nep-hea New Economics Papers
on Health Economics
Issue of 2015‒05‒30
24 papers chosen by
Yong Yin
SUNY at Buffalo

  1. Asymptotic Inference in the Lee-Carter Model for Modelling Mortality Rates By Reese, Simon
  2. Disabled People’s Financial Histories: Uncovering the disability wealth-penalty By Abigail McKnight
  3. Health and Home Ownership: Findings for the Case of Japan By Aizawa, Toshiaki; Helble, Matthias
  4. (English) Nurses from Peru: a local survey in Rome (Italiano) Gli infermieri peruviani a Roma: un’indagine locale By Marco Accorinti
  5. Health Consequences of Childhood and Adolescence Shocks: Is There a "Critical Period"? By Valeria Groppo
  6. Incentives to patients versus incentives to health care providers: The users’ perspective By Izabela Jelovac; Philippe Polomé
  7. Economic Impact of Illness with Health Insurance but without Income Insurance By Sven Neelsen; Supon Limwattananon; Owen O'Donnell; Eddy van Doorslaer
  8. Social, Demographic and Behavioral Determinants of Alcohol Consumption By Jakub Mikolasek
  9. Causal Effects of Mental Health Treatment on Education Outcomes for Youth in the Justice System By Alison Evans Cuellar; Dhaval M. Dave
  10. Developmental Origins of Cardiovascular Disease: Understanding High Mortality Rates in the American South By Richard H. Steckel; Garrett T. Senney
  11. Predicting Disability Among Community-Dwelling Medicare Beneficiaries Using Claims-Based Indicators By Yonatan Ben-Shalom; David C. Stapleton
  12. Moving Forward Together: How Programs Can Support Informal Caregivers and Parents By Jaime Thomas; Cleo Jacobs Johnson; Madeline Young; Kimberly Boller; Mindy Hu; Daisy Gonzalez
  13. On the Road to Universal Children's Health Coverage: An Interim Report on the KidsWell Campaign By Sheila Hoag; Debra Lipson; Victoria Peebles
  14. On the Road to Universal Children's Health Coverage: An Update on the KidsWell Campaign By Sheila Hoag; Debra Lipson; Victoria Peebles
  15. Title: Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS 3) – MACVIVA-LR (France) Case Study Report By Jean Bousquet; Jacques Mercier; Antoine Avignon; Rodolphe Bourret; Thierry Camuzat
  16. Title: Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS 3) – CARTS (Ireland) Case Study Report By Francisco Lupiañez-Villanueva; Alexandra Theben
  17. Title: Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS 3) – Diabmemory (Austria) Case Study Report By Ignacio Peinado; Elena Villalba; Francisco José Mansoa; Alberto Sánchez
  18. Title: Strategic Intelligence Monitor on Personal Health Systems Phase 3 (SIMPHS 3) – Healthcare PPI Galicia (Spain) Case Study Report By Ramon Sabes-Figuera
  19. Salience and health campaigns By Dertwinkel-Kalt, Markus
  20. ‘Cast Back Into The Dark Ages Of Medicine'? The Challenge Of Antimocrobial Resistance By Ó Gráda, Cormac
  21. Demand and Selection Effects in Supplemental Health Insurance in Germany By Renate Lange; Jörg Schiller; Petra Steinorth
  22. Socioeconomic Status and PhysiciansTreatment Decisions By Kurt R. Brekke; Tor Helge Holmås; Karin Monstad; Odd Rune Straume
  23. Health Disparities in Haryana - A District Level Analysis By Narayan, Laxmi
  24. Do public health interventions crowd out private health investments ? Malaria control policies in Eritrea By Carneiro,Pedro; Armand,Alex; Locatelli,Andrea; Mihreteab,Selam; Keating,Joseph Aaron

  1. By: Reese, Simon (Department of Economics, Lund University)
    Abstract: The most popular approach to modelling and forecasting mortality rates is the model of Lee and Carter (Modeling and Forecasting U. S. Mortality, Journal of the American Statistical Association, 87, 659–671, 1992). The popularity of the model rests mainly on its good fit to the data, its theoretical properties being obscure. The present paper provides asymptotic results for the Lee-Carter model and illustrates its inherent weaknesses formally. Requirements on the underlying data are established and variance estimators are presented in order to allow hypothesis testing and the computation of confidence intervals.
