nep-hea New Economics Papers
on Health Economics
Issue of 2015‒01‒03
twenty-six papers chosen by
Yong Yin
SUNY at Buffalo

  2. Money talks: Paying physicians for performance By Keser, Claudia; Peterle, Emmanuel; Schnitzler, Cornelius
  3. Health econometric evaluation of the effects of a continuous treatment: a machine learning approach By Kreif, N.;; Grieve, R.;; Díaz, I.;; Harrison, D.;
  4. Private information in life insurance, annuity and health insurance markets By Wuppermann, A.C.;
  5. Modelling nonlinearities and reference-dependence in general practitioners’ income preferences By Holte, J.H.;; Sivey, P.;; Abelsen, B.;; Olsen, J.A.;
  6. Does quality affect patients’ choice of doctor? Evidence from the UK By Santos, R.;; Gravelle, H.;; Propper, C.;
  7. Effects of Retirement and Lifetime Earnings Profile on Health Investment By Hernán Bejarano; Hillard Kaplan; Stephen Rassenti
  8. Fatal Attraction: health care agglomeration and its consequences. By Stephen Sheppard; Michael Hellstern
  9. Source of health insurance coverage and employment survival among newly disabled workers: Evidence from the health and retirement study By Matthew J. Hill; Nicole Maestas; Kathleen J. Mullen
  10. The Affordable Care Act: A Family-Friendly Policy By Helene Jorgensen; Dean Baker
  11. Inequality of Opportunity in Health and the Principle of Natural Reward: evidence from European Countries By Bricard, Damien; Jusot, Florence; Trannoy, Alain; Tubeuf, Sandy
  12. The political economy of inclusive healthcare in Cambodia Guarantee Scheme in India By Tim Kelsall; Heng Seiha
  13. Do Market Incentives in the Hospital Industry Affect Subjective Health Perceptions? Evidence from the Italian PPS-DRG Reform By Cappellari, Lorenzo; De Paoli, Anna; Turati, Gilberto
  14. A Family Affair: Job Loss and the Mental Health of Spouses and Adolescents By Melisa Bubonya; Deborah A. Cobb-Clark; Mark Wooden
  15. Risky sexual behavior: biological markers and self-reported data By Corno, Lucia; De Paula, Áureo
  16. Basic versus supplementary health insurance: moral hazard and adverse selection By Boone, Jan
  17. The Impact of Health Insurance Expansion on Physician Treatment Choice: Medicare Part D and Physician Prescribing By Tianyan Hu; Sandra L. Decker; Shin-Yi Chou
  18. Incidental Bequests: Bequest Motives and the Choice to Self-Insure Late-Life Risks By Lee M. Lockwood
  19. How Much Does Access to Health Insurance Influence the Timing of Retirement? By Norma Coe; Gopi Shah Goda
  20. Heterogeneous effect of coinsurance rate on healthcare costs: generalized finite mixtures and matching estimators By Galina Besstremyannaya
  21. Out-of-pocket expenditures of private households for dental services - Empirical evidence from Austria By Alice Sanwald; Engelbert Theurl
  22. Assessment of the impact of migration of health professionals on the labour market and health sector performance in destination countries : a report prepared for the EU-ILO project on "Decent work across borders: a pilot project for migrant health professionals and skilled workers" By Wickramasekara, Piyasiri
  23. The Effect of Job Loss on Health: Evidence from Biomarkers By Pierre-Carl Michaud; Eileen Crimmins; Michael Hurd
  24. Maternal Pre-pregnancy BMI, Gestational Weight Gain, and Infant Birth Weight: A Within-Family Analysis in the United States By Ji Yan
  25. Childhood Health and Labor Market Outcomes in the Case of Type 1 Diabetes By Persson, Sofie; Dahlquist, Gisela; Gerdtham, Ulf-G.; Steen Carlsson, Katarina
  26. Using artefactual field and lab experiments to investigate how fee-for-service and capitation affect medical service provision By Brosig-Koch , Jeannette; Hennig-Schmidt , Heike; Kairies-Schwarz, Nadja; Wiesen, Daniel

  1. By: Zoran Simonović, Vesna Simić, Janko Todorov (Institute of Agricultural Economics)
    Abstract: through the current legal framework, which consists of three laws: the Law on Health Insurance, the Law on Compulsory Social Insurance and the Law on Employment and Unemployment Insurance. These laws are observed in terms of the rules that are currently open. This approach is the study of these laws relies on the fact that these laws are applicable regulations in this area. The legislation in force in Serbia, in our opinion, should be subject to change and adjustment with the current legislation in force in the EU. Or should it be changed and improved.
