nep-hea New Economics Papers
on Health Economics
Issue of 2017‒10‒08
24 papers chosen by
Yong Yin
SUNY at Buffalo

  1. An Updated Analysis of the Roles of Cost per Case and Treated Prevalence in Health Spending Growth By Charles Roehrig; Craig Lake
  2. Introducing Risk Adjustment and Free Health Plan Choice in Employer-Based Health Insurance: Evidence from Germany By Pilny, Adam; Wübker, Ansgar; Ziebarth, Nicolas R.
  3. Healthy Business? Managerial Education and Management in Healthcare By Nicholas Bloom; Renata Lemos; Raffaella Sadun; John Van Reenen
  4. Does Loss Aversion Beat Procrastination ?A Behavioral Health Intervention at the Gym By Oliver März
  5. Does More Education Protect against Mental Health Problems? By Daniel Graeber
  6. What's Happening to U.S. Mortality Rates? By Anqi Chen; Alicia H. Munnell; Geoffrey T. Sanzenbacher
  7. Quality competition in healthcare services with regional regulators: A differential game approach By Bisceglia, Michele; Cellini, Roberto; Grilli, Luca
  8. Toxic roads: Unearthing hazardous waste dumping By Caterina Gennaioli; Gaia Narciso
  9. Optimal Paternalistic Health and Human Capital Policies By Marcelo Arbex; Enlinson Mattos
  10. Hungry children age faster By Abeliansky, Ana Lucia; Strulik, Holger
  11. Mother’s health after childbirth: does delivery method matter? By Valentina Tonei
  12. Semiparametric count data modeling with an application to health service demand By Bach, Philipp; Farbmacher, Helmut; Spindler, Martin
  13. Social Capital and Mental Health in Indonesia By Mohamad Fahmi; Adiatma Siregar; Deni K Sunjaya; Gilang Amarullah; Rahma Rahma; Nur Afni Panjaitan
  14. The length of breastfeeding and mental health status in Indonesia By Adiatma Siregar; Rahma Rahma; Nur Afni Panjaitan; Gilang Amarullah; Deni K Sunjaya; Mohamad Fahmi
  15. The effect of changing the number of elective hospital admissions on the levels of emergency provision By Sergi Jiménez-Martín; Catia Nicodemo; Stuart Redding
  16. Umbrella Branding in Pharmaceutical Markets By Suppliet, Moritz
  17. Does lack of resources impair access to breast and cervical cancer screening in Japan? By Hiroshi Sano; Rei Goto; Chisato Hamashima
  18. "Modeling the Effect of Healthcare Expenditure and Education Expenditure on Labour Productivity: A Study on OIC Countries" By Abdul Azeez Oluwanisola Abdul Wahab
  19. The Impact of Joint Commission International Healthcare Accreditation on Infection Control Performance: A Study in Dubai Hospital By Mohammad Habibur Rahman
  20. Preference of Medicinal Plants in the Treatment of Malaria Fever in Akure South Local Government Area, Ondo State Nigeria By Obisesan, Adekemi; Owoseni, Oluwakemi
  21. Early Life Health Interventions and Childhood Development: Evidence from Special Care Nursery Assignment in Australia’s Northern Territory By Schnepel, Kevin T.; Schurer, Stefanie
  22. Medical Progress, Demand for Health Care, and Economic Performance By Kuhn, Michael; Frankovic, Ivan; Wrzaczek, Stefan
  23. Does EU membership prevent crowding out of public health care? Evidence from 28 transition countries By Obrizan, Maksym
  24. The relationship between healthcare expenditure and income in Latin-American countries: A panel time By Elisabet Rodriguez Llorian; Janelle Mann

  1. By: Charles Roehrig; Craig Lake (Bureau of Economic Analysis)
    Date: 2017–08
  2. By: Pilny, Adam; Wübker, Ansgar; Ziebarth, Nicolas R.
    Abstract: To equalize differences in health plan premiums due to differences in risk pools, German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time.