    Keywords: Lee-Carter model; mortality; common factor models; panel data
    JEL: C33 C51 C53 J11
    Date: 2015–05–26
    URL: http://d.repec.org/n?u=RePEc:hhs:lunewp:2015_016&r=hea
  2. By: Abigail McKnight
    Abstract: It is well established that on average disabled people and the households in which they live face greater financial disadvantage in terms of income than their counterparts. What is less well understood is how they fare in terms of their wealth status. In this paper we use data from two large scale social surveys to examine the relationship between disability status and household wealth holdings. We find that overall disabled people have substantially lower household wealth and all components of wealth (property, financial, pension, physical) than non-disabled people but even these average differences mask important lifecycle patterns. The incidence of disability increases with age and the effect of this is that disabled people are on average older than non-disabled people. As wealth accumulation also increases with age up to retirement the effect is that average differences understate the true disability wealth-penalty. People who experience disability later in life have been in a stronger position to accumulate assets over their working lives than people who experience disability over the crucial wealth-accumulation stage (35-64 years) of the lifecycle. The full extent of the disability wealth-penalty can only be observed by looking at age or lifecycle profiles. We find evidence of cumulative disadvantage related to disability longevity and cumulative advantage to remaining disability free. Part of the disability wealth-penalty can be accounted for by lower average levels of education among disabled people and by their lower position in the socio-economic classification (NS-SEC) reflecting lower profiles of lifetime earnings and household income. The evidence points to a situation where disabled people have been unable to save and accumulate assets to anything like the extent of their non-disabled peers most likely through lower long term income and extra costs associated with disability. This puts them at a disadvantage in terms of being able to draw on an asset in times of need when expenditure needs exceed current levels of income, lower pension wealth on entering retirement and less likely to be in a position to benefit from the 'asset-effect' and more generally is a matter of concern in terms of equality and social mobility.
    Keywords: wealth, disability, inequality, lifecycle
    JEL: D31 D63
    Date: 2014–04
    URL: http://d.repec.org/n?u=RePEc:cep:sticas:case181&r=hea
  3. By: Aizawa, Toshiaki (Asian Development Bank Institute); Helble, Matthias (Asian Development Bank Institute)
    Abstract: The research objective of this paper is to test whether health conditions and health behavior are related to home ownership. This question has not yet been examined quantitatively in the existing literature. Our estimation results show that homeowners consistently report better health and less physical problems. The significance of home ownership remains even after controlling for financial assets and housing conditions. Furthermore, our estimations indicate that homeowners invest more in their future health by undergoing voluntarily medical screenings more frequently. Finally, our estimations suggest that home ownership is positively correlated with health care expenditure even when controlling for income, debt, and other financial assets and we could not reject the exogeneity of home ownership. Our empirical results thus provide evidence for the importance of home ownership for health.
    Keywords: health; home ownership; housing conditions; grossman model; medical expenditures
    JEL: I12 I15
    Date: 2015–05–13
    URL: http://d.repec.org/n?u=RePEc:ris:adbiwp:0525&r=hea
  4. By: Marco Accorinti
    Abstract: (English) The presence of migrant workers among health care in Italy has had a significant growth in the past decades, especially for specific professional and national communities. In particular, Peruvians nurses have represented an important component of the total nurses in Rome. The essay based on the results of an original investigation concluded in May 2014, analyzes the working conditions and social integration paths of Peruvians nurses engaged in Roman health services. (Italiano) La presenza di stranieri tra gli operatori sanitari in Italia ha avuto nei decenni passati una crescita significativa, soprattutto per alcune figure professionali e per alcune comunità nazionali. In particolare gli infermieri peruviani hanno rappresentato una componente importante sul totale degli infermieri presenti a Roma. Il saggio partendo dai risultati di una indagine originale conclusa nel maggio 2014, analizza le condizioni di lavoro e i percorsi di inserimento sociale degli infermieri peruviani impegnati nella sanità romana.
