nep-hea New Economics Papers
on Health Economics
Issue of 2016‒09‒04
fourteen papers chosen by
Yong Yin
SUNY at Buffalo

  1. Direct-to-Consumer Advertising and Online Search By Matthew Chesnes; Ginger Zhe Jin
  2. Does Mass Deworming Affect Child Nutrition? Meta-analysis, Cost-Effectiveness, and Statistical Power By Croke, Kevin; Hicks, Joan Hamory; Hsu, Eric; Kremer, Michael; Miguel, Edward
  3. Working Paper 239 - Concept and measure of inclusive health across countries By AfDB AfDB
  4. Meaningful Use of Electronic Health Records and Medicare Expenditures: Evidence from a Panel Data Analysis of U.S. Health Care Markets, 2010-2013 By Eric J. Lammers; Catherine G. McLaughlin
  5. Demography of Global Aging By Bloom, David E.; Mitgang, Elizabeth; Osher, Benjamin
  6. Pollution and infectious diseases By Stefano Bosi; David Desmarchelier
  7. Population Diversity in Medicaid Managed Long-Term Services and Supports Programs: Implications for Rate Setting and Risk Adjustment By Jenna Libersky; Debra Lipson
  8. Look Before You Leap: Risk Adjustment for Managed Care Plans Covering Long-Term Services and Supports By Debra Lipson
  9. Information, Choice, and Obesity: Measuring the Impact of the New York City Calorie Labeling Mandate on Obesity By Rodrigo Aranda Balcazar; Michael Darden; Donald Rose
  10. Trust but Verify: Tennessee’s Approach to Ensuring Accurate Functional Status Data in its Medicaid Managed Long-Term Services and Supports Program By Jenna Libersky
  11. Developing Capitation Rates for Medicaid Managed Long-Term Services and Supports Programs: State Considerations By Debra Lipson; Maria Dominiak; Michelle Herman Soper; Brianna Ensslin
  12. Smoke Gets in Your Eyes: Medical Marijuana Laws and Tobacco Use By Anna Choi; Dhaval Dave; Joseph J. Sabia
  13. Healthy-Time Measures of Health Outcomes and Healthcare Quality By Marguerite Burns; John Mullahy
  14. Do Minimum Wage Increases Influence Worker Health? By Brady P. Horn; Joanna Catherine Maclean; Michael R. Strain

  1. By: Matthew Chesnes; Ginger Zhe Jin
    Abstract: Beginning in 1997, the Food and Drug Administration (FDA) allowed television advertisements to make major statements about a prescription drug, while referring to detailed drug information on the internet (FDA 1997; 2015). The hope was that consumers would seek additional information online to fully understand the risks and benefits of taking the medication. To better understand the effects of the policy, we analyze direct-to-consumer advertising (DTCA) and search engine click-through data on a set of drugs over a three-year period. Regression analysis shows that advertising on a prescription drug serves to increase the frequency of online search and subsequent clicks for that drug, as well as search for other drugs in the same class. We find the relationship between DTCA and search is stronger for younger drugs, for those drugs that treat acute conditions, those drugs that are less likely to be covered by insurance, and those whose searcher population tends to be older. These findings suggest that DTCA motivates consumers to search online for drug information, but the magnitude of the effect is heterogeneous and potentially associated with clicks on websites that are more promotional in nature.
