nep-hea New Economics Papers
on Health Economics
Issue of 2015‒04‒25
29 papers chosen by
Yong Yin
SUNY at Buffalo

  1. Nonparametric Kernel Estimation of the Impact of Tax Policy on the Demand for Private Health Insurance in Australia By Xiaodong Gong; Jiti Gao
  2. Translation and Dissemination of Health Services Research for Health Policy: A Review of Available Infrastructure and Evolving Tools By Marsha Gold
  3. The Effects of Child Mortality Changes on Two Income Groups and Macroeconomics By Hideki Nakamura
  4. A Dynamic Analysis of the Demand for Health Insurance and Health Care By Jonneke Bolhaar; Maarten Lindeboom; Bas van der Klaauw
  5. Health and Inequality By Owen O'Donnell; Eddy Van Doorslaer; Tom Van Ourti
  6. Health Effects of Containing Moral Hazard: Evidence from Disability Insurance Reform By Pilar Garcia-Gomez; Anne C. Gielen
  7. Do Early Life and Contemporaneous Macro-conditions explain Health at Older Ages? By France Portrait; Rob Alessie; Dorly Deeg
  8. The Causal Effect of Retirement on Mortality - Evidence from Targeted Incentives to retire early By Hans Bloemen; Stefan Hochguertel; Jochem Zweerink
  9. Efficiency of Health Investment: Education or Intelligence? By Govert Bijwaard; Hans van Kippersluis
  10. Audit Rates and Compliance: A Field Experiment in Long-term Care By Maarten Lindeboom; Bas van der Klaauw; Sandra Vriend
  11. The Wear and Tear on Health: What is the Role of Occupation? By Bastian Ravesteijn; Hans van Kippersluis; Eddy van Doorslaer
  12. Reserve-Dependent Benefits and Costs in Life and Health Insurance Contracts By Marcus C. Christiansen; Michel M. Denuit; Jan Dhaene
  13. Self-employment and Health: Barriers or Benefits? By Cornelius A. Rietveld; Hans van Kippersluis; A. Roy Thurik
  14. Survival Analysis of very Low Birth Weight Infant Mortality in Taiwan By Chialin Chang; Wei-Chen Chen; Michael McAleer
  15. Universal Coverage on a Budget: Impacts on Health Care Utilization and Out-Of-Pocket Expenditures in Thailand By Supon Limwattananon; Sven Neelsen; Owen O'Donnell; Phusit Prakongsai; Viroj Tangcharoensathien; Eddy van Doorslaer
  16. The Health Returns to Education - What can we learn from Twins? By Petter Lundborg
  17. Childhood Intelligence and Adult Mortality, and the Role of Socio-Economic Status By Jan S. Cramer
  18. The Health Consequences of Adverse Labor Market Events: Evidence from Panel Data By Johanna Catherine Maclean; Douglas A. Webber; Michael T. French; Susan L. Ettner
  19. Does Sanitation Affect Health Outcomes? Evidence from India By Das, Amarendra; Das, Bibhunandini
  20. How are CHIPRA Quality Demonstration States Using Quality Reports to Drive Health Care Improvements for Children? By Grace Anglin; Mynti Hossain
  21. Economic Development, Novelty Consumption, and Body Weight: Evidence from the East German Transition to Capitalism By Dragone, Davide; Ziebarth, Nicolas R.
