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on Health Economics |
| By: | Congressional Budget Office |
| Abstract: | Premiums for private health insurance, which are high and rising, are affected by various federal subsidies and regulations. In 2016, the federal government will subsidize most premiums, at a cost of roughly $300 billion. |
| JEL: | I13 I18 |
| Date: | 2016–02–11 |
| URL: | http://d.repec.org/n?u=RePEc:cbo:report:511301&r=hea |
| By: | Audrey Laporte; Brian Ferguson |
| Abstract: | Prices of drugs differ greatly across countries and to a certain degree across payment agencies within countries (OECD (2015)). It is well known among health economists that the presence of insurance creates a separation between the consumer of pharmaceuticals and the payer. This separation can result in the price of drugs being driven up simply because somebody other than the consumer is responsible for paying for them. The precise impact of insurance on drug prices however, will depend critically on the structure of the insurance, a fact that has tended to get lost in health policy debate. The purpose of this paper is to use diagrammatic analysis of three types of insurance: co-insurance, reference pricing and co-payment, to investigate how each affects the price of prescription drugs. In addition, we analyze the role of a new pricing tool, which has recently been increasingly used by pharmaceutical companies in North America: co-Payment waiver coupons. Among other policy implications, we suggest that the use of co-pay waivers turns the co-payment insurance constraint into something similar to the reference pricing constraint, from the supplier's perspective, but with greater transactions costs. |
| Keywords: | drug pricing, insurance, pharmaceuticals, co-payment, reference pricing, co-insurance |
| Date: | 2016–05 |
| URL: | http://d.repec.org/n?u=RePEc:cch:wpaper:160006&r=hea |
| By: | Lorenz Kueng (Northwestern University's Kellogg School of Management, and National Bureau of Economic Research); Evgeny Yakovlev (New Economic School) |
| Abstract: | We use two quasi-natural experiments in the 1980s and 1990s to identify how public policies affect important long-run outcomes by changing preferences. Large but short-lived shocks to product availability in Russia shifted young consumers' long-run preferences from hard to light alcohol. The resulting large cohort differences in current alcohol consumption shares decades after the interventions ended explain about 60% of the recent decrease in male mortality based on both micro-level and aggregate estimates. Mortality will continue to decrease by another 23% over the next twenty years based on our analysis. Program impact evaluations that focus only on contemporaneous effects can therefore severely underestimate the total effect of such public policies. |
| Keywords: | long-run policy effects, endogenous preferences, mortality |
| JEL: | D12 H31 I10 |
| Date: | 2016–05 |
| URL: | http://d.repec.org/n?u=RePEc:cfr:cefirw:w0219&r=hea |
| By: | Jamal Othman (Department of Agricultural and Resource Economics, Faculty of Economics,Universiti Kebangsaan Malaysia); Mazrura Sahani (Universiti Kebangsaan Malaysia); Mastura Mahmud (Universiti Kebangsaan Malaysia); Md. Khadzir Sheikh Ahmad (Universiti Kebangsaan Malaysia) |
| Keywords: | Health, Malaysia, Valuation, Haze |
| Date: | 2016–04 |
| URL: | http://d.repec.org/n?u=RePEc:eep:pbrief:pb20160421&r=hea |
| By: | Sophia Kan (Georg-August University Göttingen) |
| Abstract: | This paper investigates the impact of remittances on health outcomes in Tajikistan and finds a positive effect. While existing literature shows that remittances increase health care expenditure, expenditure alone is an incomplete proxy for health outcomes. Moreover, existing literature on health outcomes focuses mainly on infants and children, leaving out a significant share of the population. Our study explores the impact of remittances on proxies of health outcomes beyond expenditure for all household members (adults and children). We use an IV-approach to control for the endogeneity of remittances, and find that on average, remittances have a much larger effect than other sources of income on health expenditure and health outcomes. We also explore two possible transmission channels for how remittances affect health and find that remittances do not affect the likelihood of purchasing medicine in lieu of seeking care when ill; instead remittances have a positive and significant effect on the likelihood of seeking direct medical care. |
| Keywords: | health; migration; remittances; Tajikistan |
| JEL: | I15 F22 R23 |
| Date: | 2016–04–27 |
| URL: | http://d.repec.org/n?u=RePEc:got:gotcrc:206&r=hea |