    Keywords: (English) Immigrants; nurses; Peru; Health Care; Rome (Italiano) Immigrati; infermieri; Perù; Sistema sanitario; Roma
    Date: 2014
    URL: http://d.repec.org/n?u=RePEc:cnz:wpaper:68:2014&r=hea
  5. By: Valeria Groppo
    Abstract: Individual health is not only determined by genetic factors, but also by negative or positive events during the life course. For example, children exposed to natural disasters or violent conflicts are more likely to have poor health as adults. Positiveexternal factors, such as nutritional programs, will, instead, improve individual health in the long-term. In turn, health can directly affect education and income opportunities, with macroeconomic consequences for economic growth. In particular,this Roundup investigates the following question: is there an age when shocks or interventions can have a magnified effect? In other words, is there a time while growing up when individual health is more responsive to external events? This is a relevant question, since timing represents a crucial dimension of health interventions. Available evidence identifies several sensitive periods, providing useful lessons for health policy with important economic implications.
    Date: 2015
    URL: http://d.repec.org/n?u=RePEc:diw:diwrup:65en&r=hea
  6. By: Izabela Jelovac (Université de Lyon, F-69007, France; CNRS, GATE Lyon St Etienne, 93, Chemin des Mouilles, F-69130, Ecully, France); Philippe Polomé (Université de Lyon, F-69007, France; CNRS, GATE Lyon St Etienne, 93, Chemin des Mouilles, F-69130, Ecully, France)
    Abstract: In theory, health care providers may adapt their professional behavior to the financial incentives driven by their remuneration. Our research question is whether the users of health care services anticipate such a behavior from their general practitioner (GP) and, if they do, what are the consequences of such an anticipation on their preferences regarding financial incentives. We propose a theoretical model to identify potential determinants of such preferences. We empirically test our theoretical predictions using the data from a survey that elicits individual preferences for either patients’ or providers’ hypothetical incentives in France. The empirical results confirm the theoretical ones by establishing that users tend to prefer to pay a copayment themselves when the amount of GPs’ incentives is high, the one of the patients’ copayment is low, they anticipate that their GP’s medical decisions are affected by financial incentives and their wealth is high. Otherwise, they prefer their GP to face financial incentives.
    Keywords: incentives, health care providers, patients, individual preferences
    JEL: I13 I18 J33
    Date: 2015
    URL: http://d.repec.org/n?u=RePEc:gat:wpaper:1510&r=hea
  7. By: Sven Neelsen (Erasmus University Rotterdam, the Netherlands); Supon Limwattananon (Ministry of Public Health, Thailand; Khon Kaen University, Thailand); Owen O'Donnell (Erasmus University Rotterdam, the Netherlands); Eddy van Doorslaer (Erasmus University Rotterdam, the Netherlands)
    Abstract: We examine economic vulnerability to illness when, as for informal sector workers in Thailand, there is universal coverage for health care but earnings losses are uninsured. Even with comprehensive health care entitlement, severe illness that strikes an initially healthy worker is found to raise out-of-pocket medical expenses by around two thirds and increase the probability that medical spending absorbs more than a tenth of the household budget by nine percentage points. Moreover, severe illness reduces the probability of remaining in employment by 18 points and precipitates a reduction in household labor income of almost one third. Despite the rise in medical expenses and fall in earnings, households are able to maintain expenditure on goods and services other than medical care by drawing on remittances and informal transfers, cutting back on saving, and by borrowing. In the short term, informal insurance fills gaps left uncovered by formal insurance but there is likely to be subst antial exposure to economic risks associated with long-term illness.