  22. Infant Health and Longevity: Evidence from a Historical Trial in Sweden By Bhalotra, Sonia R.; Karlsson, Martin; Nilsson, Therese
  23. Impact of Hospital Delivery on Child Mortality: An Analysis of Adolescent Mothers in Bangladesh By Pal, Sarmistha
  24. The Effect of Female and Male Health on Economic Growth: Cross-Country Evidence within a Production Function Framework By Gazi M. Hassan; Arusha Cooray; Mark J. Holmes
  25. The height production function from birth to maturity By De Cao, Elisabetta
  26. Evaluating the HCIA - Behavioral Health/Substance Abuse Awards: First Annual Report By Henry Ireys; Liz Babalola; Michael Barna; Laura Blue; Ellen Bouchery; Jonathan Brown; Crystal Blyler; Dan Friend; Christine Fulton; Matt Kehn; Jasmine Little; Jennifer Lyons; Jessica Nysenbaum; Allison Siegwarth; Michaela Vine
  27. Evaluation of Health Care Innovation Awards (HCIA): Primary Care Redesign Programs, First Annual Report By Boyd Gilman; Sheila Hoag; Lorenzo Moreno; Greg Peterson; Linda Barterian; Laura Blue; Kristin Geonnotti; Tricia Higgins; Mynti Hossain; Lauren Hula; Rosalind Keith; Jennifer Lyons; Brenda Natzke; Brenna Rabel; Rumin Sarwar; Rachel Shapiro; Cara Stepanczuk; Victoria Peebles; KeriAnn Wells; Joseph Zickafoose
  28. Promoting Maternal and Child Health Through Health Text Messaging: An Evaluation of the Text4baby Program (Summary of Key Findings) By Mathematica Policy Research
  29. Education, Health and Subjective Wellbeing in Europe By Leonardo Becchetti; Pierluigi Conzo; Fabio Pisani

  1. By: Xiaodong Gong; Jiti Gao
    Abstract: This paper is motivated by our attempt to answer an empirical question: how is private health insurance take-up in Australia affected by the income threshold at which the Medicare Levy Surcharge (MLS) kicks in? We propose a new difference de-convolution kernel estimator for the location and size of regression discontinuities. We also propose a bootstrapping procedure for estimating confidence bands for the estimated discontinuity. Performance of the estimator is evaluated by Monte Carlo simulations before it is applied to estimating the effect of the income threshold of Medicare Levy Surcharge on the take-up of private health insurance in Australia using contaminated data.
    Keywords: De-convolution kernel estimator, regression discontinuity, error-in-variables, demand for private health insurance.
    JEL: C13 C14 C29 I13
    Date: 2015
  2. By: Marsha Gold
    Abstract: This paper examines how user interest in health services research is shaped by the following factors: the current health care policy environment, the organizations and institutional mechanisms available to advance the movement of health services research into policy and practice, and emerging innovative models. The paper also considers the implications of these factors for health services research. It builds on earlier work defining pathways that support the translation of research (evidence) and policy (action). It is one of a series of papers commissioned by AcademyHealth to help identify strategies that the field can use to enhance the impact of health services research.
    Keywords: Health Services Research, Health Policy, Infrastructure, Evolving Tools
    JEL: I
    Date: 2015–04–17
  3. By: Hideki Nakamura (Osaka City University)
    Abstract: This study considers uncertainty about the number of surviving children. Under prohibition of child labor, a higher survival probability of a child can increase opportunities for education investment as the fertility rate declines with a temporary increase in the number of surviving children. However, per capita GDP may decrease until the start of education investment. When people accumulate their human capital, the effect of an increase in the survival probability would be ambiguous. By applying panel estimation, we examine economic development with the effect of child mortality on the fertility rate and number of surviving children.
    Keywords: Child mortality; Uncertainty about the number of surviving children; Escape from poverty by poor people; Child labor; Panel estimation.
    JEL: I10 I18 J13 O15 O50
    Date: 2015–04
  4. By: Jonneke Bolhaar (VU University Amsterdam); Maarten Lindeboom (VU University Amsterdam); Bas van der Klaauw (VU University Amsterdam)
    Abstract: This discussion paper has led to a publication in <A href="">'European Economic Review'</A>, 56(4), 669-90.<P>We investigate the presence of moral hazard and advantageous or adverse selection in a market for supplementary health insurance. For this we specify and estimate dynamic models for health insurance decisions and health care utilization. Estimates of the health care utilization models indicate that moral hazard is not important. Furthermore, we find strong evidence for advantageous selection, largely driven by heterogeneity in education, income and health preferences. Finally, we show that ignoring dynamics and unobserved fixed effects changes the results dramatically.
