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on Health Economics |
| By: | Diether W. Beuermann (Inter-American Development Bank); Rafael Anta (Inter-American Development Bank); Patricia Garcia (Universidad Peruana Cayetano Heredia); Alessandro Maffioli (Inter-American Development Bank); Jose Perez Lu (Universidad Peruana Cayetano Heredia); Maria Fernanda Rodrigo (Inter-American Development Bank) |
| Abstract: | We evaluate the effectiveness of sending text messages to pregnant women containing appointment reminders and suggestions for healthy behaviors during pregnancy. Receiving messages had an overall positive effect of 5 percent on the number of prenatal care visits attended. Moreover, for women who live close to their assigned health center and who have higher educational attainment, the intervention positively affected vitamin intake compliance, APGAR scores, and birth weight. Evidence suggests that reminders are more effective among those who are more able to understand the future benefits of preventive care (more educated) and who face lower transaction costs of going to prenatal care checkups (located near health centers). No evidence of geographical spillover effects was found. |
| Keywords: | WAWARED, Peru, e-Health, Pregnancy, Experimental Design |
| JEL: | I10 O12 |
| Date: | 2016–02 |
| URL: | http://d.repec.org/n?u=RePEc:apc:wpaper:2016-062&r=hea |
| By: | Hua Liao; Xin Tang; Yi-Ming Wei (Center for Energy and Environmental Policy Research (CEEP), Beijing Institute of Technology) |
| Abstract: | Solid fuels such as firewood and coal are widely used for cooking and heating in the developing countries, which result in serious indoor air pollutions and health effects. Governments and international organizations have been devoted to addressing this issue for a long time. Based on the micro survey data from 1989¨C2011, this paper quantitatively investigate the situations and evolutions of cooking fuel using and its health effects in rural China. We have four findings: (i) most rural households still rely on solid fuels for cooking in modern China. ii) the cooking fuels are slowly diversifying in the last two decades, (iii) there are considerably geographical differences in cooking fuel using across China, and (iv) those resident usually using solid fuel have lower levels of self-assessed health and higher prevalence of respiratory diseases. We then draw some policy implications to reduce cooking fuel use.. |
| Keywords: | rural residents; solid fuel; indoor air pollution (IAP); cooking; health |
| JEL: | Q54 Q40 |
| Date: | 2016–02–10 |
| URL: | http://d.repec.org/n?u=RePEc:biw:wpaper:90&r=hea |
| By: | Han Ye |
| Abstract: | Controlling healthcare costs while promoting maximum health impact in the recipient countries is one the biggest challenges for global health donors. This paper views global health donors as the regulators of monopolistic service providers, and explores potential optimal fund payment systems under asymmetric information. It provides a summary and assessment of the prevailing optimal price regulation designs for monopolistic serviceproviders. A set of non-Bayesian approaches that are relevant and applicable for the global health donors are discussed. It also reviews incentive contracting experience between the public and private sectors. |
| Keywords: | Healthcare costs, global health donors, monopolistic service providers, incentive contracting funding, Latin America, financial fragilities. |
| Date: | 2016–02 |
| URL: | http://d.repec.org/n?u=RePEc:cgd:wpaper:424&r=hea |
| By: | Klajdi Bregu (University of Arkansas); Cary Deck (University of Arkansas, Chapman University, University of Alaska-Anchorage); Lindsay Ham (University of Arkansas); Salar Jahedi (RAND Corporation) |
| Abstract: | It is notoriously hard to study the effect of alcohol on decision making, given the selection that takes place in who drinks alcohol and when they choose to do so. In a controlled laboratory experiment, we study the causal effect of alcohol on economic decision making. We examine the impact of alcohol on the following types of tasks: math and logic, uncertainty, overcon dence, strategic games, food choices, anchoring, and altruism. Our results indicate that alcohol consumption, as measured by the blood alcohol concentration (BAC), increases cooperation in strategic settings and altruism in Dictator games. We do not find any effects of alcohol on individual decision making tasks with the exception of anchoring. People with higher BAC did better in the anchoring task. The results suggest that the effects of alcohol are domain specifc. |
| Keywords: | Alcohol, Risk Taking, Overconfidence, Altruism, Behavioral Economics |
| JEL: | C91 D03 D81 |
| Date: | 2016 |