| By: | Böckerman, Petri (Labour Institute for Economic Research); Cawley, John (Cornell University); Viinikainen, Jutta (Jyväskylä University School of Business and Economics); Lehtimäki, Terho (University of Tampere); Rovio, Suvi (University of Turku); Seppälä, Ilkka (University of Tampere); Pehkonen, Jaakko (Jyväskylä University School of Business and Economics); Raitakari, Olli (University of Turku) |
| Abstract: | The increase in the prevalence of obesity worldwide has led to great interest in the economic consequences of obesity, but valid and powerful instruments for obesity, which are needed to estimate its causal effects, are rare. This paper contributes to the literature by using a novel instrument: genetic risk score, which reflects the predisposition to higher body mass index across many genetic loci. We estimate IV models of the effect of BMI on labor market outcomes using Finnish data that have many strengths: genetic information, measured body mass index, and administrative earnings records that are free of the problems associated with nonresponse, self-reporting error or top-coding. The first stage of the IV models indicate that genetic risk score is a powerful instrument, and the available evidence from the genetics literature is consistent with instrument validity. The results of the IV models indicate weight reduces earnings and employment and increases social income transfers, although we caution that the results are based on small samples, and are sensitive to specification and subsample. |
| Keywords: | obesity, BMI, earnings, employment, genetic instruments |
| JEL: | I10 J23 J31 |
| Date: | 2016–04 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp9907&r=hea |
| By: | Emilio, Colombo; Valentina, Rotondi; Luca, Stanca; |
| Abstract: | This paper studies the effects of labor market conditions on individual-level health, investigating the factors that moderate and mediate this relationship. Using a large and representative sample of individuals in Italy between 1993 and 2012, we shed light on the transmission mechanism, focusing on the role played by health behaviors (smoking, alcohol consumption, physical activity, eating habits) and economic stress. We find that, overall, higher local unemployment negatively affects health, with a dynamic response that differs across health conditions. Employment status and educational level play a significant role as moderators of these effects. Eating habits, in addition to economic stress, are found to play a key role in the transmission mechanism, while physical activity acts as a buffer against the adverse health effects of unemployment shocks. |
| Keywords: | economic conditions, unemployment, health behaviors, health outcomes |
| JEL: | I1 I10 I12 I18 |
| Date: | 2016–05–19 |
| URL: | http://d.repec.org/n?u=RePEc:mib:wpaper:337&r=hea |
| By: | Emily Ehrlich; Andrea Wysocki; KeriAnn Wells; Boyd Gilman; Greg Peterson; Catherine DesRoches; Sandi Nelson; Laura Blue; Keith Kranker; Kate Stewart; Frank Yoon; Jelena Zurovac; Lorenzo Moreno |
| Abstract: | Individual program summaries. |
| Keywords: | Primary Care Redesign, Implementation Evaluation, Impact Evaluation, Delivery Systems Innovation, Clinician Behavior, Workforce Development, Medicare, Medicaid |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:0fa49fdc81094967a57d614d8bcad002&r=hea |
| By: | Jody Schimmel Hyde |
| Keywords: | obesity, federal disability, determinations |
| JEL: | I J |
| Date: | 2016–01–30 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:1c6fa5a3f03043ccaa01ee0066672a8a&r=hea |
| By: | James D. Reschovsky; Kara Contreary; Joel V. Smith |
| Abstract: | Health insurance benefit structures, particularly cost-sharing amounts, can either encourage or discourage patients from seeking care. The goal is to strike the right balance so out-of-pocket costs don’t discourage people from getting needed care but do prompt them to consider costs before seeking discretionary care. |
| Keywords: | health benefit, privately insured people, access, costs |
| JEL: | I |
| Date: | 2016–03–31 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:96016aa28a9a4f3ba84e2577f0b79e81&r=hea |
| By: | Embry Howell; Brigette Courtot |
| Keywords: | Covering Kids & Families Evaluation, SCHIP, Medicaid, Public Health, insurance |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:b24966aec1304e21b93591271e8596ca&r=hea |
| By: | Deborah Peikes; Erin Fries Taylor; Stacy Dale; Ann O'Malley; Arkadipta Ghosh; Grace Anglin; Kaylyn Swankoski; Aparajita Zutshi; Lara Converse; Randall Brown |
| Abstract: | This report describes the implementation and impacts of the Comprehensive Primary Care initiative over its first two years. |
| Keywords: | Comprehensive Primary Care Initiative, advanced primary care, risk-stratified care management, patient centered medical home, Medicare fee for service, health information technology, propensity score matching |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:ba9f7ec1dc504e4abe15302c261d1321&r=hea |