    Keywords: supplementary private health insurance, health care utilization, advantageous selection, moral hazard, panel data
    JEL: I11 D82 G22 C33
  5. By: Owen O'Donnell (Erasmus University Rotterdam, The Netherlands, and University of Macedonia, Greece); Eddy Van Doorslaer (Erasmus University Rotterdam); Tom Van Ourti (Erasmus University Rotterdam)
    Abstract: This discussion paper led to a chapter in: (A.B. Atkinson, F.J. Bourguigson (Eds.)), 2014, 'Handbook of Income Distribution', volume 2B, North Holland, Elsevier, chapter 18, 143 pages.<P> We examine the relationship between income and health with the purpose of establishing the extent to which the distribution of health in a population contributes to income inequality and is itself a product of that inequality. The evidence supports a significant and substantial impact of ill-health on income mainly operating through employment, although it is difficult to gauge the magnitude of the contribution this makes to income inequality. Variation in exposure to health risks early in life is a potentially important mechanism through which health may generate, and possibly sustain, economic inequality. If material advantage can be excercised within the domain of health, then economic inequality will generate health inequality. In high income countries, the evidence that income (wealth) does have a causal impact on health in adulthood is weak. But this may simply reflect the difficulty of identifying a relationship that, should it exist, is likely to emerge over the lifetime as poor material living conditions slowly take their toll on health. There is little credible evidence to support the claim that the economic inequality in society threatens the health of all its members, or that relative income is a determinant of health.
    Keywords: income, wealth, health, inequality
    JEL: D31 I14 J3
    Date: 2013–10–15
  6. By: Pilar Garcia-Gomez; Anne C. Gielen (Erasmus University Rotterdam, the Netherlands)
    Abstract: We exploit an age discontinuity in a Dutch disability insurance (DI) reform to identify the health impact of stricter eligibility criteria and reduced generosity. Women subject to the more stringent rule experience greater rates of hospitalization and mortality. A €1,000 reduction in annual benefits leads to a rise of 4.2 percentage points in the probability of being hospitalized and a 2.6 percentage point higher probability of death more than 10 years after the reform. There are no effects on the hospitalization of men subject to stricter rules but their mortality rate is reduced by 1.2 percentage points. The negative health effect on females is restricted to women with low pre-disability earnings. We hypothesize that the gender difference in the effect is due to the reform tightening eligibility particularly with respect to mental health conditions, which are more prevalent among female DI claimants. A simple back-of-the-envelope calculation shows that every dollar reduction in DI is almost completely offset by additional health care costs. This implies that policy makers considering a DI reform should carefully balance the welfare gains from reduced moral hazard against losses not only from less coverage of income risks but also from deteriorated health.
    Keywords: disability insurance, moral hazard, health, mortality, regression discontinuity
    JEL: I14 H53 I38
    Date: 2014–08–07
  7. By: France Portrait (VU University Amsterdam); Rob Alessie (Utrecht University, and Netspar); Dorly Deeg (VU University Amsterdam)
    Abstract: The paper presents an approach which thoroughly assesses the role of early life and contemporaneous macro-conditions in explaining health at older ages. In particular, we investigate the role of exposure to infectious diseases and economic conditions during infancy and childhood, as well as the effect of current health care facilities. Specific attention is paid to the impact of unobserved heterogeneity, selective attrition and omitted relevant macro-variables. We apply our approach to self-reports on functional limitations of Dutch older individuals. Our analysis is performed using data from the Longitudinal Aging Study Amsterdam. The prevalence of functional limitations is found to increase in the nineteen-nineties, in part due to restricted access to hospital care.
    Keywords: early life macro-conditions; contemporaneous macro-conditions,functional limitations; aging
    JEL: I12 J11 J17
  8. By: Hans Bloemen (VU University Amsterdam, Netspar, IZA); Stefan Hochguertel (VU University Amsterdam, Netspar); Jochem Zweerink (VU University Amsterdam, Netspar)
    Abstract: This paper identifies and estimates the impact of early retirement on the probability to die within five years, using administrative micro panel data covering the entire population of the Netherlands. Among the older workers we focus on, a group of civil servants became eligible for retirement earlier than expected during a short time window. This exogenous policy change is used to instrument the retirement choice in a model that explains the probability to die within five years. Exploiting the panel structure of our data, we allow for unobserved heterogeneity by way of individual fixed effects in modeling the retirement choice and the probability to die. We find for men that early retirement, induced by the temporary decrease in the age of eligibility for retirement benefits, decreased the probability to die within five years by 2.5 percentage points. This is a strong effect. We find that our results are robust to several specification changes.