    JEL: D83 I12 K32 L81
    Date: 2016–08
  2. By: Croke, Kevin; Hicks, Joan Hamory; Hsu, Eric; Kremer, Michael; Miguel, Edward
    Abstract: The WHO has recently debated whether to reaffirm its long-standing recommendation of mass drug administration (MDA) in areas with more than 20% prevalence of soil-transmitted helminths (hookworm, whipworm, and roundworm). There is consensus that the relevant deworming drugs are safe and effective, so the key question facing policymakers is whether the expected benefits of MDA exceed the roughly $0.30 per treatment cost. The literature on long run educational and economic impacts of deworming suggests that this is the case. However, a recent meta-analysis by Taylor-Robinson et al. (2015) (hereafter TMSDG), disputes these findings. The authors conclude that while treatment of children known to be infected increases weight by 0.75 kg (95% CI: 0.24, 1.26; p=0.0038), there is substantial evidence that MDA has no impact on weight or other child outcomes. We update the TMSDG analysis by including studies omitted from that analysis and extracting additional data from included studies, such as deriving standard errors from p-values when the standard errors are not reported in the original article. The updated sample includes twice as many trials as analyzed by TMSDG, substantially improving statistical power. We find that the TMSDG analysis is underpowered: it would conclude that MDA has no effect even if the true effect were (1) large enough to be cost-effective relative to other interventions in similar populations, or (2) of a size that is consistent with results from studies of children known to be infected. The hypothesis of a common zero effect of multiple-dose MDA deworming on child weight at longest follow-up is rejected at the 10% level using the TMSDG dataset, and with a p-value
    Keywords: meta-analysis; weight gain; worms
    JEL: C49 I15 I18 O15
    Date: 2016–08
  3. By: AfDB AfDB
    Date: 2016–08–26
  4. By: Eric J. Lammers; Catherine G. McLaughlin
    Abstract: Health care markets that had steeper increases in EHR penetration during 2010–2013 also had steeper decreases in total Medicare and acute care expenditures per beneficiary.
    Keywords: electronic health record, EHR, health IT, Meaningful use, Medicare expenditures
    JEL: I
  5. By: Bloom, David E. (Harvard University); Mitgang, Elizabeth (Harvard School of Public Health); Osher, Benjamin (Harvard School of Public Health)
    Abstract: Individuals aged 65 years and older currently make up a larger share of the population than ever before, and this group is predicted to continue growing both in absolute terms and relative to the rest of the population. This chapter begins by introducing the facts, figures, and forecasts surrounding the aging of populations across different countries at varying levels of development. In light of these trends, we examine challenges facing graying societies through the lenses of health, economics, and policy development. The chapter concludes with a selection of adaptable strategies that countries might consider to mitigate the strain – and to harness the full potential – of aging populations worldwide.
    Keywords: health economics, health policy, noncommunicable diseases (NCDs), population aging, demography
    JEL: J10 J11 J14
    Date: 2016–08
  6. By: Stefano Bosi (EPEE, University of Evry); David Desmarchelier (Economix, University of Paris Ouest Nanterre La Défense)
    Abstract: Recent empirical contributions highlight the negative impact of pollution on labor supply. This relationship is explained by two mechanisms: (1) pollution modifies agents' work-leisure trade-off as it deteriorates their working conditions (incentive effect); (2) a polluted environment is likely to generate more frequent epidemic outbreaks and to affect agents' immune systems (health effect). Bosi et al. (2015) explore the aggregate consequences of the incentive effect and show that it can generate endogenous fluctuations of the economic activity. The present paper rather focuses on the health effect as we study a Ramsey model augmented with the spread of infectious disease. We find that industrial pollution may generate limit cycles around an endemic steady state. More precisely, the economic system may undergo a transcritical bifurcation followed by two Hopf bifurcations near this steady state.
    Keywords: Pollution, SIS model, Ramsey model, Hopf bifurcation, Transcritical bifurcation
    JEL: D9 Q5 I1
    Date: 2016–07
  7. By: Jenna Libersky; Debra Lipson
    Abstract: This brief discusses how states can use information on demographic and functional limitations to predict the cost of care for people with disabilities through risk adjustment and identifies variables that can affect the predictability of Long-Term Services and Supports needs and costs that may not be captured in functional assessment data.
    Keywords: MLTSS, managed care long-term services and supports, population diversity, rate setting, risk adjustment
    JEL: I
  8. By: Debra Lipson
    Abstract: This brief reviews risk-adjustment strategies in Medicaid managed long-term services and supports programs that account for enrollees’ functional and cognitive status to improve the accuracy of capitation rates, as well as technical challenges and state program features that may affect the need to use risk adjustment.