| By: | Debra A. Strong; Sarah A. Avellar; Caroline Massad Francis; Megan Hague Angus; Andrea Mraz Esposito |
| Abstract: | Mathematica is designing and conducting a cross-site evaluation of the Congressionally authorized Regional Partnership Grants (RPG) program funded by the Children’s Bureau, and providing evaluation technical assistance to the partnerships to conduct their own independent evaluations. This report describes the evidence-based and evidence-informed programs and practices the 17 partnerships selected, including which ones are included in prior evidence reviews. It presents a systematic review of evidence for nine of the EBPs that were of high interest to the Children’s Bureau. |
| Keywords: | children, substance abuse, regional partnership grants, evidence-based, health, child welfare |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:db654cbf07ec49d5b0d8a5a11908e6c2&r=hea |
| By: | Debra A. Strong; Sarah A. Avellar; Patricia Del Grosso |
| Abstract: | This report describes how the U.S. Department of Health and Human Services established the second cohort of partnerships, describes the grantees and their planned program services and local evaluation designs, and presents the design for the national cross-site evaluation. |
| Keywords: | children, substance abuse, regional partnership grants, evidence-based, health, child welfare |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:e3687135a0304a44b425be470567af6f&r=hea |
| By: | Luojia Hu; Robert Kaestner; Bhashkar Mazumder; Sarah Miller; Ashley Wong |
| Abstract: | We examine the effect of the Medicaid expansions under the 2010 Patient Protection and Affordable Care Act (ACA) on financial outcomes using credit report data for a large sample of individuals. We employ the synthetic control method (Abadie et al., 2010) to compare individuals living in states that expanded Medicaid to those that did not. We find that the Medicaid expansions significantly reduced the number of unpaid bills and the amount of debt sent to third-party collection agencies among those residing in zip codes with the highest share of low income, uninsured individuals. Our estimates imply a reduction in collection balances of around $600 to $1,000 among those who gain Medicaid coverage due to the ACA. Our findings suggest that the ACA Medicaid expansions had important financial impacts beyond health care use. |
| JEL: | H20 I13 I38 |
| Date: | 2016–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:22170&r=hea |
| By: | Claudia Persico; David Figlio; Jeffrey Roth |
| Abstract: | Millions of tons of hazardous wastes have been produced in the United States in the last 60 years which have been dispersed into the air, into water, and on and under the ground. Using new population-level data that follows cohorts of children born in the state of Florida between 1994 and 2002, this paper examines the short and long-term effects of prenatal exposure to environmental toxicants on children living within two miles of a Superfund site, toxic waste sites identified by the Environmental Protection Agency as being particularly severe. We compare siblings living within two miles from a Superfund site at birth where at least one sibling was conceived before or during cleanup of the site, and the other(s) was conceived after the site cleanup was completed using a family fixed effects model. Children conceived to mothers living within 2 miles of a Superfund site before it was cleaned are 7.4 percentage points more likely to repeat a grade, have 0.06 of a standard deviation lower test scores, and are 6.6 percentage points more likely to be suspended from school than their siblings who were conceived after the site was cleaned. Children conceived to mothers living within one mile of a Superfund site before it was cleaned are 10 percentage points more likely to be diagnosed with a cognitive disability than their later born siblings as well. These results tend to be larger and are more statistically significant than the estimated effects of proximity to a Superfund site on birth outcomes. This study suggests that the cleanup of severe toxic waste sites has significant positive effects on a variety of long-term cognitive and developmental outcomes for children. |
| JEL: | I20 I24 Q53 |
| Date: | 2016–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:22263&r=hea |
| By: | O'Hare, Colin; Li, Youwei |
| Abstract: | The area of mortality modelling has received significant attention over the last 25 years owing to the need to quantify and forecast improving mortality rates. This need is driven primarily by the concern of governments, insurance and actuarial professionals and individuals to be able to fund their old age. In particular, to quantify the costs of increasing longevity we need suitable model of mortality rates that capture the dynamics of the data and forecast them with sufficient accuracy to make them useful. In this paper we test several of the leading time series models by considering the fitting quality and in particular, testing the residuals of those models for normality properties. In a wide ranging study considering 30 countries we find that almost exclusively the residuals do not demonstrate normality. Further, in Hurst tests of the residuals we find evidence that structure remains that is not captured by the models. |