    Keywords: health insurance of farmers, farmers' pension insurance, Serbia.
    JEL: H7 H75
    Date: 2014–04
  2. By: Keser, Claudia; Peterle, Emmanuel; Schnitzler, Cornelius
    Abstract: Pay-for-performance attempts to tie physician payment to quality of care. In a controlled laboratory experiment, we investigate the effect of pay-for-performance on physician provision behavior and patient benefit. For that purpose, we compare a traditional fee-for-service payment system to a hybrid system that blends fee-for-service and pay-for-performance incentives. Physicians are found to respond to pay-for-performance incentives. Approximately 89 percent of the participants qualify for a pay-for-performance bonus payment in the experiment. It follows that a patient treated under the hybrid payment system is significantly more likely to receive optimal treatment than a similar fee-for-service patient. Pay-for-performance generally tends to alleviate over- and under-provision of medical treatment relative to fee-for-service. Irrespective of the payment system, we observe unethical treatment behavior, i.e., the provision of medical services with zero benefit to the patient.
    Keywords: experimental economics,physician remuneration,pay-for-performance (P4P)
    Date: 2014
  3. By: Kreif, N.;; Grieve, R.;; Díaz, I.;; Harrison, D.;
    Abstract: When the treatment under evaluation is continuous rather than binary, the marginal causal effect can be reported from the estimated dose-response function. Here, regression methods can be employed that specify a model for the endpoint, given the treatment and covariates. An alternative is to estimate the generalised propensity score (GPS), which can adjust by the conditional density of the treatment, given the covariates. Witheither regression or GPS approaches, model misspecification can lead to biased estimates. This paper introduces a machine learning approach, the “Super Learnerâ€, to estimate both the GPS and the dose-response function. The Super Learner selects the convex combination of candidate estimation algorithms, to create new estimators. We take a two stage estimation approach whereby the Super Learner selects a GPS, and then a dose-response function conditional on the GPS. We compare this approach to parametric implementations of the GPS and regression methods. We contrast the methods in the Risk Adjustment In Neurocritical care (RAIN) cohort study, in which we estimate the marginal causal effects of increasing transfer time from emergency departments to specialised neuroscience centres, for patients with traumatic brain injury. With parametric models for the outcome we find that dose-response curves differ according to choice of parametric specification. With the Super Learner approach to both regression and the GPS, we find that transfer time does not have a statistically significant marginal effect on the outcome.
    Keywords: program evaluation; generalised propensity score; machine learning;
    JEL: C1 C5
    Date: 2014–08
  4. By: Wuppermann, A.C.;
    Abstract: Economic theory predicts that private information on risks in insurance markets leads to adverse selection. To counterbalance private information insurers collect and use information on applicants to assess their risk and calculate premiums in an underwriting process. Using data from the English Longitudinal Study of Ageing (ELSA) this paper documents that dierences in the information used in underwriting across life insurance, annuity and health insurance markets attenuate private information to dierent extents. The results are in line with - and might help to reconcile - the mixed empirical evidence on adverse selection across these markets.
    Keywords: ELSA; private information; health-related risks; insurance; biomarkers;
    JEL: D82 I13
    Date: 2014–08
  5. By: Holte, J.H.;; Sivey, P.;; Abelsen, B.;; Olsen, J.A.;
    Abstract: This paper tests for the existence of nonlinearity and reference-dependence in income preferences for general practitioners. Confirming the theory of reference dependent utility, within the context of a discrete-choice experiment, we find that losses loom larger than gains in income for Norwegian GPs, a 10% decrease in income is valued approximately equal to a 30% gain. Our results are validated by comparison with equivalent contingent valuation values for marginal willingness to pay and marginal willingness to accept compensation for changes in job characteristics. Physicians’ income preferences determine the effectiveness of ‘pay for performance’ and other incentive schemes. Our results may explain the relative ineffectiveness of financial incentive schemes that rely on increasing physicians’ incomes.