    Keywords: instruments, mortality, retirement
    JEL: C26 I1 J26
    Date: 2013–08–19
  9. By: Govert Bijwaard (University of Groningen, the Netherlands); Hans van Kippersluis (Erasmus School of Economics, Erasmus University Rotterdam, the Netherlands)
    Abstract: In this paper we hypothesize that education is associated with a higher efficiency of health investment, yet that this efficiency advantage is solely driven by intelligence. We operationalize efficiency of health investment as the probability of dying conditional on a certain hospital diagnosis, and estimate a multistate structural equation model with three states: (i) healthy, (ii) ill (in hospital), and (iii) death. We use data from a Dutch cohort born around 1940 that links intelligence tests at age 12 to later-life hospitalization and mortality records. The results suggest that higher Intelligence induces the higher educated to be more efficient users of health investment - intelligent individuals have a clear survival advantage for most hospital diagnoses - yet for unanticipated health shocks and diseases that require complex treatments such as COPD, education still plays a role.
    Keywords: Education, Intelligence, Health, Multistate duration model
    JEL: C41 I14 I24
    Date: 2014–01–09
  10. By: Maarten Lindeboom (VU University Amsterdam); Bas van der Klaauw (VU University Amsterdam); Sandra Vriend (VU University Amsterdam)
    Abstract: We provide evidence from a large-scale field experiment on the causal effects of audit rules on compliance in a market for long-term care. In this setting care should be provided quickly and, therefore, the gatekeeper introduced ex-post auditing. Our results do not show significant effects of variations in random audit rates and switching to a conditional audit regime on the quantity and quality of applications for care. We also do not find evidence for heterogeneous effects across care providers differing in size or hospital status. Our preferred explanation for the lack of audit effects is the absence of direct sanctions for noncompliance. The observed divergence of audit rates in the conditional audit regime is the consequence of sorting and thus identifies the quality of application behavior of providers.
    Keywords: auditing, field experiment, compliance, feedback, long-term care
    JEL: C93 H51 I18
    Date: 2014–03–18
  11. By: Bastian Ravesteijn (Erasmus University Rotterdam); Hans van Kippersluis (Erasmus University Rotterdam); Eddy van Doorslaer (Erasmus University Rotterdam)
    Abstract: This discussion paper led to chapter <A href="">Health and Inequality</A>, pages 311-332 in: (P. Rosa Dias and O. O’Donnell (Eds)) Vol. 21 of 'Research on Economic Inequality', Emerald Group Publishing, 2013, 536 pages.<P> While it seems evident that occupations affect health, effect estimates are scarce. We use a job characteristics matrix in order to characterize occupations by their physical and psychosocial burden in German panel data spanning 26 years. Employing a dynamic model to control for factors that simultaneously affect health and selection into occupation, we find that manual work and low job control both have a substantial negative effect on health that increases with age. The effects of late career exposure to high physical demands and low control at work are comparable to health deterioration due to aging by 16 and 23 months respectively.
    Keywords: Labor, health, dynamic panel data
    JEL: J24 I12
    Date: 2013–09–17
  12. By: Marcus C. Christiansen (University of Ulm, Germany); Michel M. Denuit (Université Catholique de Louvain, Belgium); Jan Dhaene (Katholieke Universiteit Leuven, Belgium, and University of the Free State, South Africa)
    Abstract: Premiums and benefits associated with traditional life insurance contracts are usually specified as fixed amounts in policy conditions. However, reserve-dependent surrender values and reserve-dependent expenses are common in insurance practice. The famous Cantelli theorem in life insurance ensures that under appropriate assumptions surrendering can be ignored in reserve calculations provided the surrender payment equals the accumulated reserve. In this paper, more complex reserve-dependent payment patterns are considered, in line with insurance practice. Explicit formulas are derived for the corresponding reserve.