    Keywords: employer-based health insurance,free health plan choice,risk adjustment,health plan switching,adverse selection,German sickness funds,SOEP
    JEL: D12 H51 I11 I13 I18
    Date: 2017
  3. By: Nicholas Bloom; Renata Lemos; Raffaella Sadun; John Van Reenen
    Abstract: We investigate the link between hospital performance and managerial education by collecting a large database of management practices and skills in hospitals across nine countries. We find that hospitals that are closer to universities offering both medical education and business education have higher management quality, more MBA trained managers and lower mortality rates. This is true compared to the distance to universities that offer only business or medical education (or neither). We argue that supplying joint MBA-healthcare courses may be a channel through which universities increase medical business skills and raise clinical performance.
    Keywords: management, hospitals, mortality, education
    JEL: M1 I1
    Date: 2017–09
  4. By: Oliver März
    Abstract: Financial incentives are a common tool to encourage overcoming self-control problems and developing beneficial habits. There are different means by which such incentives can be provided, yet, up to date there is little empirical evidence on the relative effectiveness of different incentive designs. In this paper, we conduct a field experiment to explore whether and how incentives that are economically equivalent but framed differently affect the likelihood of exercising at a gym. We find that framing incentives in terms of losses, meaning individuals lose cash incentives by not exercising, encourages more frequent visits to the gym than framing incentives in terms of financial gains. After removing these incentives, we observe habit formation in gym exercise only if incentives were framed as losses rather than gains. The findings are consistent with the concept of loss aversion and suggest that cost reductions and performance improvements can be achieved if opting to frame incentives in terms of losses.
    Keywords: framing; self-control; financial incentives; habit formation; loss aversion
    JEL: C93 D30 I10
    Date: 2017–09
  5. By: Daniel Graeber
    Abstract: Mental health conditions are a leading cause of disability-adjusted life years (DALYs) and health costs worldwide: They account for 199 million DALYs or 37 percent of healthy life years lost from non-communicable diseases. The sum of direct and indirect costs worldwide were estimated to amount to 2.5 trillion US dollars in 2010 and projected to increase to 6 trillion US dollars in 2030 (Bloom et al., 2010). The heavy financial and societal burdens of mental health impairments also mean that prevention measures to alleviate these problems will have high financial and societal returns. Education has been theorized to be such a prevention measure. This DIW Roundup reviews contemporaneous research on the causal effect of education on mental health.
    Date: 2017
  6. By: Anqi Chen; Alicia H. Munnell; Geoffrey T. Sanzenbacher
    Abstract: A key factor affecting the cost of the Social Security program is how long beneficiaries live. Life expec­tancy is determined by mortality rates – that is, the probability of dying at each age. While mortality rates have been declining over time, progress has not been uniform. Sometimes mortality rates decline very rapidly, and sometimes they decline slowly. More­over, rates of improvement vary by age. For example, during most of the 20th century the mortality of in­fants and the working-age population fell faster than the mortality of retirees. This “age-gradient” matters for Social Security, since mortality improvements for young adults tend to help Social Security’s finances by expanding the size of the workforce paying into the system, while improvements at, say, age 65 tend to worsen it by increasing spending on benefits for longer-lived retirees. This brief explores the swings in the rate at which mortality has improved since 1900 and the impor­tance of the age gradient in these improvements over the period. It also takes a closer look at the years since 1969, when detailed data on cause of death are available. In retrospect, the factors leading to the speeding up and slowing down of mortality improve­ment are relatively clear. The future, as always, is harder to predict. This brief is the first of two on mortality rates; the second one will provide an inter­national perspective. The discussion proceeds as follows. The first section provides an overview of mortality trends and the age patterns since 1900. The second section focuses on the swings in mortality improvement in the last 40 years and the patterns by education level and by disease. The third section discusses the major drivers of these outcomes – such as developments in medicine, greater access to health care, the decline in smoking, and the rise in obesity. The fourth section explores the major factors that will influence the rate of improvement in mortality over the next 75 years. The final section concludes that the key debate for the long term is whether the future will mirror the past, with mortality rates of improvement fluctuating around 1 percent per year, or whether the big gains are behind us, with mortality improving less rapidly in the future.
