nep-hea New Economics Papers
on Health Economics
Issue of 2014‒08‒09
ten papers chosen by
Yong Yin
SUNY at Buffalo

  1. A unified structural equation modeling approach for the decomposition of rank-dependent indicators of socioeconomic inequality of health By KESSELS, Roselinde; ERREYGERS, Guido
  2. Self discrimination: A field experiment on obesity By Antonios Proestakisy; Pablo Branas-Garza; Praveen Kujal
  3. The Effect of Local Area Crime on Mental Health By Christian Dustmann; Francesco Fasani
  4. GPs' Response to Price Regulation : Evidence from a Nationwide French Reform By Elise Coudin; Anne Pla; Anne-Laure Samson
  5. Inequality of Opportunity in Health in Indonesia By Jusot, Florence; Mage-bertomeu, Sabine; Menendez, Marta
  6. Integrating Physical Health Care in Behavioral Health Agencies in Rural Pennsylvania. By Angela M. Gerolamo; Jung Y. Kim; Jonathan Brown
  7. How Does Family Health Care Use Respond to Economic Shocks? Realized and Anticipated Effects By Alan C. Monheit; Irina Grafova; Rizie Kumar
  8. Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance By Michael Geruso; Thomas G. McGuire
  9. Does the letter matter (and for everyone)? Quasi-experimental evidence on the effects of home invitation on mammography uptake By Carrieri, V.;; Wuebker, A.;
  10. Rational Addictive Behavior under Uncertainty By Zaifu Yang; Rong Zhang