    Keywords: Health; medical expenditure; social insurance; universal coverage; Thailand
    JEL: I13 O12
    Date: 2015–05–21
    URL: http://d.repec.org/n?u=RePEc:tin:wpaper:20150060&r=hea
  8. By: Jakub Mikolasek (Institute of Economic Studies, Faculty of Social Sciences, Charles University in Prague, Smetanovo nábreží 6, 111 01 Prague 1, Czech Republic)
    Date: 2015–05
    URL: http://d.repec.org/n?u=RePEc:fau:wpaper:wp2015_10&r=hea
  9. By: Alison Evans Cuellar; Dhaval M. Dave
    Abstract: This study assesses whether mental health interventions can improve academic outcomes for justice-involved youth. Only a limited number of studies have linked justice policies to outcomes beyond crime, particularly education, which carries large monetary and non-monetary benefits. The current study relies on detailed administrative data and unique policy rules under which youth are assigned to behavioral treatment programs. The administrative data allow for a rich set of controls for observed family- and youth-specific heterogeneity. In addition, the treatment assignment rules create a discontinuity among youth who are deemed eligible or not eligible for treatment, rules which the study exploits empirically to address the non-random selection bias in estimating plausibly causal effects of treatment eligibility and treatment receipt. Estimates indicate that certain types of intensive mental health intervention can lower dropout and increase high-school completion for justice-involved youth. Effects on grades are negative or not significant, possibly due to the greater retention of less academically-skilled students. We also assess heterogeneity in the treatment effects, and find that the effects on dropout tend to be greater among youth believed to be less academically engaged prior to treatment.
    JEL: I1 I21
    Date: 2015–05
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:21206&r=hea
  10. By: Richard H. Steckel (Department of Economics, Ohio State University); Garrett T. Senney (Department of Economics, Ohio State University)
    Abstract: Many studies by social scientists view heart disease as the outcome of current or recent conditions such as poverty, smoking and obesity. An alternative approach gaining recognition is developmental origins of health and disease, which we apply to understand high death rates of whites in the South from cardiovascular disease (CVD). In this interpretation CVD vulnerability follows from unbalanced physical development created by poor conditions in utero that underbuilds major organs such as the kidneys and the cardiovascular system relative to those needed to process lush nutrition later in life. The South underwent an economic transformation from generations of poverty to rapid economic growth in the post-WWII era, exposing many children born in the 1950s through the 1980s to unbalanced physical development. Here we use state-level data for whites on income growth, smoking, obesity and education to explain variation in CVD death rates in 2010-2011. Our proxy for unbalanced physical growth, the ratio of average household income in 1980 to that in 1950, has a large systematic influence on CVD mortality, an impact that increases dramatically with age. The income ratio combined with smoking, obesity, and education explains two thirds of the variance in CVD mortality across states. Metaphorically, persistent intergenerational poverty loads the gun and rapid income growth pulls the trigger.
    Keywords: Developmental Origins, Mortality, American South
    JEL: I13 J15 N32
    Date: 2015–05
    URL: http://d.repec.org/n?u=RePEc:osu:osuewp:15-01&r=hea
  11. By: Yonatan Ben-Shalom; David C. Stapleton
    Abstract: The predictive performance of the regression-based models is better than that of the individual claims-based indicators. At a predicted probability threshold chosen to maximize the sum of sensitivity and specificity, sensitivity is 0.72 for beneficiaries age 65 or older and specificity is 0.65. For those under 65, sensitivity is 0.54 and specificity is 0.67. The findings also suggest ways to improve predictive performance for specific disability populations of interest to researchers.
    Keywords: Self-reported disability, Medicare, claims-based algorithms, receiver operating characteristic (ROC) curves
    JEL: I J
    Date: 2015–05–25
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:dfdf0c142bbb4ecd972e630dc3b6eca7&r=hea
  12. By: Jaime Thomas; Cleo Jacobs Johnson; Madeline Young; Kimberly Boller; Mindy Hu; Daisy Gonzalez
    Abstract: This brief discusses the varied roles of parents and informal caregivers, their strengths in caring for children, their needs for information and support, and barriers they face in accessing caregiving resources. It also provides recommendations for outreach methods, programs, and policies to address their needs. The main data source is a set of interviews with parents and informal caregivers conducted during site visits to community organizations in Alameda and Santa Clara counties. We visited two public library branches, two family resource centers, and two other community organizations, and talked with adults who were there with children to attend story hours and arts, educational, and other activities.