    Date: 2017–09
  7. By: Bisceglia, Michele; Cellini, Roberto; Grilli, Luca
    Abstract: This article proposes a differential-game model, in order to analyze markets in which regional regulation is operative and competition is based on quality. The case we have in mind is healthcare public service, where consumers (patients) choose the provider mainly basing on the providers' location and the quality of services, while prices play a more limited role. In most European countries, within the same State, regional (or local) providers compete on quality to attract demand. Market regulation is set at national and/or regional level. Our model highlights the features of equilibrium in such a framework, and specifically investigates how the differences in product quality evolve among regions, and how inter-regional demand flows behave. Differently from some available similar models (that do not take into account the regional dimension of the decision process), we find that quality differentials among regions may persist in equilibrium.
    Keywords: Healthcare Services; Diffrential Game; Quality Competition;� Regional Regulators.
    JEL: C72 C73 I11 I18 L13 R38
    Date: 2017–10–02
  8. By: Caterina Gennaioli; Gaia Narciso
    Abstract: Illegal disposal of toxic waste has become an issue of concern in both developing and developed countries. Recycling hazardous waste entails very high costs, which might give strong incentives to dispose toxic material in an illegal way. This paper adopts an innovative strategy to identify where toxic waste might have been illicitly dumped. The strategy relies on a crucial premise: road constructions provide an ideal setting in which the burial of hazardous waste may take place. Guided by the medical literature, we investigate the health outcomes of individuals living along recently constructed roads in Ethiopia. We construct a unique dataset, which includes the extensive Demographic and Health Survey, together with georeferenced data on roads, villages and economic development, covering a 10-year period. We find that an additional road within a 5 kilometres radius is associated with an increase in infant mortality by 3 percentage points. Moreover, we provide evidence that young children living near a recently built road show a lower level of haemoglobin and are more likely to suffer from severe anaemia. A series of robustness checks confirms the above findings and excludes other potential confounding factors.
    Keywords: Hazardous Waste, Health, Infant Mortality, Ethiopia
    JEL: I15 Q51 Q53 O10
    Date: 2017–09
  9. By: Marcelo Arbex (Department of Economics, University of Windsor); Enlinson Mattos (São Paulo School of Economics, Getulio Vargas Foundation)
    Abstract: We study optimal human and health linear policies when there is a paternalistic motive to overcome present bias problems of agents with heterogeneous cognitive skills. The paternalistic intervention is meant to reward individuals for physical capital accumulation and the combined effect of health and human capital on future earnings. Our results highlight a novel effect of paternalistic policies due to the interaction between present-biased preferences and cognitive skills. We show that a single policy on the agent's earnings captures all the corrections that would be required if the planner were to implement other policy instruments, for instance, subsidies targeting human and health capital separately or current biased decisions. A numerical exercise illustrates that this policy package is the most effective, requiring lower tax revenues to correct for present bias and agents misperception of their own cognitive skills problems. We analyze the relevance of agent's cognitive skills and present-biased preferences for the determination of first-best and constrained first-best optimal policies.t technologies. Welfare is higher if consumer auditing is the only tax enforcement policy.
    Keywords: Paternalism; Optimal Taxation; Education; Health.
    JEL: D61 D91 H21 I18 I28
    Date: 2017–09
  10. By: Abeliansky, Ana Lucia; Strulik, Holger
    Abstract: We analyze how childhood hunger affects human aging for a panel of European individuals. For this purpose, we use six waves of the Survey of Health, Aging, and Retirement in Europe (SHARE) dataset and construct a health deficit index. Results from log-linear regressions suggest that, on average, elderly European men and women developed about 20 percent more health deficits when they experienced a hunger episode in their childhood. The effect becomes larger when the hunger episode is experienced earlier in childhood. In non-linear regressions (akin to the Gompertz-Makeham law), we obtain greater effects suggesting that health deficits in old age are up to 40 percent higher for children suffering from hunger. The wedge of health deficits between hungry and and non-hungry individuals increases absolutely and relatively with age. This implies that individuals who suffered from hunger as children age faster.
