nep-hea New Economics Papers
on Health Economics
Issue of 2014‒08‒28
sixteen papers chosen by
Yong Yin
SUNY at Buffalo

  1. Extreme Weather Events and Child Height: Evidence from Mongolia By Valeria Groppo; Kati Schindler
  3. Self-Assessed Health Status in Turkey by Demographic Factors, Labor Market Status and Risky Health Behaviors By Aysıt Tansel; Karaoğlan, Hanife Deniz
  4. Disability and life satisfaction in Italy By Tindara Addabbo; Elena Sarti; Dario Sciulli
  5. The Willingness to Pay for a QALY: a Review of the Empirical Literature By Ryen, Linda; Svensson, Mikael
  6. What Determines Performance Gap Index of Healthcare in Gujarat? By Iyengar, Shreekant; Dholakia, Ravindra H.
  7. Fertility Responses to Expectations of Child Mortality in a Tuscan Village 1700-1913: A Micro-Data Approach By Mette Ejrnes; Karl Gunnar Persson
  8. Matching Study Designs to Disability-Related Comparative Effectiveness Research Questions. By Jeffrey Ballou; Eugene Rich; Matthew Kehn
  9. Risk Factors Associated with Disability Following Work-Related Injuries. By Nan L. Maxwell; Nathan Wozny
  10. Moral Hazard and Less Invasive Medical Treatment for Coronary Artery Disease: The Case of Cigarette Smoking By Jesse Margolis; Jason Hockenberry; Michael Grossman; Shin-Yi Chou
  11. Unleashing the Power of Big Data for Alzheimer's Disease and Dementia Research: Main Points of the OECD Expert Consultation on Unlocking Global Collaboration to Accelerate Innovation for Alzheimer's Disease and Dementia By OECD
  12. The Short-Run Impacts of Connecticut’s Paid Sick Leave Legislation By Ahn, Thomas; Yelowitz, Aaron
  13. Do Elderly Choose Nursing Homes by Quality, Price or Location? By Hendrik Schmitz; Magdalena Stroka
  14. Is temporary employment a cause or consequence of poor mental health? By Chris Dawson; Michail Veliziotis; Gail Pacheco; Don J Webber
  15. Maternal Health Out-of-Pocket Expenditure and Service Readiness in Lao PDR : Evidence for the National Free Maternal and Child Health Policy from a Household and Health Center Survey By World Bank
  16. Maternal Health, Child Health and Nutrition in Lao PDR : Evidence from a Household Survey in Six Central and Southern Provinces By World Bank

  1. By: Valeria Groppo; Kati Schindler
    Abstract: We provide new evidence on the impact of one severe weather shock on child height in Mongolia. Our focus is on the extremely harsh winter - locally referred to as dzud - of 2009/10, which caused more than 23 percent of the national livestock to perish. This resulted in a food insecurity situation for many Mongolian households. Our analysis identifies causal effects by exploiting exogenous variation in the intensity of the shock across time and space. Results reveal that the shock significantly slowed the growth trajectory of exposed children from herding households. This negative effect is still observable three years after the shock and, hence, likely to persist. Moreover, we explore the role of socioeconomic characteristics and mitigation channels to cushion the impact of the weather shock. Wealthier households and households led by a more experienced head are better able to protect their children from the negative consequences of the 2009/10 winter shock. There are also gender-specific effects, with boys more strongly affected than girls. There is indicative evidence showing that the provision of emergency aid mitigates the negative consequences of the dzud. Moreover, child height has a significant and positive association with households' receipt of informal help. Our findings are robust to alternative measures of shock intensity.
    Keywords: Aid, anthropometrics, children, health, Mongolia, weather shocks
    JEL: I15 J13 O12
    Date: 2014
  2. By: Bogdan Nedanov (Department of Economics,University of Delaware); Charles R. Link (Department of Economics,University of Delaware)
    Abstract: The objective is to estimate the effect on one’s weight decades later of choosing a blue collar job as his/her initial job. OLS and probit models are estimated, using dummy variables for overweight and obesity as the dependent variables. Various two stage models treat occupational choice to be endogenous. Using strong instrumental variables to identify occupational choice, yields statistically significant results indicating that the initial choice of a blue collar job is associated with an increase of 6.6% (4.8%) in the probability of being overweight (obese). We also find that an additional year of blue collar work is associated with an increase of 1.1% and 1.4% in the probability of being overweight and obese, respectively.
    Keywords: occupational choice; obesity; initial blue collar jobs; strong instruments; health general
    JEL: I10 I12 I13 I19 J24
    Date: 2014
  3. By: Aysıt Tansel (Middle East Technical University, Ankara, Turkey); Karaoğlan, Hanife Deniz (Middle East Technical University, Ankara, Turkey)
    Abstract: In this study, we provide both a descriptive analysis and ordered probit analysis of the self-reported health status for adult men and women in Turkey. Self -reported health is considered to be a reliable measure of adult health status and comparable to the clinical measures of health status. We will report on how self- reported health varies by demographic factors, such as education, household income, age, region and gender. We will also consider how Self-reported health varies by labor market indicators. Further, we will also provide evidence on the self -reported health and its variation by different risky health behaviors. The risky health behaviors considered are smoking, drinking, lack of exercise and the body mass index (BMI). Finally, the variation of SAH by objective health measures will be examined. For the study, we will use Health Research Survey of Turkish Statistical Institute (TURKSTAT) for 2008 and 2010. This will be the first study of self -reported health status by gender in Turkey. It will provide a baseline for further studies of the various aspects of health issues in Turkey.