    Keywords: InCare, Informal Caregivers, Child Care, Early Childhood
    JEL: I
    Date: 2015–05–27
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:a9d3a66ce1214da7a8b868f652b018e6&r=hea
  13. By: Sheila Hoag; Debra Lipson; Victoria Peebles
    Keywords: KidsWell, Children's Health Coverage
    JEL: I
    Date: 2015–05–01
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:c3bc411ac90f4e8f920da8963953a4b2&r=hea
  14. By: Sheila Hoag; Debra Lipson; Victoria Peebles
    Keywords: KidsWell, Children's Health Coverage
    JEL: I
    Date: 2015–05–01
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:ba41904f8eb14e67ba32c8cf50db6490&r=hea
  15. By: Jean Bousquet (CHRU Montpellier); Jacques Mercier (CHRU Montpellier); Antoine Avignon (CHRU Montpellier); Rodolphe Bourret (CHRU Montpellier); Thierry Camuzat (Region Languedoc-Roussillon)
    Abstract: The MACVIA-LR integrated care approach deployed in the Languedoc-Roussillon region in the South of France rests on three main initiatives that put particular emphasis on the prevention of unhealthy ageing of patients suffering from chronic conditions by implementing a series of actions that range from the early diagnosis and management of chronic respiratory diseases to the detection of un-recognised co-morbidities. The initiatives form part of a set of activities as a reference site for the European Innovation Partnership on Active and Healthy Ageing initiative in the Languedoc-Roussillon region and comprise: Integrated care pathways for airway diseases (AIRWAYS ICPs); Allergic Rhinitis and its Impact on Asthma (ARIA); and the Co-morbidity Clinics.
    Keywords: SIMPHS, eHealth, Remote Monitoring, ageing, integrated care, independent living, case studies, facilitators, governance, impact, drivers, barriers, integration, organisation
    JEL: I11 I18 O33 O38
    Date: 2015–03
    URL: http://d.repec.org/n?u=RePEc:ipt:iptwpa:jrc94487&r=hea
  16. By: Francisco Lupiañez-Villanueva (Open Evidence); Alexandra Theben (Open Evidence)
    Abstract: The Community Assessment of Risk Assessment and Treatment Strategy (CARTS) programme is defined by the investigators as a risk intervention strategy that aims to screen, triage, assess and treat to reduce the risk of frailty and three adverse outcomes (AO) - institutionalisation, hospitalisation and death - in community dwelling older adults. The programme uses two instruments, Risk Instrument for Screening in the Community (RISC) and the Community Assessment of Risk Instrument (CARI). The RISC screens individuals to identify concerns in three domains, mental state, activities of daily living (ADLs) and medical state. The RISC then triages people into low, medium and high risk and describes the factors that are causing risk. The CARI is a more comprehensive assessment tool which also aims to identify the factors that create risk. The programme has been developed by researchers at the Centre for Gerontology and Rehabilitation in University College Cork.
    Keywords: SIMPHS, eHealth, Remote Monitoring, ageing, integrated care, independent living, case studies, facilitators, governance, impact, drivers, barriers, integration, organisation
    JEL: I11 I18 O33 O38
    Date: 2015–03
    URL: http://d.repec.org/n?u=RePEc:ipt:iptwpa:jrc94499&r=hea
  17. By: Ignacio Peinado (Hospital Universitario de Getafe); Elena Villalba (Hospital Universitario de Getafe); Francisco José Mansoa (Hospital Universitario de Getafe); Alberto Sánchez (Hospital Universitario de Getafe)
    Abstract: In 2010, the Austrian Social Insurance Institution for Railways and Mining Industry (Versicherungsanstalt für Eisenbahnen und Bergbau, VAEB) started a proof-of-concept diabetes telemonitoring project called DiabMemory, as part of a wider programme called "Health Dialogue" (“Gesundheitsdialog”). DiabMemory allows diabetes patients to track health parameters using a mobile phone and share this data with their General Practitioner (GP). After being diagnosed with type 1 or 2 diabetes in primary or secondary care, patients insured by VAEB are given the opportunity to stay for a period of one to three weeks at a special rehabilitation facility in Breitenstein (Lower Austria) to receive education on all aspects relevant to their health and medical conditions like nutrition, physical activity, and psychological aspects. If they decide to join the programme, they receive the equipment and training on how to use the DiabMemory system and how to integrate it into their everyday lives. After their stay in Breitenstein, participants are able to use DiabMemory without further help. A web-based application allows health professionals responsible for therapy management within the Health Dialogue programme to access patient data and adjust therapy plans when needed. Moreover, they can provide users with motivational messages and feedback can be sent directly to the patient’s mobile.