    Keywords: general practitioners; income; reference-dependence; discrete choice experiment;
    JEL: I11 J44 J31
    Date: 2014–08
  6. By: Santos, R.;; Gravelle, H.;; Propper, C.;
    Abstract: Provider competition is a currently popular healthcare reform model. A necessary condition for greater competition to improve quality is that providers will face higher demand if they improve their quality. In this paper we test this crucial assumption in an important part of the health care market by examining whether quality affects the choice of family doctor. We use data on the choices made by 3.4 million English patients from amongst nearly 1000 family doctor practices to estimate the determinants of choice and, in particular, whether quality affects choice. The English setting is a particularly useful test bed since all individuals are entitled to register with a family physician and generally cannot access non-emergency hospital care without doing so. All care is free, so choice of family doctor is not affected by price. Moreover, measures of clinicalquality are publicly available. We find that patients do respond to quality and are willing to travel further to higher quality practices. Our estimates suggest that a one standard deviation increase in the publicly available measure of quality would increase the number of patients a practice would attract by around 15% of the practice patient list.
    Keywords: quality; demand; healthcare; choice; competition; family practice;
    JEL: I11 I18
    Date: 2014–08
  7. By: Hernán Bejarano (Economic Science Institute, Chapman University, Orange, CA); Hillard Kaplan (Economic Science Institute, Chapman University, Orange, CA and University of New Mexico, Albuquerque, NM); Stephen Rassenti (Economic Science Institute, Chapman University, Orange, CA)
    Abstract: We report the results of experiments where in each period of her lifetime the subject must choose how to allocate real earned income between health investment and life enjoyment in each period of a nine-period life in order to maximize aggregate life enjoyment. The key dynamic optimization challenge of the experiment to subjects derives from the fact that investments in health affect future income, but detract from current consumption. Our experimental results show that subjects were successful at reproducing the qualitative predictions of the theoretical model, investing more in health in the absence of retirement and with increasing income profiles. However, we did observe a systematic bias in health investments, being less than optimal in early periods and greater than optimal in late periods of life. We also found a significant effect due to social groupings. These results highlight the potential of lab experiments as a method to study health decisions and understand their determinants.
    Keywords: experimental economics, behavioral economics, health economics, dynamic programming
    Date: 2014
  8. By: Stephen Sheppard (Williams College); Michael Hellstern (Williams College)
    Abstract: In this paper we focus on a fundamental tension between the economies of agglomeration available to health care organizations and the impacts of spatial concentration of health care organizations on overall health outcomes. We identify plausible measures of health care concentration and dispersion, and adapt them to the US urban context. We calculate these measures for nonprofit health organizations for all US metropolitan areas from 1989 to 2009. We use these data to test for signs that agglomeration economies are important for these organizations. We use mortality rates to serve as an indicator of health outcomes, and provide an analysis of the impacts of agglomeration on health outcomes in US cities. This analysis highlights some disturbing results. The analysis suggests that health care organizations in US cities are more clustered than desirable for achieving the best health outcomes.
    Keywords: Health, agglomeration, nonprofits
    JEL: R38 I11 L30
    Date: 2014–11
  9. By: Matthew J. Hill; Nicole Maestas; Kathleen J. Mullen
    Abstract: We use prospective longitudinal data on newly disabled older workers to examine the effect of employer sponsorship of health insurance (ESHI) on post-onset employment and disability insurance claiming. We compare outcomes of workers with ESHI and no access to spousal coverage prior to onset with outcomes of two comparison groups: individuals with ESHI who also have access to spousal coverage and those who are covered by a spouse’s employer prior to onset. We find evidence of "employment lock" among the 20 percent of individuals whose disabilities do not impact their immediate physical capacity but are associated with high medical costs.