  1. By: KESSELS, Roselinde; ERREYGERS, Guido
    Abstract: In this paper we present a unified structural equation modeling (SEM) framework for the regression-based decomposition of rank-dependent indicators of socioeconomic inequality of health and compare it with simple ordinary least squares (OLS) regression. The SEM framework forms the basis for a proper use of the most prominent one- and two-dimensional decompositions and provides an argument for using the bivariate multiple regression model for two-dimensional decomposition. Within the SEM framework, the two-dimensional decomposition integrates the feedback mechanism between health and socioeconomic status and allows for dierent sets of determinants of these variables. We illustrate the SEM approach and its outperformance to OLS using data from the Ethiopia 2011 Demographic and Health Survey (DHS).
    Keywords: Inequality measurement, Concentration index, Decomposition methods, Structural Equation Modeling (SEM)
    JEL: C36 D63 I00
    Date: 2014–07
  2. By: Antonios Proestakisy (Institute for Health and Consumer Protection, Joint Research Centre, European Commission); Pablo Branas-Garza (Middlesex University Business School, Middlesex University London); Praveen Kujal (Middlesex University London)
    Abstract: Empirical evidence suggests that physical characteristics such as obesity can result in a salary gap in the work place. It is, however, not clear how much of this (gap) is due to factors emanating from the demand or supply side of the market. In this paper we use a field experiment to study whether a part of this wage gap can be attributed to personality traits of individuals on the supply side. Monitors randomly select individuals to respond to a questionnaire. Individuals can make money requests for completing the questionnaire. In the questionnaire they also self-report several personality chracteristics. We nd that the more obese individuals perceive themselves to be, lesser is the money they request. The negative association between money requests and obesity is mostly driven by female participants. The eect of (self-perceived) non-obese individuals is asymmetric across gender. Self perceived "normal" females, perceived thin by the monitors, request more, meanwhile, males in this category request less relative to those that do not overstate their obesity levels. Our results suggest that lower salary request may anchor obese individuals to lower thresholds and may partly explain the wage gap.
    Keywords: Self-reported obesity, eld experiments, willingness to accept, gender bias
    Date: 2014
  3. By: Christian Dustmann (University College London); Francesco Fasani (Queen Mary University)
    Abstract: This paper analyses the effect of local crime rates on residents’ mental health. Using longitudinal information on individuals’ mental well-being, we address the problem of sorting and endogenous moving behaviour. We find that crime causes considerable mental distress for residents, mainly driven by property crime. Effects are stronger for females, and mainly related to depression and anxiety. The distress caused by one standard deviation increase in local crime is 2-4 times larger than that caused by a one standard deviation decrease in local employment, and about one seventh of the short-term impact of the 7 July 2005 London Bombings.
    Keywords: neighbourhoodeffects,mentalwellbeing,fearofcrime
    JEL: I18 K42 R23
    Date: 2014–07
  4. By: Elise Coudin (CREST); Anne Pla (DREES); Anne-Laure Samson (Université Paris Dauphine)
    Abstract: This paper uses a French reform to evaluate the impacts of price regulation on general practitioners (GP) care provision, fees, and income. This reform has restricted, since 1990, the conditions self-employed GPs have to fulfill to be allowed to over-bill. We exploit 2005 and 2008 Public Health insurance administrative data on GPs activity and fees. We use regression discontinuity techniques in a fuzzy design to estimate causal impacts for GPs who set up practice in 1990 and were constrained to charge regulated prices. Our results suggest that GPs react to income effects. Under price regulation, facing prices lower of 42%, GPs provide 50% of more care than if they could overbill. Male GPs react more than female GPs, which leads to opposite effects on their labor income. GPs are more accessible to patients but may also induce demand. They reduce aside salaried activities, use more lump-sum payment schemes, and occupy more often gate-keeper positions. A complementary analysis at dates closer to the reform suggests that these figures may underestimate the short-term effects of price regulation
    Keywords: extra-billings, fee-for-service, GPs’ activity, causal evaluation, regression discontinuity
    JEL: I11 C21 H51
    Date: 2014–03
  5. By: Jusot, Florence; Mage-bertomeu, Sabine; Menendez, Marta
    Abstract: Whereas health equity issues are undoubtedly more relevant in developing countries, research on health inequalities and, more specifically, on inequality of opportunity in the health dimension, remains scarce in this context. This paper explores the degree of inequality of opportunity in health in a developing country, using the 2007 Indonesian Family Life Survey, a large-scale survey with extremely rich information about individual health outcomes (biomarkers and self-reports) and individual circumstances. We compute a continuous synthetic index of global health status based on a comprehensive set of health indicators and subsequently implement non-parametric and parametric methods in order to quantify the level of inequality of opportunity in the health dimension. Our results show large inequality of opportunities in health in Indonesia, compared to European countries. Concerning transmission mechanisms, parental (particularly maternal) vital status appears as the main channel. Compared to what has been observed in more developed countries, the effect of parental education on health is relatively smaller, and mainly indirect (passing through descendants’ socioeconomic, marital and migration statuses), while the existence of long-term differences in health related to religion, language spoken and particularly province of location suggest a relatively higher relevance of community belonging variables for health equity in the context of a developing country as Indonesia.
    Keywords: Egalité des chances; santé; Indonésie; dominance stochastique; indicateur continu de santé; Equality of opportunity; health; Indonesia; stochastic dominance; continuous health index;
    JEL: D63 I14 O15
    Date: 2014–05
  6. By: Angela M. Gerolamo; Jung Y. Kim; Jonathan Brown
    Keywords: Physcial Health Care, Behavioral Health, Pennsylvania, Health
    JEL: I
    Date: 2014–01–30
  7. By: Alan C. Monheit; Irina Grafova; Rizie Kumar
    Abstract: Families in constrained economic circumstances resulting from economic shocks face difficult choices regarding how best to spend their diminished resources. As families strive to preserve their living standards, decisions regarding health care use and its allocation among family members may become more discretionary and complex. Using two-year panel data from the Medical Expenditure Panel Survey for 2004 to 2011, we examine how the intra-family allocation of health care spending responds to realized and anticipated changes in family economic status. We focus on the share of total family health care spending allocated to children, and measure realized economic shocks based on changes in the family’s income, employment, and health insurance status. We account for anticipated economic shocks by differentiating families by whether they are observed prior to, at the onset of, or during the Great Recession, or in the post-recession period. Our findings suggest that both types of economic shocks affect the share of family health care spending allocated to children, with findings more pronounced for single-mother families. We also find that realized economic shocks have a greater impact on children’s spending share than the anticipated change in economic status associated with the Great Recession and its recovery.
    JEL: I12 I13 I18
    Date: 2014–07
  8. By: Michael Geruso; Thomas G. McGuire
    Abstract: In many markets, including the new U.S. Exchanges, health plans are paid by risk-adjusted capitation, in some markets combined with reinsurance and other payment features. This paper proposes three metrics for grading these complex payment systems: fit, power and balance, each of which addresses a distinct market failure in health insurance. We implement these metrics in a study of Exchange payment systems with data similar to that used to develop the Exchange risk adjustment scheme and describe the tradeoffs among the metrics. We find that a simple reinsurance system scores better on fit, power and balance than the risk adjustment formula in use in the Exchanges.
    JEL: H42 H51 I13 I18
    Date: 2014–07
  9. By: Carrieri, V.;; Wuebker, A.;
    Abstract: We exploit regional variation in the availability of breast cancer screening policies and variations in age eligibility criteria across European regions to estimate the causal effect of home invitation on mammography uptake. We link administrative public data about regional breast cancer screening policies from various sources to individual Survey of Health Ageing and Retirement in Europe (SHARE) data. We find that home invitation increases mammography uptakes by around 24 percentage points. At the same time, we find that home invitation reduces education-related inequalities but increases gradient in the use related to cognitive functions. In addition, significant effects on mammography use are found only when at least 50 per cent of the population is reached by the home invitation. Our results suggest that an exogenous informational shock significantly affects preventive decisions especially among less informed individuals but the effectiveness of the informational shock is strongly reduced for women who are less able to process information.
    Keywords: home invitation; preventive health care; quasi-experiment;
    JEL: C10 I11 I14 I18
    Date: 2014–07
  10. By: Zaifu Yang; Rong Zhang
    Abstract: We develop a new model of addictive behavior that takes as a starting point the classic rational addiction model of Becker and Murphy, but incorporates uncertainty. We model uncertainty through the Wiener stochastic process. This process captures both random events such as anxiety, tensions and environmental cues which can precipitate and exacerbate addictions, and those sober and thought-provoking episodes that discourage addictions. We derive closed-form expressions for optimal (and expected optimal) addictive consumption and capital trajectories and examine their global and local properties. Our theory provides plausible explanations of several important patterns of addictive behavior, and has novel implications for addiction control policy.
    Keywords: Rational Addiction; Stochastic Control; Uncertainty
    JEL: C61 D01 D11 I10 I18 K32
    Date: 2014–07

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