    Keywords: SIMPHS, eHealth, Remote Monitoring, ageing, integrated care, independent living, case studies, facilitators, governance, impact, drivers, barriers, integration, organisation
    JEL: I11 I18 O33 O38
    Date: 2015–04
    URL: http://d.repec.org/n?u=RePEc:ipt:iptwpa:jrc95122&r=hea
  18. By: Ramon Sabes-Figuera (European Commission – JRC - IPTS)
    Abstract: The ultimate objective of the SIMPHS research is to provide an understanding of the role of ICT in facilitating integrated health and social care. Therefore, a key aspect to be considered is how these technological elements (e.g. devices, platforms, medical records systems) are procured within European health and social care systems and to explore the benefits of innovative approaches to this process. Indeed, the fact that the public sector is by far the largest buyer and consumer of health care products and services in Europe creates an opportunity for using procurement process of ICT on a strategic level. The European Commission is behind several ongoing initiatives and is planning further ones with the aim to foster the use of innovative public procurement tools in the healthcare field and specifically in relation to innovative technologies . This is why it was deemed relevant in the context of the SIMPHS3 research to explore public procurement experiences and try to draw lessons from innovative public procurement initiatives in the healthcare field. We identified the initiatives currently developed in this area by the regional government of Galicia (Spain) as particularly relevant not only because of their comprehensive and ambitious scope, but also because of the highly innovative approach that has been developed and implemented in that region. In addition, as the Galician project makes use of different procurement tools, it allows us to present findings that may be relevant for a wider spectrum of stakeholders and experiences.
    Keywords: SIMPHS, eHealth, Remote Monitoring, ageing, integrated care, independent living, case studies, facilitators, governance, impact, drivers, barriers, integration, organisation
    JEL: I11 I18 O33 O38
    Date: 2015–04
    URL: http://d.repec.org/n?u=RePEc:ipt:iptwpa:jrc94502&r=hea
  19. By: Dertwinkel-Kalt, Markus
    Abstract: Motivated by current topics in health economics, we apply the theory of salience to consumer policy. If a government intends to stifle healthier diets without harming consumers by raising taxes, it could initiate information campaigns which focus consumers' attention either on the healthiness of one item or the unhealthiness of the other item. According to our approach, both campaigns work, but it is more efficient to proclaim the unhealthiness of one product in order to present it as a "bad." Our findings imply that comparative advertisement is particularly efficient for entrant firms into established markets.
    Keywords: Salience,Health Policy,Information Campaign,Comparative Advertisement
    JEL: I18 D11 D03
    Date: 2015
    URL: http://d.repec.org/n?u=RePEc:zbw:dicedp:186&r=hea
  20. By: Ó Gráda, Cormac (University College Dublin and CAGE, University of Warwick)
    Abstract: Today people in high-income countries can expect to live about twice as long as their forebears a century ago. This huge increase in life expectancy is due in large part to the eradication or near-eradication of a whole range of potentially fatal infectious diseases. In the UK c. 1900 one such disease, tuberculosis, was responsible for one death in ten; it cut short the lives of Emily Brontë (1848, aged 30), Aubrey Beardsley (1898, aged 26), D. H. Lawrence (1930, aged 45), George Orwell (1950, aged 46), and myriad others. Measles, scarlet fever, diphtheria, and whooping cough accounted for another 6.5 per cent of British deaths, and diarrhoea and typhus carried off another 5 per cent. Today those diseases kill virtually no one in high-income countries. The share of all deaths in England and Wales due to infectious diseases dropped from nearly half in 1850 to one-third in 1900, whereas today they account for about 7 per cent, mainly elderly people succumbing to pneumonia or acute bronchitis. In high-income countries like the UK most of us can expect to succumb, not to infectious diseases, but to cancer, heart disease, and other non-contagious causes and illnesses.