    Date: 2014–09
  10. By: Helene Jorgensen; Dean Baker
    Abstract: Most of the discussion of the Affordable Care Act (ACA) has focused on the extent to which it has extended health insurance coverage to the formerly uninsured. This is certainly an important aspect of the law. However by allowing people to buy insurance through the exchanges and extending Medicaid coverage to millions of people, the ACA also largely ends workers’ dependence on their employer for insurance. This gives tens of millions of people the option to change their job, to work part-time, or take time off to be with young children or family members in need of care, or to retire early.
    Keywords: affordable care act, family, working families, aca, part-time employment
    JEL: I I1 H J J8 J83 J88 J3 J33 J38
    Date: 2014–09
  11. By: Bricard, Damien; Jusot, Florence; Trannoy, Alain; Tubeuf, Sandy
    Abstract: This paper aims to quantify and compare inequalities of opportunity in health across European countries considering two alternative normative ways of treating the correlation between effort, as measured by lifestyles, and circumstances, as measured by parental and childhood characteristics, championed by Brian Barry and John Roemer. This study relies on regression analysis and proposed several measures of inequality of opportunities. Data from the Retrospective Survey of SHARELIFE, which focuses on life histories of European people aged 50 and over, are used. In Europe at the whole, inequalities in opportunities stand for almost 50% of the health inequality due to circumstances and efforts in Barry scenario and 57.5% in Roemer scenario. The comparison of the magnitude of inequalities of opportunity in health across European countries shows considerable inequalities in Austria, France, Spain, Germany, whereas Sweden, Poland, Belgium, the Netherlands and Switzerland present the lowest inequalities of opportunities. The normative principle on the way to treat the correlation between circumstances and effort makes little difference in Spain, Austria, Greece, France, Czech Republic, Sweden and Switzerland whereas it would matter the most in Belgium, the Netherlands, Italy, Germany, Poland and Denmark. In most countries, inequalities of opportunity in health are mainly driven by social background affecting adult health directly, and so would require policies compensating for poorer initial conditions. On the other hand, our results suggest a strong social and family determinism of lifestyles in Belgium, the Netherlands, Italy, Germany, Poland and Denmark, which emphasises the importance of inequalities of opportunities in health within those countries and calls for targeted prevention policies.
    Keywords: Equality of opportunity; Principle of reward; Europe; health; inequality decomposition; efforts; circumstances;
    JEL: D63 I14 N30
    Date: 2014–09
  12. By: Tim Kelsall; Heng Seiha
    Abstract: Over the past 15 years, Cambodia has made significant strides in expanding effective access to free healthcare for poor people, thanks largely to 'Health Equity Funds' (HEFs), a multi-stakeholder health-financing mechanism. HEF operators have helped expand access, incentivise health staff, and lobby on behalf of poor patients. However, despite their successes, they have been unable convincingly to address some of the deeper-seated problems of the Cambodian health system, such as under-resourced facilities, underpaid, poorly qualified staff, and a burgeoning private sector. This paper explains this state of affairs as a product of Cambodia's 'political settlement', in which relatively successful multi-stakeholder initiatives exist as 'islands of effectiveness' in a sea of rent-seeking and patronage. While such islands may currently be the best solution available for poor people, the deeper problems are unlikely to be solved without a shift in the political settlement itself.
    Date: 2014
  13. By: Cappellari, Lorenzo (Università Cattolica del Sacro Cuore); De Paoli, Anna (University of Milan Bicocca); Turati, Gilberto (University of Turin)
    Abstract: We exploit time variation across Italian Regions in the implementation of a prospective pay systems (PPS) for hospitals based on Diagnosis Related Groups (DRGs) to assess their impact on self-assessed health status and on the use of health care services. We consider a survey of more than 600,000 individuals, over the years 1993-2007, with information on both individuals' perceived health and their access to a number of health services. Results suggest that the introduction of market incentives via a fixed-price payment system does not lead to worst health perceptions. Instead, the reform marked a moderate decrease in hospitalization and day hospital treatments, coupled with a clear decrease in the access to emergency services. Results are robust to a number of sensitivity checks.