    Keywords: life insurance, multistate models, Markov process, surrender value, Cantelli theorem
    Date: 2014–08–29
  13. By: Cornelius A. Rietveld (Erasmus University Rotterdam); Hans van Kippersluis (Erasmus University Rotterdam); A. Roy Thurik (Erasmus University Rotterdam)
    Abstract: Forthcoming in 'Health Economics'.<P> The self-employed are often reported to be healthier than wage workers; however, the cause of this health difference is largely unknown. The longitudinal nature of the US Health and Retirement Study allows us to gauge the plausibility of two competing explanations for this difference: a contextual, causal effect of self-employment on health (benefit effect), or a health-related selection of individuals into self-employment (barrier effect). Our main finding is that the selection of comparatively healthier individuals into self-employment accounts for the positive cross-sectional difference. The results rule out a positive contextual effect of self-employment on health, and we present tentative evidence that, if anything, engaging in self-employment is bad for one's health. Given the importance of the self-employed in the economy, these findings contribute to our understanding of the vitality of the labor force.
    Keywords: Health, HRS, selection, self-employment
    JEL: I19 L26
    Date: 2013–09–03
  14. By: Chialin Chang (National Chung Hsing University, Taiwan); Wei-Chen Chen (National Chung Hsing University, Taiwan); Michael McAleer (National Tsing Hua University, China; Erasmus University Rotterdam, the Netherlands; Complutense University of Madrid, Spain)
    Abstract: This paper examines the determinants of very low birth weight infant (or neonatal) mortality using the Taiwan National Health Insurance Research database from 1997 to 2009. After infants are discharged from hospital, it is not possible to track their mortality, so the Cox proportional hazard model is used to analyze the very low birth weight infant mortality rate. In order to clarify treatment responsibility and to avoid selective referral effects, we use the number of infants treated in the preceding five years to observe the effect of a physician’s and hospital’s medical experience on the mortality rate of hospitalized minimal birth weight infants. The empirical results show that, given disease control variables, a higher infant weight, higher quality hospitals, increased hospital medical experience, and higher investment in pediatrics can reduce the mortality rate significantly. However, an increased physician’s medical experience does not seem to influence significantly the very low birth weight infant mortality rate.
    Keywords: Very low birth weight, Neonatal mortality, Physician’s infant experience, Hospital infant experience, Statistical analysis, Cox proportional hazard model, Selective referral, Taiwan National Health Insurance Scheme
    JEL: C41 I10 I13 I18
    Date: 2014–06–10
  15. By: Supon Limwattananon (International Health Policy Program, Ministry of Public Health, Thailand); Sven Neelsen (Institute of Health Policy and Management, Erasmus University Rotterdam); Owen O'Donnell (Erasmus University Rotterdam); Phusit Prakongsai (International Health Policy Program, Ministry of Public Health, Thailand); Viroj Tangcharoensathien (International Health Policy Program, Ministry of Public Health, Thailand); Eddy van Doorslaer (Erasmus University Rotterdam)
    Abstract: We estimate the impact on health care utilization and out-of-pocket (OOP) expenditures of a major reform in Thailand that extended health insurance to one-quarter of the population to achieve universal coverage while keeping health spending below 4% of GDP. Identification is through comparison of changes in outcomes of groups to whom coverage was extended with those of public sector employees and their dependents whose coverage was not affected. The reform is estimated to have reduced the probability that a sick person goes without formal treatment by 3.2 percentage points (11%). It increased the probability of receiving public ambulatory care by 2.7 ppt (5%) and of admission to a public hospital by 1 ppt (18%). OOP expenditures were reduced by one-third on average, as was the probability of spending more than 10% of the household budget on health care, while spending at the very top of the OOP distribution was reduced by one-half representing substantial reductio ns in exposure to medical expenditure risk. Supply-side measures implemented with the coverage extension are likely to have helped realize these effects from an increased, but still very tight, budget.