    Keywords: health,aging,health deficit index,hunger episodes,childhood health
    JEL: I10 I19 J13
    Date: 2017
  11. By: Valentina Tonei
    Abstract: The dramatic increase in the utilization of caesarean section has raised concerns on its impact on public expenditure and health. While the financial costs associated with this surgical procedure are well recognized, less is known on the intangible health costs borne by mothers and their families. We contribute to the debate by investigating the effect of unplanned caesarean deliveries on mothers’ mental health in the first nine months after the delivery. Differently from previous studies, we account for the unobserved heterogeneity due to the fact that mothers who give birth through an unplanned caesarean delivery may be different than mothers who give birth with a natural delivery. Identification is achieved exploiting exogenous variation in the position of the baby in the womb at the time of delivery while controlling for hospital unobserved factors. We find that mothers having an unplanned caesarean section are at higher risk of developing postnatal depression and this result is robust to alternative specifications.
    Keywords: Caesarean Section, Instrumental Variables, Maternal Health, Millennium Cohort Study, Postnatal Depression.
    JEL: I12 I18
    Date: 2017–09
  12. By: Bach, Philipp; Farbmacher, Helmut; Spindler, Martin
    Abstract: Heterogeneous effects are prevalent in many economic settings. As the functional form between outcomes and regressors is generally unknown a priori, a semiparametric negative binomial count data model is proposed which is based on the local likelihood approach and generalized product kernels. The local likelihood framework allows to leave unspecified the functional form of the conditional mean, while still exploiting basic assumptions of count data models (i.e. non-negativity). Since generalized product kernels allow to simultaneously model discrete and continuous regressors, the curse of dimensionality is substantially reduced. Hence, the applicability of the proposed estimator is increased, for instance in estimation of health service demand where data is frequently mixed. An application of the semiparametric estimator to simulated and real-data from the Oregon Health Insurance Experiment provide results on its performance in terms of prediction and estimation of incremental effects.
    Keywords: semiparametric regression,nonparametric regression,count data,mixed data,health care demand
    JEL: C14 C21 I13
    Date: 2017
  13. By: Mohamad Fahmi (Department of Economics, Padjadjaran University); Adiatma Siregar (Department of Economics, Padjadjaran University); Deni K Sunjaya (Department of Public Health, Padjadjaran University); Gilang Amarullah (Department of Economics, Padjadjaran University); Rahma Rahma (Department of Economics, Padjadjaran University); Nur Afni Panjaitan (Department of Economics, Padjadjaran University)
    Abstract: Mental health is the integral part of overall health. Despite the importance of mental health, most health policy are directed for physical, while mental issues left behind.The similar pattern is also happen in Indonesia. This paper aim to examine the impact of social capital to individual mental health. We utilize IFLS 2014 database since it provide comprehensive information on mental health as well as social capital. Mental health is represented by self-reported of depression CESD-R-10 scale. Social capital represented by social trust in individual and community level as well as participation in community. The research using mixed level regression model method with number of observation 28,257 respondents. We also incorporated control variable such as age, gender, marital status, working status, household size, income, and education. Result of the study showed that social trust and participation in community has no significant contribution to depression. On the other hand, control variables such as being older, male, and married associated with lower probability of depression.
    Keywords: social capital, mental health, Indonesia
    JEL: I0
    Date: 2017–09
  14. By: Adiatma Siregar (Department of Economics, Padjadjaran University); Rahma Rahma (Department of Economics, Padjadjaran University); Nur Afni Panjaitan (Department of Economics, Padjadjaran University); Gilang Amarullah (Department of Economics, Padjadjaran University); Deni K Sunjaya (Department of Public Health, Padjadjaran University); Mohamad Fahmi (Department of Economics, Padjadjaran University)
    Abstract: Mental illness is one of the diseases needs to be prioritized in Indonesia as it causes significant burden [1,2]. Currently, 14 million people of population above 15 years of age (6%) are suffering from emotional disorder, and more than 400,000 people are suffering from psychotic disorder [2]. Furthermore, people suffering from mental illness are still marginalized group and do not receive proper attention from development program [3]. Investment related to mental health in developing countries is relatively low, ranging between 1,5% - 2,4% of their health expenditure [4]. As Indonesia health expenditure is already low [5], this may become a problem as mental illness becomes more severe. This may worsen the condition of double burden of disease currently faced by Indonesia.