    Keywords: health reforms, self-assessed health
    JEL: I11 I18
    Date: 2014–11
  14. By: Melisa Bubonya (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne); Deborah A. Cobb-Clark (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne; Institute for the Study of Labor (IZA); and ARC Centre of Excellence for Families and Children over the Life Course); Mark Wooden (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne; and Institute for the Study of Labor (IZA))
    Abstract: This study examines the impact of involuntary job loss on the mental health of family members. Estimates from fixed-effects panel data models, using panel data for Australia, provide little evidence of any negative spillover effect on the mental health of husbands as a result of their wives’ job loss. The mental well-being of wives, however, declines following their husbands’ job loss, but only if that job loss results in a sustained period of nonemployment or if the couple experienced financial hardship or relationship strain prior to the husband’s job loss. A negative effect of parental job loss on the mental health of co-resident adolescent children is also found, but appears to be restricted to girls.
    Keywords: Unemployment, involuntary job loss, mental health, families, spouses, adolescents, HILDA Survey
    JEL: I31 J10 J65
    Date: 2014–11
  15. By: Corno, Lucia; De Paula, Áureo
    Abstract: Self-reported data on sexual behaviors have been criticized to be unreliable. In recent studies, risky sexual behaviors have therefore been measured using biomarkers for curable sexually transmitted infections (STIs). Nevertheless, no previous research have tested how reliable such data are. In this paper, we first build an epidemiological model to assess the relative performance of biomarkers versus self-reported data. We then suggest an econometric strategy that combines both types of measures, biomarkers and self-reported data, to improve the estimation of correlates of risky sexual behaviors. Using the Demographic and Health Survey from Zambia, we calibrate the model and provide conditions under which self-reported data are a better proxy for risky sexual behaviors than biomarkers. In countries with low STIs prevalence, the biomarker has a higher probability of misclassification of risky behaviors than self-reported answers. Finally, we apply our estimation strategy to these data.
    Keywords: biomarker; misclassification; risky behaviour; self-reported
    JEL: C25 I12 I15
    Date: 2014–11
  16. By: Boone, Jan
    Abstract: This paper introduces a tractable model of health insurance with both moral hazard and adverse selection. We show that government sponsored universal basic insurance should cover treatments with the biggest adverse selection problems. Treatments not covered by basic insurance can be covered on the private supplementary insurance market. Surprisingly, the cost effectiveness of a treatment does not affect its priority to be covered by basic insurance.
    Keywords: adverse selection; cost effectiveness; moral hazard; public vs private insurance; universal basic health insurance; voluntary supplementary insurance
    JEL: D82 H51 I13
    Date: 2014–10
  17. By: Tianyan Hu; Sandra L. Decker; Shin-Yi Chou
    Abstract: We test the effect of the introduction of Medicare Part D on physician prescribing behavior by using data on physician visits from the National Ambulatory Medical Care Survey (NAMCS) 2002-2004 and 2006-2009 for patients aged 60-69. We use a combined DD-RD specification that is an improvement over either the difference-in-difference (DD) or regression discontinuity (RD) designs. Comparing the discrete jump in outcomes at age 65 before and after 2006, we find a 35% increase in the number of prescription drugs prescribed or continued per visit and a 55% increase in the number of generic drugs prescribed or continued, providing evidence of physician response to changes in patient out-of-pocket costs.
    JEL: I13 I18 I31
    Date: 2014–11
  18. By: Lee M. Lockwood
    Abstract: Despite facing significant uncertainty about how long they will live and how much costly health care they will require, few retirees buy life annuities or long-term care insurance. Low rates of long-term care insurance coverage are often interpreted as evidence against the importance of bequest motives since failing to buy insurance exposes bequests to significant risk. In this paper, however, I find that low rates of long-term care insurance coverage, especially in combination with the slow rate at which many retirees draw down their wealth, constitute evidence in favor of bequest motives. Retirees' saving and long-term care insurance choices are highly inconsistent with standard life cycle models in which people care only about their own consumption but match well models in which bequests are luxury goods. Such bequest motives reduce the value of insurance by reducing the opportunity cost of precautionary saving. Buying insurance reduces one's need to engage in precautionary saving, which is most valuable to individuals without bequest motives who wish to consume all of their wealth. The results suggest that bequest motives significantly increase saving and significantly decrease purchases of long-term care insurance and annuities.