    Keywords: Turkey, Self-Reported Health, Education, Risky Health Behaviors, Demographic Factors, Objective Health Criteria, Ordered Probit.
    JEL: I10 I12 I19
    Date: 2013
  4. By: Tindara Addabbo; Elena Sarti; Dario Sciulli
    Abstract: During the last decades, the socio-economic policy agenda has devoted an increasing attention to the inclusion of disabled people into society. Understanding the drivers of life outcomes and conditions of disabled people is essential to analyze the sources of disadvantaged positions. This paper brings evidence on the predictors of life satisfaction of disabled people in Italy, focusing on four specific dimensions (relations with relatives and friends, economic conditions, and leisure time) and analyzing information on people with functional limitations and health problems, as provided by the 2011 ISTAT survey. Estimation results show that household structure, health and disability status affect life satisfaction more significantly than personal and income variables. Education attainments significantly affect satisfaction with the economic conditions. Finally, we find that older disabled people are, on average, more satisfied than younger disabled people, while gender is relevant when interacted with the household type.
    Keywords: disability, life satisfaction, non-linear response models, average partial effects
    Date: 2014–02
  5. By: Ryen, Linda (Dept. of Economics); Svensson, Mikael (Dept. of Economics)
    Abstract: There has been a rapid increase in the use of cost-effectiveness analysis, with Quality Adjusted Life Years (QALYs) as an outcome measure, in evaluating both medical technologies and public health interventions. Alongside, there is a growing literature on the monetary value of a QALY based on estimates of the willingness to pay (WTP). This paper conducts a review of the literature on the WTP for a QALY. In total 24 studies containing 383 unique estimates of the WTP for a QALY are identified. Trimmed mean and median estimates amount to 74,159 and 24,226 Euros (2010 price level), respectively. In regression analyses the results indicate that the WTP for a QALY is significantly higher if the QALY gain comes from life extension rather than quality of life improvements. The results also show that the WTP for a QALY is dependent on the size of the QALY gain valued.
    Keywords: QALY; Willingness to pay; Literature Review
    JEL: D61 H51 I18
    Date: 2014–07–28
  6. By: Iyengar, Shreekant; Dholakia, Ravindra H.
    Abstract: Health performance of Gujarat viewed in terms of the Human Development Index (HDI) portrays it as a medium performer in the country. However, the index of health component for Gujarat is found to be positively contributing to the HDI ranking of the state. It is, therefore, crucial to review the status of health performance of Gujarat among the other states for improving its relative standing in human development. In this context the present paper attempts to identify the gaps in performance of the health related outcome, output and input indicators from the best performers in each indicator. Moreover, the paper also reviews the trends in health performance of Gujarat over time and also estimates the effectiveness of the state in converting its health inputs to outputs and outputs to outcomes. The results indicate that the outcome indicators have improved in the absolute sense but have high performance gaps except the maternal mortality rate (MMR). Majority of the output and input indicators, however, show poor absolute performance and high performance gaps that have been expanding over time. The effectiveness of conversion of health indicators in Gujarat suggests that while the state has moved above average in conversion of outputs into outcomes, it has moved at a slightly below average level in converting its inputs to outputs over time. Improving the health status of Gujarat requires targeted efforts in specific areas such as controlling neo-natal deaths, improving coverage of children under immunization and address malnourishment. Additionally, building adequate health infrastructure and employing required manpower are also relevant.
  7. By: Mette Ejrnes (Department of Economics, Copenhagen University); Karl Gunnar Persson (Department of Economics, Copenhagen University)
    Abstract: This paper exploits microdata from parish registers in a rural Tuscan village to trace the relationship between experienced and expected child mortality on household fertility strategies. It turns out that spacing of births and hence completed fertility are not only linked to economic risks and infant mortality but also to expected mortality risks as proxied by past child mortality in the village and in previous generations. The results indicate that before the demographic transition households made sequential fertility choices within marriage as a response to economic shocks as well as expected child mortality.
    Keywords: Fertility, Child mortality, Historical demography, Hazard model
    JEL: J13 N33 C41
    Date: 2014–04–24
  8. By: Jeffrey Ballou; Eugene Rich; Matthew Kehn
    Abstract: This article presents methodological and design issues for researchers to consider when addressing disability-related comparative effectiveness research questions.