| Keywords: | Mortality; stochastic models; residuals; Hurst exponents |
| JEL: | C51 C52 C53 G22 G23 J11 |
| Date: | 2016–05–17 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:71394&r=hea |
| By: | Keita, Moussa |
| Abstract: | The number of mobile health applications has witnessed a soaring during the recent years. According the IMS Institute for Healthcare Informatics, more than 165,000 digital health applications have been available in the Apple iTunes Store and the Android App Store in 2015. Despite the enthusiasm aroused by such a growth, the main concern is the lack of evidence regarding the safety and the efficacy of these devices in terms of health benefits. This study attempts to bring in new insight on this problematic by trying to identify the causal effect of the use of technology on health status. For this purpose, we focus on the specific case of health-tracking applications which are among the most used health applications. Our analysis is based on 1020 subjects suffering from Diabetes and High Blood Pressure to compare the results of those using health-tracking applications to monitor their health and those who are not using these applications. We have estimated the model by Ordinary Least Squares (OLS) and multinomial logit regressions methods. We have also corrected potential selection bias in technology adoption by using the Heckman approach. In terms of results, our estimations show significant positive association between technology use and reported health status and quality of life. In particular, we have found that patients who use digital health-tracking feel better and report better health status than those who do not use them. For example, we have found that HealthApps users are 38 % more likely to achieve "good" health status and are 27% more likely to achieve "excellent" health status as compared to non-HealthApps users. These results appear robust to various sensitivity and robustness checks. However, although its promising nature, the effect of technology identified in this study should be regarded as short-term effect since the configuration of the data does not allow to capture potential contextual-effect in health status declaration and possible novelty-effect in technology use. |
| Keywords: | Digital Technology, Health Applications, Health, Quality of life. |
| JEL: | I1 I3 O33 |
| Date: | 2016–05 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:71453&r=hea |
| By: | Barbieri, Paolo Nicola |
| Abstract: | Immigrants upon their arrival in the United States are in better health condition with respect to their American counterpart however such advantage erodes over time. In this paper, we study the heterogeneity of such unhealthy behaviours assimilation among different arrival cohorts. We focus our analysis on binge drinking and cigarette consumption as a proxy for unhealthy behaviour assimilation by immigrants. Regarding binge drinking we show that more recent immigrant cohorts arrive with a higher probability of being binge drinker and experience a faster "unhealthy assimilation" in terms of increased consumption of alcohol and an increase in the probability of starting to drink over guideline on a daily basis. Such assimilation is less pronounced for smoking habits, in fact both earlier and later arrival cohorts report lower smoking rates. However, such health advantage is decreasing with time spent in the US. |
| Keywords: | health immigration effects, unhealthy assimilation |
| JEL: | I0 J15 |
| Date: | 2016–05–24 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:71560&r=hea |
| By: | Monika Stasiak (University of Gdańsk); Henryk Olszewski (University of Gdańsk) |
| Abstract: | Sense of control is an important factor regulating every-day functioning and influencing appraisal of individual quality of life. In the situation of loss of motor functions, as observed in case of spinal cord injury, all aspects of person’s life undergo a significant change. Unfitness to perform certain actions may be felt as a limitation of ability to influence and control both surroundings as well as a personal (physiological and emotional) sphere. It is especially crucial for people with injury level of Th6 and above, experiencing symptoms of autonomic dysreflexia, which poses a significant threat of rapid deterioration of one’s health and untreated, may lead to death. Health locus of control, either internal or external, determines individual perception of factors