    Keywords: Health Insurance, Health Care, Medical Expenditures, Universal Coverage, Thailand
    JEL: H42 H51 I18
    Date: 2013–05–16
  16. By: Petter Lundborg (Free University Amsterdam)
    Abstract: This paper estimates the health returns to education, using data on identical twins. I adopt a twin-differences strategy in order to obtain estimates that are not biased by unobserved family background and genetic traits that may affect both education and health. I further investigate to what extent within-twin-pair differences in schooling correlates with within-twin-pair differences in early life health and parent-child relations. The results suggest a causal effect of education on health. Higher educational levels are found to be positively related to self-reported health but negatively related to the number of chronic conditions. Lifestyle factors, such as smoking and overweight, are found to contribute little to the education/health gradient. I am also able to rule out occupational hazards and health insurance coverage as explanations for the gradient. In addition, I find no evidence of heterogenous effects of education by parental education. Finally, the results suggest that factors that may vary within twin pairs, such as birth weight, early life health, parental treatment and relation with parents, do not predict within-twin pair differences in schooling, lending additional credibility to my estimates and to the general vailidy of using a twin-differences design to study the returns to education.
    Keywords: health production; education; schooling; twins; siblings; returns to education; ability bias
    JEL: I12 I11 J14 J12 C41
  17. By: Jan S. Cramer (University of Amsterdam)
    Abstract: The initial purpose of this study was to establish the effect of childhood conditions on longevity from the Brabant data set. This data set combines information at ages 12, 43, 53 and mortality between 53 and 71 for a sample of some 3000 individuals born around 1940 in the Dutch province of North Brabant. Proportional hazard analysis confirms the known association of early intelligence or cognitive ability with longevity, with a standardized hazard ratio of .80; this is the only significant childhood influence. Among men, the effect of some elements of adult socio-economic status can also be ascertained: education, income and wealth are each found to contribute about as much to a longer life as intelligence. The joint effect of all four variables is dominated by childhood intelligence and adult wealth at the expense of education and income.
    Keywords: Cognitive ability, mortality, socio-economic status, proportional hazards
    JEL: C21 I14
    Date: 2012–07–17
  18. By: Johanna Catherine Maclean (Department of Economics, Temple University); Douglas A. Webber (Department of Economics, Temple University); Michael T. French (Health Economics Research Group, University of Miami); Susan L. Ettner (Department of Medicine, University of California Los Angeles)
    Abstract: This study investigates the associations between self-assessed adverse labor market events (experiencing problems with coworkers, employment changes, financial strain) and health. Longitudinal data are obtained from the National Epidemiological Survey of Alcohol and Related Conditions. Our findings suggest problems with coworkers, employment changes, and financial strain are associated with a 3.1% (3.3%), 0.9% (0.6%), and 4.5% (5.1%) reduction in mental health among men (women). Associations are smaller in magnitude and less significant for physical health.
    Keywords: mental health, physical health, employment, income
    JEL: I1 I12 J2
    Date: 2013–11
  19. By: Das, Amarendra; Das, Bibhunandini
    Abstract: In this paper we have attempted to unravel the disparity in sanitation facilities across rural and urban regions of Indian states and the impact of sanitation on health outcomes. Based on the 69th National Sample Survey data set which covers more than 95 000 households we find a wide disparity in the access to sanitation facilities across rural and urban areas of Indian states and across states. While the north-eastern and southern states perform better in sanitation indicators, the eastern and central part of India performs poorly. So far as the relationship between the sanitation and health outcome is concerned our analysis shows that better sanitation facilities do have a positive impact on the health outcomes. From our analysis of four diseases (stomach problem, malaria, skin diseases and fever) that are more caused due to sanitation facilities we observed that better sanitation facilities in terms of access to toilets and bathroom access to regular safe drinking water, practice of storing drinking water in metal or non-metal container, absence of flies and mosquitoes, having separate kitchen and proper disposal of wastes reduces the incidence of diseases
    Keywords: Sanitation, Health
    JEL: I00 I1 I19
    Date: 2015–04–01
  20. By: Grace Anglin; Mynti Hossain
    Abstract: This Highlight focuses on how six States are using quality reports to draw attention to State- or practice-level performance on quality measures in order to drive improvements in the quality of care for children.