    Keywords: Comparative Effectiveness, Disability, Healthcare, Observational Study; randomized controlled trial; study design
    JEL: I
    Date: 2013–01–30
  9. By: Nan L. Maxwell; Nathan Wozny
    Keywords: Risk Factors, Disability, Work-Related Injuries
    JEL: I J
    Date: 2014–06–16
  10. By: Jesse Margolis; Jason Hockenberry; Michael Grossman; Shin-Yi Chou
    Abstract: Over the last several decades, numerous medical studies have compared the effectiveness of two common procedures for Coronary Artery Disease: Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG). Most evidence indicates that CABG – the more invasive procedure – leads to superior long term outcomes for otherwise similar patients, though there is little consensus as to why. In this article, we propose a novel explanation: patient offsetting behavior. We hypothesize that patients who undergo the more invasive procedure, CABG, are more likely to improve their behavior – eating, exercise, smoking, and drinking – in a way that increases longevity. To test our hypothesis, we use Medicare records linked to the National Health Interview Survey to study one such behavior: smoking. We find that CABG patients are 12 percentage points more likely to quit smoking in the one-year period immediately surrounding their procedure than PCI patients, a result that is robust to numerous alternative specifications.
    JEL: I10 I12
    Date: 2014–08
  11. By: OECD
    Abstract: More than 35 million people worldwide had dementia in 2010, when annual costs were estimated at USD 604 billion; the number of people with dementia is expected to exceed 115 million by 2050. Alzheimer’s disease is today considered the prototype problem for the Grand Global Challenge in healthcare. Despite decades of intensive research, the causal chain of mechanisms behind Alzheimer’s has remained elusive as reflected in recent failures of well-designed clinical trials on promising investigational new drugs. The multi-factorial nature of the disease requires the collection, storage and processing of increasingly large and very heterogeneous datasets (behavioural, genetic, environmental, epigenetic, clinical data, brain imaging, etc.). No one nation has all the assets to pursue this type of research independently. In an effort to tackle this huge challenge, the OECD held a consultation on "Unlocking Global Collaboration to Accelerate Innovation for Alzheimer’s Disease and Dementia" which looked at ways to harness developments in life sciences and information technologies to accelerate innovation in the prevention and treatment of the disease. This paper reports on the opportunities offered by the informatics revolution and big data. Creating and using big data to change the future of Alzheimer’s and dementia requires careful planning and multi-stakeholder collaboration. Numerous technical, administrative, regulatory, infrastructure and financial obstacles emerge and will need to be hurdled to make this vision a reality.
    Date: 2014–03–17
  12. By: Ahn, Thomas; Yelowitz, Aaron
    Abstract: In 2012, Connecticut became the first state to enact paid sick leave legislation. Using a difference-in-differences framework, we find the law had modest but negative effects on the labor market, particularly on the likelihood of working in the past week.
    Keywords: Paid sick leave, Mandated benefits, Difference-in-differences, Fringe benefits, Employment
    JEL: H75 I12 I18 J33 J38
    Date: 2014–08
  13. By: Hendrik Schmitz; Magdalena Stroka
    Abstract: Quality report cards addressing information asymmetry in the health care market have become a popular strategy used by policymakers to improve the quality of care for elderly. Using individual level data from the largest German sickness fund merged with institutional level data, we examine the relationship between nursing home quality, as measured by recently introduced report cards, nursing home prices, nursing home’s location and the individual choice of nursing homes. Report cards were stepwise introduced as of 2009 and we use a sample of 2010 that includes both homes that had been evaluated at that time and that had not yet been. Thus, we can distinguish between institutions with good and bad ratings as well as non-rated nursing homes. We find that the probability of choosing a nursing home decreases in distance and price. However, we find no significant effect of reported quality on individuals’ choice of nursing homes.
    Keywords: Nursing home choice; quality report cards; quality information; demand
    JEL: I10
    Date: 2014–07
  14. By: Chris Dawson (University of Bath); Michail Veliziotis (University of the West of England, Bristol); Gail Pacheco (Auckland University of Technology); Don J Webber (University of the West of England, Bristol)
    Abstract: Mental health status often has a strong association with labour market outcomes. If people in temporary employment have poorer mental health than those in permanent employment then it is consistent with two mutually inclusive possibilities: temporary employment generates adverse mental health effects and/or individuals with poorer mental health select into temporary from permanent employment. We reveal that permanent workers with poor mental health appear to select into temporary employment thus signalling that prior cross sectional studies may overestimate the influence of employment type on mental health. We also reveal that this selection effect is significantly mitigated by job satisfaction.
    Keywords: Employment transitions; Psychological distress; Anxiety; Life satisfaction; Job satisfaction
    JEL: I12 I31 J23
    Date: 2014–01–09
  15. By: World Bank
    Keywords: Health Monitoring and Evaluation Transport Economics Policy and Planning Housing and Human Habitats Health Systems Development and Reform Health, Nutrition and Population - Population Policies Communities and Human Settlements Transport
    Date: 2013–10
  16. By: World Bank
    Keywords: Health Monitoring and Evaluation Health, Nutrition and Population - Population Policies Housing and Human Habitats Health Systems Development and Reform Disease Control and Prevention Communities and Human Settlements
    Date: 2013–06

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