influencing one’s wellbeing and general assessment of health. It lays foundations to positive or negative evaluation of life.The aim of this study is to investigate health locus of control and its impact on quality of life in individuals with spinal cord injury, experiencing symptoms of autonomic dysreflexia, in Poland and Great Britain.A total of 65 individuals with spinal cord injury, level Th6 and above experiencing symptoms of autonomic dysreflexia, from Poland (33 participants) and Great Britain (32 participants) were recruited. Study group consisted of people in young and middle adulthood with mean age of 31 ± 5. Each culturally diverse group represented a different type of care system, accordingly: institutional and person- centred/ individual. Research methods used include: Multidimentional Health Locus of Control Questionnaire (MHLC), Quality of Life Questionnaire – Short Form Health Survey (SF-36), Sociodemographic Questionnaire and Autonomic Dysreflexia Questionnaire (author’s construction).Results of psychometric analysis show significant differences in quality of life as well as health locus of control in two groups. Higher scores on MHLC internal subscale were found in participants from Great Britain, and were related to more positive assessment (higher scores) of quality of life in this group. Lower quality of life as well as higher results of internal subscale in MHLC questionnaire was found in participants from Poland. Internal health locus of control is associated with positive evaluation of one’s ability to control physical aspects of functioning, which is important for psychological wellbeing. Understanding relationship between locus of control and quality of life is a key to designing and implementing accurate intervention as well as education programs; being the source of support for patients. |
| Keywords: | spinal cord injury, autonomic dysreflexia, disability, health locus of control, quality of life |
| URL: | http://d.repec.org/n?u=RePEc:sek:iacpro:3606171&r=hea |
| By: | Scheerer, David (Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)); Nimeh, Zina (UNU‐MERIT, Maastricht University); Weinmann, Stefan (Universitäre Psychiatrische Kliniken (UPK), Basel, Switzerland) |
| Abstract: | Mental health plays a key role in human development, both as a driver and as a goal in itself. Despite this, mental health has been strikingly neglected to date. The HIV movement has revolutionised health advocacy and registered remarkable successes in the past decades. The present study draws on the experience of this exceptional movement in order to find ways forward in the field of mental health. Adopting a broad analytical perspective, it discusses the differences and similarities between the fields of HIV and mental health and, based on this analysis, provides a concrete model for action that takes into account the peculiarities of mental health as a policy issue |
| Keywords: | mental health, health, public policy, social mobilisation, social exclusion, poverty, HIV movement, AIDS, HIV, development, stigma, discrimination, social networks |
| JEL: | I11 I12 I14 I15 I18 I30 O10 O19 O20 |
| Date: | 2016–05–10 |
| URL: | http://d.repec.org/n?u=RePEc:unm:unumer:2016022&r=hea |
| By: | Alfredo Perazzo; Carmen Carpio; Renzo Sotomayor |
| Abstract: | Verification differentiates results-based financing (RBF) from other health-financing mechanisms, and it is considered an important process of RBF program design and implementation. Despite the vital role it plays in RBF, not much has been written about verification as a process, and information about different elements of the process, frequency, cost, and direct and indirect effects among others, is scarce. Panama’s Health Protection for Vulnerable Populations Program (PSPV) uses an RBF mechanism to deliver health services to the country’s rural poor. As in many RBF schemes, a major component of the PSPV is the verification of results. This study focuses on PSPV’s verification process, highlights its results and their application, and identifies lessons learned. Such information is useful to policy makers and technical experts interested in or designing RBF mechanisms. |