    Keywords: CHIPRA quality demonstration, quality measure, feedback report, pediatric, Maine, North Carolina, Florida, Illinois, Alaska, Massachusetts
    JEL: I
    Date: 2015–04–20
  21. By: Dragone, Davide (University of Bologna); Ziebarth, Nicolas R. (Cornell University)
    Abstract: This paper develops a conceptual framework that can explain why economic development goes along with increases in body weight and obesity rates. We first introduce the concept of novelty consumption, which refers to an increase in food availability due to trade or innovation. Then we study how novel food products alter the optimal consumption bundle and welfare, and possibly lead to changes in body weight. We test our model employing the German reunification as a fast motion natural experiment of economic development. Our data elicit detailed information on East Germans' food consumption, body mass, and diet-related health. After the fall of the Wall, East Germans permanently changed their diet by consuming novel western food products. A significant population share permanently gained weight. This is consistent with our theoretical framework where past affects current consumption, and where novel goods determine consumption changes over time with ambiguous effects on diet-related health.
    Keywords: economic development, food consumption, habit formation, learning, novel goods, obesity, nutrition-related health, German reunification
    JEL: D11 D12 I12 I15 L66 O10 O33 Q18 R22
    Date: 2015–04
  22. By: Bhalotra, Sonia R. (University of Essex); Karlsson, Martin (University of Duisburg-Essen); Nilsson, Therese (Lund University)
    Abstract: This paper investigates the potential of an infant intervention to improve life expectancy, contributing to emerging interest in the early life origins of chronic disease. We analyse a pioneering program trialled in Sweden in the 1930s, which provided information, support and monitoring of infant care. Using birth certificate data from parish records matched to death registers, we estimate that the average duration of program exposure in infancy led to a 1.54% point decline in the risk of infant death (23% of baseline risk) and a 2.37% decline in the risk of dying by age 75 (6.5% of baseline risk).
    Keywords: infant health, life expectancy, early life interventions, program evaluation
    JEL: I15 I18 H41
    Date: 2015–04
  23. By: Pal, Sarmistha (University of Surrey)
    Abstract: The present paper provides new evidence that hospital delivery can significantly lower child mortality risks, especially among vulnerable young adolescent mothers in Bangladesh. We exploit the exogenous variation in community's access to local health facilities (both traditional and modern) before and after the completion of the 'Women's Health Project' in 2005 (that enhanced emergency obstetric care in women friendly environment) to identify the causal effect of hospital delivery on various mortality rates among children born during 2002-2007. Our best estimates come from the parents fixed effects models that help limiting any parents-level omitted variable estimation bias. Ceteris paribus, access to family welfare clinic boosts hospital delivery likelihood, which in turn tends to lower neo-natal, early and infant mortality rates, especially among adolescent mothers after the completion of Women's Health Project.
    Keywords: Women's Health Project, emergency and obstetric care, adolescent mothers, household fixed effects models, endogeneity and identification, access to health facilities, infant and child mortality indices
    JEL: D13 I12 O15
    Date: 2015–04
  24. By: Gazi M. Hassan (University of Waikato); Arusha Cooray (University of Nottingham, Malaysia); Mark J. Holmes
    Abstract: Adopting a production function based approach, we model the role of health as a regular factor of production on economic growth, and use disaggregate measures of male and female health capital using principal components analysis. Allowing for the dynamics of TFP to be embedded in the production function, we estimate it both in levels and in growth rates to distinguish between long- and short-run effects. We use appropriate panel cointegration methodology to control for endogeneity, cross-sectional dependence and heterogeneity. Our main finding is that while male and female health capital stock has a significantly positive effect on level of output in the long-run, changes in gender disaggregated health capital has a negative or insignificant effect on output growth in the short-run.