    JEL: D91 E21 H55
    Date: 2014–12
  19. By: Norma Coe (University of Washington); Gopi Shah Goda (Stanford University)
    Abstract: Access to health insurance is a known determinant in the decision of when to retire. What remains unknown, however, is how much retirement behavior will change in response to the set of reforms that will be enacted in 2014 with the Patient Protection and Affordable Care Act (ACA). These reforms include more regulation of the non-group market, subsidies to health insurance for the low-to middle-class households, and Medicaid expansions. This project examines the effect of the state-level reforms that are most similar to those included in the ACA on the timing of retirement. We find that non-group health insurance reform substantially increases the hazard of leaving the labor force. For workers aged 63, the hazards of exiting the labor force increases by 2.2 percentage points, or approximately doubling the exit hazard at that age. For workers who report themselves to be in fair or poor health – those most likely to gain access to the individual market through these regulations, we find that the exit hazard differentially increases at age 64, and the self-reported retirement hazard also increase at age 62. These changes in retirement and labor force participation also lead to a hastening of claiming Social Security at age 63.
    Keywords: Retirement, non-group health insurance
    Date: 2014–11
  20. By: Galina Besstremyannaya (Stanford University)
    Abstract: The paper proposes a combination of finite mixture models and matching estimators to account for heterogeneous and nonlinear effects of the coinsurance rate on healthcare expenditure. We use loglinear model and generalized linear models with different distribution families, and measure the conditional average treatment effect of a rise in the coinsurance rate in each component of the model. The estimations with panel data for adult Japanese consumers in 2008-2010 and for female consumers in 2000-2010 demonstrate the presence of subpopulations with high, medium and low healthcare expenditure, and subpopulation membership is explained by lifestyle variables. Generalized linear models provide adequate fit compared to loglinear model. Conditional average treatment effect estimations reveal the existence of nonlinear effects of the coinsurance rate in the subpopulation with high expenditure.
    Keywords: finite mixture model; generalized linear model; matching estimators
    JEL: C44 C61 I13
    Date: 2014–11
  21. By: Alice Sanwald; Engelbert Theurl
    Abstract: Background: Dental services differ from other health services in several dimensions. One important difference is that a substantial share of costs of dental services ? especially those beyond routine dental treatment - are paid directly by the patient out-of-pocket. Objectives: We analyze the socio-economic determinants of out-of-pocket expenditures for dentals services (OOPE) in Austria on the household level. Methods: We use cross-sectional information on OOPE and on household characteristics provided by the Austrian household budget survey 2009/10. We apply a two-part model (Logit/GLM) and a one-part GLM. Results: The probability of OOPE is strongly affected by the life cycle (structure) of the household. It increases with adults? age, with income and partially with the level of education. The type of public insurance has an influence on the expenditure probability while the existence of private health insurance has no significant effect. In contrast to the highly statistically significant coefficients in the first stage the covariates of the second stage remain predominantly insignificant. According to our results, the level of expenditures is mainly driven by the level of education and income. The results of the one-part GLM confirm the results of the two-part model. Conclusions: Our results allow new insights into the determinants of OOPE for dental care. The household level turns out to be an adequate basis to study the determinants of OOPE, although we should be cautious to jump to conclusions for the individual level.
    Keywords: Out-of-pocket expenditures, dental services, two-part model, generalized linear model
    JEL: I1
    Date: 2014–11
  22. By: Wickramasekara, Piyasiri
    Keywords: labour migration, international migration, physician, nurse, health service, quality of care, economic implication, EU countries, OECD countries, UK, USA, migrations de main-d'oeuvre, migration internationale, médecin, infirmière, service de santé, qualité des soins, conséquences économiques, pays de l'UE, pays de l'OCDE, Royaume-Uni, Etats-Unis, migraciones laborales, migración internacional, médico, enfermera, servicio de salud, calidad de la atención, consecuencias económicas, países de la UE, países de la OCDE, Reino Unido, Estados Unidos
    Date: 2014
  23. By: Pierre-Carl Michaud; Eileen Crimmins; Michael Hurd
    Abstract: The effect of job loss on health may play an important role in the development of the SES-health gradient. In this paper, we estimate the effect of job loss on objective measures of physiological dysregulation using longitudinal data from the Health and Re- tirement Study and biomarker measures collected in 2006 and 2008. We use a variety of econometric methods to account for selection and reverse causality. Distinguishing between layoffs and business closures, we find no evidence that business closures lead to worse health outcomes. We also find no evidence that biomarker health measures predict subsequent job loss becaue of business closures. We do find evidence that layoffs lead to diminished health. Although this finding appears to be robust to confounders, we find that reverse causality tends to bias downward our estimates. Matching estimates, which account for self-reported health conditions prior to the layoff and subjective job loss ex- pectations, suggest even stronger estimates of the effect of layoffs on health as measured from biomarkers, in particular for glycosylated hemoglobin (HbA1c) and C-reactive pro- tein (CRP). Overall, we estimate that a layoff could increase annual mortality rates by 9.4%, which is consistent with other evidence of the effect of mass layoffs on mortality.