| Keywords: | waste, data entry, e-mail, quality of services, people, vaccination, financing, financial management, information technology, information system, antenatal care, income ... See More + under-five mortality, laws, live births, morbidity, basic health services, information, monitoring, health care, legal status, copyright, incentives, health, health professionals, breast cancer, high blood pressure, verification, verifications, hypertension, registry, health facilities, maternal mortality, knowledge, translation, capitation, diabetes, data, ministry of health, costs, iron, check– ups, patient, patients, performance indicators, health indicators, targets, technical experts, health care services, health management, vulnerable populations, access to health services, dissemination, medical care, service provision, mortality rate, material, tuberculosis, folic acid, health organization, screening, databases, disparities in health, mortality, health promotion, telephone, health information, technology, equity, infant mortality, transaction, infant, health service provision, general population, aged, patient satisfaction, software, results, care, policy makers, level of development, medical services, health outcomes, fax, internal process, family planning, protocols, preventive health services, nutrition, populations, quality control, queries, check–ups, policy, primary health care, internet, administration, health results, result, demands, weight, physicians, pregnant women, children, licenses, network, evaluation, human resources, health expenditure, integration, performance, administrative processes, software solution, innovation, management of patients, population, profit, protocol, practitioners, maternal mortality rate, strategy, gross national income, flow of information, registration, database, health interventions, certification, health service, infant mortality rate, health services, implementation, pregnancy, target, uses, human development |
| Date: | 2015–08 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:hnpdps:104656&r=hea |
| By: | Helene Barroy; Rafael A. Cortez; Nora Le Jean; Hui Wang |
| Abstract: | The aim of the study is to better understand adolescents’ sexual and reproductive health (SRH) needs in order to inform the design of interventions and policies that improve access to and use of adolescent SRH services in Niger. A mixed-methods study was conducted and included: (i) a quantitative analysis of Niger’s Demographic Health Survey/Multiple Indicator Cluster Survey (DHS/MICS) 2012; (ii) 17 focus group discussions conducted in urban and rural areas among 128 adolescents; and (iii) a set of recommendations to improve access to and use of SRH services for adolescents in the country. The study found that age at first marriage among adolescent females is 15.7 years and is followed soon thereafter by sexual debut (15.9 years). According to focus group discussions (FGDs), adolescent’s boys and girls start spending time together at 12 years in urban areas and 10 years in rural areas; this may lead to sexual intercourse in exchange for material and financial resources. Over 70 percent of adolescents have given birth by 18 years of age. Although knowledge about modern contraception is high (73 percent among female adolescents 15-19 years of age), the majority of adolescent girls do not use contraception due to societal and cultural beliefs. Moreover, FGDs reveal that the main barriers to use of SRH services is a lack of privacy and confidentiality, as well as finances, despite the government’s elimination of user fees. The government has increased supply side interventions for adolescents and prioritized adolescents on the national agenda by approving the Family Planning Action Plan (2012-2020) and the National Plan for Adolescent Sexual and Reproductive Health (2011), however these plans need to be monitored and evaluated to determine their effectiveness in reaching this population group. There is also a need to increase multi-sectoral demand-side interventions in the country. |
| Keywords: | use of contraception, sex education, child health, risks, social norms, maternal death, sexually active, reproductive health, contraception, people, peer education, adolescent ... See More + mother, traditional medicine, young girls, informed choice, unsafe abortions, adolescent birth rate, older adolescents, antenatal care, youth centers, prevention, laws, sexual intercourse before marriage, contraceptive pills, youth groups, young mother, sexual behaviour, morbidity, health education, women of childbearing age, services, health care, sexually transmitted infections, privacy, old adolescents, birth control, puberty, health, health facilities, public health, maternal mortality, births to adolescents, hospitalization, middle school, knowledge, health facility, access to health information, pregnancies, abortions, young woman, community mobilization, patients, contraceptive prevalence, intervention, boys, urban adolescents, sexuality, adequate health, adolescent-friendly approaches, medication, adolescent mothers, unmarried adolescents, stis, cultural beliefs, violence, sexual education, access to health services, gender norms, sexual experience, first sexual intercourse, immune deficiency syndrome, unplanned pregnancy, mortality rate, sexual intercourse, first sex, basic human rights, services for adolescents, primary school, care services, family_planning, birth rate, adolescent fertility, self-medication, adolescent-friendly services, social development, foster families, early childbearing, mortality, modern