    Keywords: health and economic development; economic growth; endogeneity; panel data; TFP convergence; economics of gender
    JEL: J16
    Date: 2015–04–21
  25. By: De Cao, Elisabetta (Groningen University)
    Date: 2014
  26. By: Henry Ireys; Liz Babalola; Michael Barna; Laura Blue; Ellen Bouchery; Jonathan Brown; Crystal Blyler; Dan Friend; Christine Fulton; Matt Kehn; Jasmine Little; Jennifer Lyons; Jessica Nysenbaum; Allison Siegwarth; Michaela Vine
    Abstract: The Affordable Care Act authorized the Center for Medicare & Medicaid Innovation (CMMI) in the Centers for Medicare & Medicaid Services (CMS) to test innovative health care payment and service delivery models with the potential to lower spending on Medicare, Medicaid, and Children’s Health Improvement Program (CHIP) services while maintaining or improving beneficiaries’ health and the quality of care they receive. The 107 awardees in the first round of the Health Care Innovations Award (HCIA) initiative included a broad range of service delivery models. Innovations that succeed in meeting their objectives may lend themselves to implementation on a broad scale. Consequently, rigorous evaluation of the interventions is critical to achieving HCIA goals.
    Keywords: mental health, substance abuse, Medicaid, Medicare, uninsured, care coordination, integration, telehealth, program evaluation, CMMI
    JEL: I
    Date: 2014–12–11
  27. By: Boyd Gilman; Sheila Hoag; Lorenzo Moreno; Greg Peterson; Linda Barterian; Laura Blue; Kristin Geonnotti; Tricia Higgins; Mynti Hossain; Lauren Hula; Rosalind Keith; Jennifer Lyons; Brenda Natzke; Brenna Rabel; Rumin Sarwar; Rachel Shapiro; Cara Stepanczuk; Victoria Peebles; KeriAnn Wells; Joseph Zickafoose
    Abstract: In July 2012, the Center for Medicare & Medicaid Innovation (CMMI) awarded cooperative agreements to a select group of programs proposing innovative ways to improve the quality and lower the cost of care for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollees. This initiative, the Health Care Innovation Awards (HCIA), is a central part of CMMI’s overall objective of finding effective and efficient ways to achieve better quality of care, improved population health, and lower costs. The initiative also seeks to increase and improve the performance of the health care workforce through enhanced training and education, as well as to rethink the roles and functions of different types of health care workers. CMMI subsequently classified 14 of the 107 HCIA awards as primary care redesign (PCR) programs, representing a broad range of intervention models, target populations, and organizational settings.
    Keywords: Primary Care Redesign, Implementation Evaluation, Impact Evaluation, Delivery Systems Innovation, Clinician Behavior, Workforce Development, Medicare, Medicaid
    JEL: I
    Date: 2014–11–14
  28. By: Mathematica Policy Research
    Abstract: Text4baby is a free text messaging program for pregnant women and new mothers with an infant up to one year of age, designed to improve maternal and child health (MCH) among underserved populations in the United States.
    Keywords: Text4baby, evaluation, Maternal health, child health, text messaging
    JEL: I
    Date: 2015–02–28
  29. By: Leonardo Becchetti (DEDI & CEIS, University of Rome "Tor Vergata"); Pierluigi Conzo (Dept. of Economics and Statistics, University of Turin); Fabio Pisani (Faculty of Economics, University of Rome "Tor Vergata")
    Abstract: The productive and allocative theories predict that education has positive impact on health: the more educated adopt healthier life styles and use more efficiently health inputs and this explains why they live longer. We find partial support for these theories with an econometric analysis on a large sample of Europeans aged above 50 documenting a significant and positive correlation among education years, life styles, health outputs and functionalities. We however find confirmation for an anomaly already observed in the US, namely the more educated are more likely to contract cancer. Our results are robust when controlling for endogeneity and reverse causality in IV estimates with instrumental variables related to quarter of birth and neighbours’ cultural norms
    Keywords: health satisfaction, education, life satisfaction, public health costs
    JEL: I21 I12 I31
    Date: 2015–04–17

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