| URL: | http://d.repec.org/n?u=RePEc:chu:wpaper:16-03&r=hea |
| By: | De Donder, P. (GREMAQ); Leroux, M.-L. (Université du Québec à Montréal) |
| Abstract: | We develop a model where families consist of one parent and one child, with children differing in income and all agents having the same probability of becoming dependent when old. Young and old individuals vote over the size of a social long-term care transfer program, which children complement with help in time or money to their dependent parent. Dependent parents have an intrinsic preference for help in time by family members. We first show that low (resp., high) income children provide help in time (resp. in money), whose amount is decreasing (resp. increasing) with the child's income. The middle income class may give no family help at all, and its elderly members would be the main beneficiaries of the introduction of social LTC transfers. We then provide several reasons for the stylized fact that there are little social LTC transfers in most countries. First, social transfers are dominated by help in time by the family when the intrinsic preference of dependent parents for the latter is large enough. Second, when the probability of becoming dependent is lower than one third, the children of autonomous parents are numerous enough to oppose democratically the introduction of social LTC transfers. Third, even when none of the first two conditions is satisfied, the majority voting equilibrium may entail no social transfers, especially if the probability of becoming dependent when old is not far above one third. This equilibrium may be local (meaning that it would be defeated by the introduction of a sufficiently large social program). This local majority equilibrium may be empirically relevant whenever new programs have to be introduced at a low scale before being eventually ramped up. |
| Keywords: | Majority Voting, local Condorcet winner, crowding out, intrinsic preference for informal help, tax reform |
| JEL: | H55 I13 D91 |
| Date: | 2015–05–26 |
| URL: | http://d.repec.org/n?u=RePEc:cor:louvco:2015025&r=hea |
| By: | Iain Cockburn; Jean O. Lanjouw; Mark Schankerman |
| Abstract: | Analysis of the timing of launches of 642 new drugs in 76 countries during 1983-2002 shows that patent and price regulation regimes strongly affect how quickly new drugs become commercially available in different countries. Price regulation delays launch, while longer and more extensive patent rights accelerate it. Health policy institutions and economic and demographic factors that make markets more profitable also speed up diffusion. The estimated effects are generally robust to controlling for endogeneity of policy regimes with country fixed effects and instrumental variables. The results highlight the important role of policy choices in driving the diffusion of new innovations. |
| JEL: | I18 L11 L51 L65 O31 O33 O34 |
| Date: | 2016 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:65415&r=hea |
| By: | Hernandez-Alava, Monica; Pudney, Stephen |
| Abstract: | EQ-5D is used in cost-e ectiveness studies underlying many important health policy decisions. It comprises a survey instrument generating a description of health states across ve domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but little is known about the consequences of this change. We develop a multi-equation ordinal response model incorporating a copula speci cation with normal mixture marginals to analyse the joint responses to EQ- 5D-3L and EQ-5D-5L in a survey of people a ected by rheumatoid disease, and use it to generate mappings between the 3-level and 5-level descriptive systems. We nd signi cant con icts between the two, which would imply the reversal of an important conclusion in a real-world evaluation of drug therapies. |
| Date: | 2016–02–24 |
| URL: | http://d.repec.org/n?u=RePEc:ese:iserwp:2016-04&r=hea |
| By: | KURODA Sachiko; YAMAMOTO Isamu |
| Abstract: | This study focuses on firms' profit rate, instead of This study focuses on firms' profit rate, instead of conventional self-reported subjective indices, to objectively assess the total impact of employees' mental illness on firm performance. We found the following results from a unique data set obtained by linking Japanese firms' 2004-2014 financial data to longitudinal information on their workers' mental health. First, long work hours have a small but significant effect on employee' mental health. Second, firms with higher sick leave or turnover rate of employees with mental disorders tend to have lower annual profit rates even after controlling for unobservable firm heterogeneity. These findings imply that the percentage of employees who take sick leave or leave firms due to bad mental health is the tip of the iceberg and should be considered as a proxy variable for the mental health of a firm's employees. Third, the negative effect of workers' bad mental health on firm performance is greater for firms with high fixed employment costs. These facts indicate that keeping employees' mental health in good condition is beneficial not only for employee welfare but also from a business perspective. |