    URL: http://d.repec.org/n?u=RePEc:cge:wacage:233&r=hea
  21. By: Renate Lange; Jörg Schiller; Petra Steinorth
    Abstract: This paper empirically assesses the selection effects and determinants of the demand for supple-mental health insurance that covers hospital and dental benefits in Germany. Our representative dataset provides doctor-diagnosed indicators of the individual’s health status, risk attitude, demand for medical services and insurance purchases in other lines of insurance as well as rich demographic and socioeconomic information. Controlling for a wide range of individual preferences, we find evidence of adverse selection for individuals aged 65 and younger for hospital coverage despite initial individual underwriting by insurers. The reverse is true for individuals older than 65; individuals with supplemental hospital coverage are healthier on average. In addition, insurance affinity and income are the most important drivers of the demand for both types of coverage.
    Keywords: Supplemental health insurance, adverse selection, insurance demand, German Statutory Health Insurance, insurance affinity
    JEL: D82 G22 I11
    Date: 2015
    URL: http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp757&r=hea
  22. By: Kurt R. Brekke (Department of Economics, Norwegian School of Economics); Tor Helge Holmås (Uni Rokkan Centre and Health Economics Bergen); Karin Monstad (Uni Rokkan Centre and Health Economics Bergen); Odd Rune Straume (Universidade do Minho - NIPE)
    Abstract: This paper aims at shedding light on the social gradient by studying the relationship between socioeconomic status (SES) and provision of health care. Using administrative data on services provided by General Practitioners (GPs) in Norway over a fi…ve year period (2008-12), we analyse the quantity, composition and value of services provided by the GPs according to patients`SES measured by education, income or ethnicity. Our data allow us to control for a wide set of patient and GP characteristics. To account for (unobserved) heterogeneity, we limit the sample to patients with a speci…c disease, diabetes type 2, and estimate a model with GP fi…xed effects. Our results show that patients with low SES visit the GPs more often, but the value of services provided per visit is lower. The composition of services varies with SES, where patients with low education and African or Asian ethnicity receive more medical tests but shorter consultations, whereas patients with low income receive both shorter consultations and fewer tests. Thus, our results show that GPs differentiate services according to SES, but give no clear evidence for a social gradient in health care provision.
    Keywords: Socio-economic status; Primary care; General Practitioners
    JEL: I11 I14 I18
    Date: 2015
    URL: http://d.repec.org/n?u=RePEc:nip:nipewp:05/2015&r=hea
  23. By: Narayan, Laxmi
    Abstract: Using principal component analysis(PCA) the paper construct a composite health index for each district for comparing the health status in various districts of Haryana. The health status was measured by various indicators covering three aspects of health, viz., health outcome indicators, health infrastructure indicators and access to and uses of health facilities. We found wide inter-district disparities in various health indicators. Health is not sole responsibilities of state and public in general uses both public and private health services. The private health care has grown significantly Hence, the paper also compared health outcome by comparing Infant Mortality rates and Child Mortality rate (CMR) across district of the state. We found that some districts scoring high on health infrastructure performed poorly on uses of health facilities and vice-versa.
    Keywords: Haryana, Health Indicators, Factor Analysis, Composite Health Indicator
    JEL: I1 I10
    Date: 2015–03
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:64478&r=hea
  24. By: Carneiro,Pedro; Armand,Alex; Locatelli,Andrea; Mihreteab,Selam; Keating,Joseph Aaron
    Abstract: It is often argued that engaging in indoor residual spraying in areas with high coverage of mosquito bed nets may discourage net ownership and use. This is just a case of a public program having perverse incentives. This paper analyzes new data from a randomized control trial conducted in Eritrea, which surprisingly shows the opposite: indoor residual spraying encouraged net acquisition and use. The evidence points to the role of imperfect information. The introduction of indoor residual spraying may have made the problem of malaria more salient, leading to a change in beliefs about its importance and to an increase in private health investments.
    Keywords: Disease Control&Prevention,Housing&Human Habitats,Malaria,Population Policies,Health Monitoring&Evaluation
    Date: 2015–05–15
    URL: http://d.repec.org/n?u=RePEc:wbk:wbrwps:7268&r=hea

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