    Keywords: social capital, mental health, Indonesia
    JEL: I0
    Date: 2017–09
  15. By: Sergi Jiménez-Martín; Catia Nicodemo; Stuart Redding
    Abstract: In England as elsewhere, policy makers are trying to reduce the pressure on costs caused by rising hospital admissions by encouraging GPs to refer less patients to hospital specialists.This could have an impact on elective treatment levels, particularly procedures for conditions which are not life-threatening and can be delayed or perhaps withheld entirely. This study attempts to identify the potential consequences on levels of emergency treatment if elective care is managed downwards. Using administrative data from Hospital Episode Statistics (HES) in England we estimate dynamic fixed effects panel data models for emergency admissions at Primary Care Trust and Hospital Trust levels for the years 2004–13, controlling for a group of area-specific characteristics and other secondary care variables. We find that increasing levels of elective care tends to increase the future requirement for emergency treatment. While there is no guarantee that the positive correlation between emergency and elective activity will persist if policy is effective in reducing levels of elective treatment, it does suggest that the cost-saving benefits to the NHS from reducing elective treatment may not be as great in aggregate as anticipated.
    Keywords: Health care services, elective and emergency hospital admissions, secondary care, NHS, dynamic panel data
    JEL: I11 I C30 C33
    Date: 2017–09
  16. By: Suppliet, Moritz
    Abstract: Umbrella branding is a marketing practice whereby multi-product firms leverage their reputation across different product categories. This paper investigates how advertising in the market of over-the-counter (OTC) drugs affects the decision to buy prescription drugs from a promoted brand name. I exploit specific charac- teristics of market regulation in Germany to identify the effect of advertising and find positive effects of umbrella branding on sales of prescription drugs. Umbrella branding results in market expansion, particularly for generic firms which invest in OTC drug advertising. If the effect leads to more consumers of generic substitutes or to more patients in undertreated therapeutic areas, market expansion can have a positive effect on welfare.
    Keywords: umbrella branding; regulation; empirical io; pharmaceuticals ; marketing
    JEL: I3 L51 I1 M37 D22 C18
    Date: 2017
  17. By: Hiroshi Sano; Rei Goto; Chisato Hamashima (Faculty of Economics, Shiga University)
    Abstract: "Objectives"To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. "Methods"Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. "Results"The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). "Conclusions" Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.
    Keywords: Breast cancer screening, Cervical cancer screening, Participation rate, Resource; Mammography unit, Gynecologist
    Date: 2017–09
  18. By: Abdul Azeez Oluwanisola Abdul Wahab (Faculty of Economics and Muamalat, Universiti Sains Islam, Malaysia Author-2-Name: Zurina Kefeli Author-2-Workplace-Name: Faculty of Economics and Muamalat, Universiti Sains Islam, Malaysia)
    Abstract: "Objective – The possibility of healthcare expenditure and education expenditure are becoming a thought-provoking issue for numerous governments globally, in spite of the fact that healthcare is unique and vital rudiments of well-being. On the other hand, education is the strength and spinal column of ground-breaking thoughts. Nevertheless, with an ageing population and ballooning protracted health difficulties, the preservation of the quality of life demands improved healthcare and education expenditure on the part of government. However, this study scrutinizes the effect of healthcare expenditure and education expenditure on labour productivity using Organization of Islamic Cooperation (OIC) countries as a case study. Methodology/Technique – The research utilized pooled-panel data method with data from 1990 to 2015. Findings – The result of the findings shows that there is the statistical significant relationship between healthcare expenditure, education expenditure and labour productivity in OIC countries. Novelty – Research suggests that healthcare and education is a mechanism to stimulate the productivity of labour in OIC countries."
    Keywords: Education Expenditure; Healthcare Expenditure; Labour Productivity; OIC Countries.
    JEL: H51 H52 J24
    Date: 2017–03–23
  19. By: Mohammad Habibur Rahman (Mohammed Bin Rashid School of Government, United Arab Emirates Author-2-Name: Fatima Mahmoud Salim Author-2-Workplace-Name: Duabi Health Authority, Dubai, United Arab Emirates)
    Abstract: "Objective – The United Arab Emirates (UAE) Vision 2021 aims to achieve a world-class healthcare system and the national agenda has set multiple Key Performance Indicators (KPIs) to accomplish accreditation by all healthcare facilities in the country by 2021. The purpose of this study was to assess the impact of Joint Commission International (JCI) accreditation on Infection Control (IC) KPIs in Dubai Hospital (DH). Methodology/Technique – A longitudinal case study covering 2007 to 2013 was conducted to examine this impact based on secondary data of the KPIs during this period and semi-structured interviews with senior health officials. Findings – The study reveals that the healthcare accreditation acts as a catalyst for implementing and monitoring changes but it also underscores some challenges. It proposes recommendations such as improving surveillance systems, ensuring proper resources allocation, and undertaking further research. Novelty – The study recommends improving the surveillance and reporting systems at the national level through frequent internal surveys."