| Date: | 2016–03 |
| URL: | http://d.repec.org/n?u=RePEc:eti:dpaper:16016&r=hea |
| By: | Gajate-Garrido, Gissele; Ahiadeke, Clement |
| Abstract: | Access to and use of health services are concerns in poor countries. If implemented correctly, health insurance may help solve these concerns. Due to selection and omitted variable bias, however, it is difficult to determine whether joining an insurance scheme improves medical care–seeking behaviors. This paper uses representative data for the whole country of Ghana and an instrumental variable approach to estimate the causal impact on healthcare use of participating in Ghana’s National Health Insurance Scheme. Idiosyncratic variations in membership rules at the district level provide exogenous variation in enrollment. The instrument is the existence of nonstandard verification methods to allow enrollment of children. Using the 2008 Ghana Demographic and Health Survey and a census of all district insurance offices, this paper finds that insurance membership increases the probability of (1) seeking higher-quality (but no greater quantity of) maternal services and (2) parents’ becoming more active users of child curative care. Instrumental variable estimates are larger than ordinary least squares ones, indicating that “compliers” have much higher returns to being insured than the average participant. Results are robust to several validity checks; this paper shows that the instrument is indeed idiosyncratic and proves that government officials did not establish less-cumbersome membership rules in districts with worse initial indicators. |
| Keywords: | health insurance, child health, maternal health, heterogeneous treatment effects, |
| Date: | 2015 |
| URL: | http://d.repec.org/n?u=RePEc:fpr:ifprid:1495&r=hea |
| By: | Rehwald, Kai (Aarhus University); Rosholm, Michael (Aarhus University); Rouland, Benedicte (University of Nantes) |
| Abstract: | Using data from a large-scale randomized controlled trial conducted in Danish job centers, this paper investigates the effects of an intensification of mandatory return-to-work activities on the subsequent labor market outcomes for sick-listed workers. Using variations in local treatment strategies, both between job centers and between randomly assigned treatment and control groups within a given job center, we compare the relative effectiveness of alternative interventions. Our results show that the use of partial sick leave increases the length of time spent in regular employment and non-reliance on benefits, and also reduces the time spent in unemployment. Traditional active labor market programs and the use of paramedical care appear to have no effect at all, or even an adverse effect. |
| Keywords: | long-term sickness, vocational rehabilitation, treatment effects, randomized controlled trial |
| JEL: | J68 C93 I18 |
| Date: | 2016–02 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp9771&r=hea |
| By: | Giuntella, Osea (University of Oxford); Mazzonna, Fabrizio (USI Università della Svizzera Italiana) |
| Abstract: | Most economic models consider sleeping as a pre-determined and homogeneous constraint on individuals' time allocation neglecting its potential effects on health and human capital. Several medical studies provide evidence of important associations between sleep deprivation and health outcomes suggesting a large impact on health care systems and individual productivity. Yet, there is little causal analysis of the effects of sleep duration. This paper uses a spatial regression discontinuity design to identify the effects of sleep on health status, weight, and cognitive abilities. Our results suggest that delaying morning work schedules and school start times may have non-negligible effects on health. |
| Keywords: | health, obesity, sleep deprivation, time use, regression discontinuity |
| JEL: | I12 J22 C31 |
| Date: | 2016–02 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp9773&r=hea |
| By: | Kudo, Yuya |
| Abstract: | This study investigates whether the Liberian civil war increased infant mortality by exposing pregnant women to a high risk of malaria infection, thus retarding fetal development. I find that the war-induced, one-percent increase in maternal infection risk resulted in a 0.44 percent increase in one-year mortality. This mortality effect gradually increased following childbirth as maternal passive immunity waned. The consequences were pronounced for infants conceived in rainy seasons by young mothers residing in rural, battle-intensive areas, with no gender difference detected. I also provide evidence suggesting the wartime culling of the weakest infants associated with maternal malaria infection. |