contraceptive methods, adolescent boys, sexual initiation, emotional violence, posters, access to information, first sexual experience, childbirth, sexual reproductive health, reproductive health rights, young men, young adults, female adolescents, aged, adolescence, contraceptives, social services, adolescent girls, schools, age, exposure to violence, births, male adolescents, dignity, health outcomes, sexual activity, victims, radio programs, adolescent-friendly policies, family planning, unwanted pregnancy, adolescent females, birth spacing, risk of morbidity, youth, decision making, contraceptive method, nutrition, workshops, adolescents, unprotected sex, childbearing, peer pressure, mobile clinics, contraceptive use, sexual encounter, internet, national health, child mortality, sexual behavior, sex, female counterparts, human rights, pregnant women, recreational activities, reproductive health services, form of contraception, children, adolescents’ health, clinics, modern contraception, maternal deaths, adolescent males, younger adolescents, risk of exposure, contraceptive methods, violence against women, adolescent, birth attendants, young women, adolescent childbearing, youth health, physical activity, infections, traditional birth attendants, young people, premarital sex, girls, married adolescent girls, neonatal mortality, strategy, physical violence, families, family planning services, sexual violence, cancers, adolescent health, violence among adolescents, married adolescents, pregnancy outcomes, aids, early marriage, adolescent pregnancies, health services, implementation, pregnancy, abortion, condoms, adolescent birth, interventions for adolescents, breastfeeding |
| Date: | 2016–01 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:hnpdps:104964&r=hea |
| By: | Roller, Christiane; Stroka-Wetsch, Magdalena A.; Linder, Roland |
| Abstract: | Due to the demographic change and the concomitant ageing of society, the labor force will reduce in Germany in the following decades. Simultaneously, the demand for informal care will increase as a result of the ageing society. Informal care is assumed being the least expensive form of care and is the most common form of care in Germany. However, the literature conveys the impression that informal care is not easily compatible with a range of situations in life. This is especially confirmed by findings of negative health effects of informal caregiving. Based on these findings, it could be suspected that there have to be large effects on employment, as individuals with health restrictions are supposed to work less. Indeed, findings on effects of informal care provision on employment indicate a rather small or even an insignificant effect. We think that health problems become manifest in some form or another. Thus, the effects of informal care provision on labor supply are possibly larger than it has been assumed so far. To verify our hypothesis, we examine the effects of informal caregiving on a health related labormarket outcome in the form of work disability days using administrative data of Germany's largest sickness fund, the Techniker Krankenkasse with more than 5 million observations. In order to identify the effects of informal care on work disability days, linear regression models are estimated in which is controlled for timeinvariant heterogeneity. The results illustrate a significant positive relationship between informal caregiving and the number of work disability days. |
| Abstract: | Während als eindeutig belegt gilt, dass die informelle Pflege durch Angehörige die in Deutschland am weitesten verbreitete Pflegeform darstellt, besteht in der Literatur kein Konsens über die Auswirkungen der Erbringung derartiger Pflegeleistungen auf die Arbeitsmarktpartizipation und Gesundheit. Die Ergebnisse bereits vorhandener Studien weisen zwar überwiegend auf negative Effekte der Pflege auf die Gesundheit hin, dies spiegelt sich jedoch nicht in einer entsprechenden Verringerung des Arbeitsangebotes wider. Ziel dieser Studie ist es daher zu untersuchen, inwiefern es eine indirekte Verringerung des Arbeitsangebotes gibt, die aus der gesundheitlichen Belastung durch die Pflege resultiert und sich womöglich auf Arbeitsunfähigkeitstage auswirkt. Hierzu werden Routinedaten Deutschlands größter Krankenkasse (der Techniker Krankenkasse) mit über 10 Millionen Versicherten ausgewertet. Die Ergebnisse zeigen große Effekte der informellen Pflegeerbringung auf die Arbeitsunfähigkeitstage, was darauf hinweist, dass die Arbeitsmarkteffekte ohne die Betrachtung der Arbeitsunfähigkeitstage in der bisher existierenden Literatur unterschätzt wurden. |
| Keywords: | informal care,work disability days,demographic change,ageing society,administrative data,fixed-effects |
| JEL: | I10 J10 |
| Date: | 2016 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:rwirep:616&r=hea |