    Keywords: Job loss, Health, SED-health gradient, Biomarkers
    JEL: I14 J10 J14
    Date: 2014
  24. By: Ji Yan
    Abstract: In the United States, the high prevalence of unhealthy preconception body weight and inappropriate gestational weight gain among pregnant women is an important public health concern. However, the relationship among pre-pregnancy BMI, gestational weight gain, and newborn birth weight has not been well established. This study uses a very large dataset of sibling births and a within-family design to thoroughly address this issue. The baseline regression controlling for mother fixed effects indicates maternal preconception overweight, preconception obesity, and excessive gestational weight gain significantly increase the risk of having a high birth weight baby, while underweight before pregnancy and inadequate gestational weight gain increase the low birth weight incidence. The benchmark results are robust in a variety of sensitivity checks. Since poor birth outcomes especially high birth weight and low birth weight have lasting adverse impacts on newborn’s health, education and socio-economic outcomes later in life, the findings of this research suggest promoting healthy weight among women before pregnancy and preventing inappropriate weight gain during pregnancy can generate significant intergenerational benefits. Key Words: Pre-pregnancy BMI; Gestational weight gain; Birth weight; High birth weight; Low birth weight
    JEL: I12 I18
    Date: 2014
  25. By: Persson, Sofie (Health Economics Unit, Department of Clinical Sciences, Lund University); Dahlquist, Gisela (Pediatrics Unit, Department of Clinical Sciences, Umeå University, Sweden); Gerdtham, Ulf-G. (Department of Economics, Lund University); Steen Carlsson, Katarina (Health Economics Unit, Department of Clinical Sciences, Lund University)
    Abstract: This study investigates the impact of childhood health on labor market outcomes. We used type 1 diabetes as an instrument of health because its cause is multifactorial and it is triggered by a complex combination of genetic and environmental components; its incidence is low and unforeseeable for the individual; and its onset may be considered an exogenous health shock. Using data from the Swedish Childhood Diabetes Register and national registers on education, employment, and earnings for 2,485 individuals born in 1972–1978 and diagnosed with type 1 diabetes at <15 years old, we found that childhood health impacts on labor market outcomes. The results also imply that causality in the often observed correlation between health and socioeconomic status is partly explained by a gradient that runs from health to earnings, rather than the other way around, which has important implications for policy to reduce socioeconomic-related health inequality.
    Keywords: Health; chronic disease; earnings; employment; education
    JEL: I00 I10 I14 J01
    Date: 2014–12–08
  26. By: Brosig-Koch , Jeannette (Faculty of Economics and Business Administration); Hennig-Schmidt , Heike (Department of Health Management and Health Economics); Kairies-Schwarz, Nadja (Faculty of Economics and Business Administration); Wiesen, Daniel (Department of Health Management and Health Economics)
    Abstract: We analyze how physicians, medical students, and non-medical students respond to nancial incentives from fee-for-service and capitation. We employ a series of artefactual eld and conventional lab experiments framed in a physician decision-making context. Physicians, participating in the eld, and medical and non-medical students, participating in lab experiments, respond to the incentives in a consistent way: Signi - cantly more medical services are provided under fee-for-service compared to capitation. Our ndings are robust regarding subjects' gender, age, and personality traits.
    Keywords: artefactual field Experiment; laboratory experiment; fee-for-service; capitation; physician behavior
    JEL: C91 I11
    Date: 2014–11–26

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