| Keywords: | Liberia, Diseases, Maternal and infant welfare, Health and hygiene, Internal conflicts, Armed conflict, Fetal development, Infant mortality, Malaria in pregnancy |
| JEL: | I15 |
| Date: | 2016–02 |
| URL: | http://d.repec.org/n?u=RePEc:jet:dpaper:dpaper556&r=hea |
| By: | Jean M. Mitchell; James D. Reschovsky; Elizabeth Anne Reicherter |
| Abstract: | The number of total knee replacement (TKR) surgeries, also known as total knee arthroplasty, has grown substantially over the past two decades. |
| Keywords: | Use of physical therapy, self-referral, total knee replacement surgery |
| JEL: | I J |
| Date: | 2016–02–23 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:732f0821ffed4fecbb30157814fae376&r=hea |
| By: | Tricia Collins; Leslie Foster; Dana Petersen; Rachel Miller |
| Abstract: | Focusing on the diverse states of California, Colorado, and Texas, this issue brief conveys recent policy developments, remaining unmet needs, and emerging issues in children’s health care coverage and delivery, from the perspective of knowledgeable stakeholders. |
| Keywords: | Health Care Coverage , Children, Low-Income Families, Stakeholder , California, Colorado, Texas, Insuring America's Children , Packard Foundation |
| JEL: | I |
| Date: | 2016–02–26 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:9d955973005240df993718199c966e58&r=hea |
| By: | Hu, Zihan; Li, Teng |
| Abstract: | We examine the relationships between high temperatures during pregnancy and birth weight and later outcomes using random temperature fluctuations across 131 counties in China. One standard deviation increase of high-temperature days during pregnancy triggers about 0.07 kg lower birth weight, and, in adulthood, a 0.80 cm decrease in height, 0.27 fewer years of schooling, 13.30% less annual earnings, and 8.77%, 10.96%, and 7.31% of one standard deviation lower for evaluated health, word-, and math-test score, respectively. The impacts seem to be concentrated in the second trimester. Such effects should be included in calculations of the costs of global warming. Back-of-the-envelope predictions suggest that at the end of the 21st century, newborns on average will weigh 0.02-0.09 kg less; losses in height and education years will be 0.27-1.05 cm and 0.09-0.35 years, respectively. We also conclude that adverse effects of high temperatures are more likely to be consistent with physiological effects than income effects, because: (i) places with the high proportion of heat-tolerant crop area do not mitigate any estimated temperature sensitivity during pregnancy and (ii) total precipitation and high temperatures in the last year growing season before birth have no significant effects on all outcomes. |
| Keywords: | High temperatures during pregnancy, birth weight, adult welfare outcomes, global warming |
| JEL: | I12 I21 Q51 Q54 |
| Date: | 2016–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:69644&r=hea |
| By: | Audrey Pereira; UNICEF Office of Research - Innocenti |
| Abstract: | Approximately half of all mental health disorders begin by age 14, and three-quarters by age 24. Among adolescents, depression is one of the leading contributors to morbidity, while suicide and interpersonal violence are among the leading causes of mortality. Mental ill-health also reinforces poverty through decreased productivity and loss of earnings, increased health expenditures, and social stigma. Since the evidence on the effects of poverty-alleviation programmes on mental health have been inconclusive, there is a need for research on specific poverty-alleviation interventions for vulnerable groups who are more at risk for poor mental well-being. |
| Keywords: | adolescents; cash transfers; mental health; poverty alleviation; vulnerable groups; |
| JEL: | H55 I1 |
| Date: | 2016 |
| URL: | http://d.repec.org/n?u=RePEc:ucf:inores:inores801&r=hea |
| By: | Pilar García-Gómez; Sergi Jiménez-Martín; Judit Vall Castello |
| Abstract: | In a world with limited PAYGO financing possibilities this paper explores whether older Spanish individuals have the health capacity to work longer. For that purpose we use Milligan-Wise and Cutler-Meara Cutler-Meara- Richards-Shubik simulation methods. Our results suggest that Spanish workers have significant additional capacities to extend their working careers. |
| Keywords: | work capacity, retirement, health |
| JEL: | J11 J26 I12 I18 |
| Date: | 2016–02 |
| URL: | http://d.repec.org/n?u=RePEc:upf:upfgen:1508&r=hea |