    Keywords: MLTSS, Managed Long-Term Services and Supports, Risk adjustment
    JEL: I
  9. By: Rodrigo Aranda Balcazar (Department of Economics, Tulane University); Michael Darden (Department of Economics, Tulane University); Donald Rose (School of Public Health and Tropical Medicine, Tulane University)
    Abstract: The New York City Calorie Labeling Mandate of 2008 required fast food restaurants to post calorie information for all standardized items. We estimate the impact of the mandate on the rate of obesity using data from the Selected Metropolitan/Metropolitan Area Risk Trends of the Behavioral Risk Factor Surveillance System (SMART-BRFSS) from 2004 to 2010. We show that the mandate plausibly reduced the obesity rate by 2.5 percentage points - a 12% decline. Our results are robust to a variety of sensitivity checks and strengthened by various placebo tests. Using data from the Consumer Expenditure Survey and the American Time Use Survey, we show that our obesity result was not driven by changes in fast food frequency or expenditure but may have been driven by a large increase in the extensive margin of physical activity.
    Keywords: Information Asymmetry; Obesity; Calorie Labeling
    JEL: D82 D83 I12 I18
    Date: 2016–08
  10. By: Jenna Libersky
    Abstract: This brief describes how TennCare’s robust approach to collecting and validating data on enrollees’ functional status can help other states to advance strategies for Medicaid managed long-term services and supports program rate setting.
    Keywords: TennCare, Medicaid managed long-term services and supports program , rate setting
    JEL: I
  11. By: Debra Lipson; Maria Dominiak; Michelle Herman Soper; Brianna Ensslin
    Abstract: This brief identifies themes from the experiences of states at the forefront of Medicaid managed long-term services and supports that other states may want to consider as they seek to improve rate-setting and risk-adjustment methods, including efforts that promote services in home- and community-based settings.
    Keywords: Capitation Rates, Medicaid Managed Long-Term Services and Supports, State Considerations
    JEL: I
  12. By: Anna Choi; Dhaval Dave; Joseph J. Sabia
    Abstract: This study comprehensively examines whether medical marijuana laws (MMLs) have affected the trajectory of a decades-long decline in adult tobacco use in the United States. Using data from three large national datasets — the Behavioral Risk Factor Surveillance Survey (BRFSS), the Current Population Survey Tobacco Use Supplements (CPS-TUS), and the National Survey of Drug Use and Health (NSDUH) — we estimate the relationship between MMLs and cigarette consumption. Our results show that the enactment of MMLs between 1990 and 2012 are associated with a 0.3 to 0.7 percentage-point reduction in tobacco consumption among US adults, though this estimate is somewhat sensitive to controls for state-specific linear time trends. These findings suggest that tobacco and marijuana are substitutes for many users. However, this average response masks heterogeneity in the effects of MMLs among early versus late-adopting states and across the age distribution.
    JEL: D1 I1
    Date: 2016–08
  13. By: Marguerite Burns; John Mullahy
    Abstract: The purposes of this paper are to describe some conceptual and empirical foundations of "healthy-time" measures of health outcomes or healthcare quality, and to explore how to expand the empirical opportunities for measuring such outcomes using U.S. national survey data. To these ends, the paper provides an overview of Grossman's seminal health production framework, surveys some of the healthy-time outcome/quality measures in use across a variety of contexts and applications, explores how data from the U.S. Medical Expenditure Panel Survey (MEPS) might be used to develop ongoing healthy-time measures for U.S. samples, describes an econometric strategy for studying such outcomes, and presents estimates of regression models describing two sets of healthy-time outcome measures obtained from 2011 and 2012 MEPS data.
    JEL: I1
    Date: 2016–08
  14. By: Brady P. Horn; Joanna Catherine Maclean; Michael R. Strain
    Abstract: This study investigates whether minimum wage increases in the United States affect an important non-market outcome: worker health. To study this question, we use data on lesser-skilled workers from the 1993-2014 Behavioral Risk Factor Surveillance Surveys coupled with differences-in-differences and triple-difference models. We find little evidence that minimum wage increases lead to improvements in overall worker health. In fact, we find some evidence that minimum wage increases may decrease some aspects of health, especially among unemployed male workers. We also find evidence that increases reduce mental strain among employed workers.
    JEL: I10 I18
    Date: 2016–08

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