borns. Statistically significant effects are related with a longer gestational age, an increased number of visits during the pregnancy, and the gender of infants. On the other hand, we do not observe any significant effect related with mother’s age and with other characteristics of interest.
    Keywords: Birthweight; Maternal characteristics; Standard Certificate of Live Birth
    JEL: I00
    Date: 2014–05–07
  20. By: Berthelemy, Jean-Claude; Thuilliez, Josselin
    Abstract: Malaria still claims a heavy human and economic toll, specifically in sub-Saharan Africa. Even though the causality between malaria and poverty is presumably bi-directional, malaria plays a role in the economic difficulties of the region. This article pro
    Keywords: malaria, poverty, economic epidemiology
    Date: 2014
  21. By: Ricardo Bitran
    Abstract: The aim of the report is to review existing approaches and available policy options to improve access to health care services and financial protection against health shocks for informal-sector workers (ISWs). Along with their families, ISWs represent the majority of the population in many developing countries. The report reviews the definition and measurement of the informal sector and the literature on efforts toward its health insurance coverage. It also examines several country cases based on published and unpublished reports and on structured interviews of expert informants. Developing country efforts to expand health coverage are characterized by a common enrollment and financing pattern, starting with formal-sector workers and following with government-subsidized enrollment of the poor. Thus, ISWs are typically left behind and have been referred to as "the missing middle." They find themselves financially unprotected against health shocks and with limited access to quality and timely health care. ISWs are generally reluctant to enroll in insurance schemes, including social health insurance (SHI), community insurance, and other arrangements. Further, initiatives to enroll them in self-financed contributory schemes have generally resulted in adverse selection, as those with high anticipated health needs are more willing to pay and enroll than others. Successful initiatives to cover this population group are the ones where government has abandoned its expectations to derive relatively substantial revenue from it. Offering this group a benefits package that is relatively smaller than that of formal workers and charging them a premium that is only a fraction of that charged to formal workers is a strategy used by some countries to limit the need for public subsidies. While there is evidence that greater insurance coverage has improved access to health services for ISWs and their dependents, in several countries it has not yet improved financial protection for this target group. A broad set of reforms will be required to strengthen the supply side to ensure that additional public financing translates into improved coverage for ISWs.
    Keywords: absenteeism, access to health care, access to health care services, access to health services, access to services, administrative costs, adverse selection, adverse selection ... See More + problems, Ambulatory care, Capita Health Spending, casual employment, catastrophic expenditures, catastrophic health spending, child health, child health services, Choice of Health Financing System, chronic condition, cities, collection of contributions, Community health, contractual arrangements, costs of health care, delivery system, drugs, elderly people, Employee, Employer contribution, employment effects, Employment Status, enrollees, exposure, families, family income, financial incentives, financial protection, financial risk, financial viability, health care, health care delivery, health care providers, health care reform, HEALTH COVERAGE, Health Expenditure, health expenditures, health facilities, Health Financing, health insurance, health insurance fund, health insurance funds, Health Insurance Plan, health insurance program, Health Insurance Scheme, health insurance schemes, health needs, Health Organization, health policy, health providers, health results, health savings accounts, health sector, health services, health status, health system, health systems, health workers, Health-care, hospitals, household enterprises, household expenditure, household income, Household Survey, Human Development, illness, immigrants, impact evaluations, Income, income countries, income groups, income households, informal economy, INFORMAL EMPLOYMENT, informal sector, informal sector workers, insurance arrangements, insurance contributions, Insurance Plan, integration, jobs, labor force, labor market, Labor relations, Labor supply, Labour, laid-off workers, laws, legal protections, legal requirements, Low income, low-income countries, medical care, medical conditions, medical expenditures, Medical Insurance, medicines, migrants, monthly premium, moral hazard, National Health, National Health Insurance, nongovernmental organizations, Nutrition, outpatient care, outpatient services, patients, payroll tax, pocket payments, preliminary results, previous studies, private employment, private enterprises, private health insurance, private insurance, private insurers, Private providers, private sector, private sector workers, probability, production units, public health, public providers, public sector, public spending, quality of care, risk sharing, safety nets, Servants, social development, social health insurance, Social Security, Social security benefits, total employment, unemployed, unemployment, unemployment insurance, unintended consequence, universal health insurance coverage, unpaid workers, wage gap, worker, workers, working conditions, younger workers
    Date: 2014–01
  22. By: Lefevre, M.;
    Abstract: This paper investigates whther physicians induce demand for C-sections in the days preceding leisure periods. I reject that doctors are meaningfully increasing the number of primary cesareans to accommodate their own preferences for control of deliveries around holiday Mondays. Using a sample of more than 1,300,000 deliveries, I can estimate that the induced demand due to convenience is close to zero. A small significant effect is found for women having had a previous C-section. While I replicate previous results of lower C-section rates on leisure periods, I show that they are due to the way doctors schedule planned cesareans rather than to an induced demand for reason of physicians' convenience. If induced demand occurs, the decision takes place in the labour room and is not planned in advance.
    Keywords: C-section, convenience incentive; physician induced demand;
    JEL: I10 I12
    Date: 2014–03

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