    Keywords: Dubai; Infection Control; Joint Commission International Accreditation; Key Performance Indicators; United Arab Emirates.
    JEL: H51 I11 P46
    Date: 2017–01–13
  20. By: Obisesan, Adekemi; Owoseni, Oluwakemi
    Abstract: Malaria is a common and devastating disease affecting half of the world’s population. The study investigated preference of medicinal plants in the treatment of malaria fever in Akure South Local Government Area of Ondo state, Nigeria. Primary data were obtained for the purpose of this study using structured questionnaire. The data collected included the socio-economic characteristics, preference and use of medicinal plants as well as types of medicinal plants utilized for malaria treatment. Multi-stage sampling was employed in the selection of one hundred respondents. Data were analyzed using descriptive statistics and probit regression model. The mean age of the respondents was 40 years and the mean household size was 6 persons. Despite access to modern health facilities, 64.0% of the respondents preferred medicinal plants in the treatment of malaria fever. Medicinal plants / parts commonly used in malaria treatment are neem leaves, lemon grass, mango bark and leaves, cashew bark and leaves, moringa olifera, bitter gourd and unripe pawpaw. Preference for medicinal plants in the treatment of malaria was influenced by sex, income, and taste. Lack of standardization and unpalatable taste are key constraints to utilization of medicinal plants in the treatment of malaria fever. The study recommends the extraction of the active agents in these plants by relevant research and development agencies to ensure standardization. Government should intensify efforts towards the eradication of malaria fever in Nigeria.
    Keywords: Anti-malarial, Medicinal plants, Preference, medicare
    JEL: I11
    Date: 2017–09–28
  21. By: Schnepel, Kevin T.; Schurer, Stefanie
    Abstract: This paper studies the effect of improved early-life health care, through assignment to a special care nursery (SCN), on childhood development and school achievement. We use linked administrative data in the Northern Territory of Australia and exploit the fact that assignment to SCN is largely based on rules of thumb involving low birth weight thresholds. We find large positive effects of SCN assignment on development at age five and some persistent improvements in test scores. Our results suggest that costly early-life health interventions, that are shown to increase survival probabilities of children in the short run, can also substantially boost cognitive and non-cognitive skills.
    Keywords: Early-life health treatments,special care nurseries,school achievements,noncognitive skills,school readiness
    JEL: J13 I14 I18 I24
    Date: 2017
  22. By: Kuhn, Michael; Frankovic, Ivan; Wrzaczek, Stefan
    Abstract: We study medical progress within an economy of overlapping generations subject to endogenous mortality. We characterize the individual optimum and the general equilibrium of the economy and study the impact of improvements in the effectiveness of health care. We find that general equilibrium effects dampen strongly the increase in health care usage following medical innovation and that an increase in savings offsets the negative impact on GDP per capita of a decline in the support ratio..
    JEL: D91 I11 I12 I18 J11 J17 O31 O41
    Date: 2017
  23. By: Obrizan, Maksym
    Abstract: This paper investigates changes in public health care use in 28 transition countries in the aftermath of the global financial crisis using data on more than 60 thousand households from “Life in Transition” surveys II and III conducted by the European Bank for Reconstruction and Development in 2010 and 2016. A difference-in-difference model with robust standard errors clustered at a country level is applied to two sets of transition countries defined by their membership status in the European Union. While there was no difference in public health care use between the two groups in 2010 the share of households using the public health care system dropped by a remarkable 22.2% points between 2010 and 2016 in non-EU transition countries compared to new EU members. There is also some evidence of crowding out of public health care with private out-of-pocket expenditures in non-EU members. These findings represent a serious policy concern in terms of falling access to health care in non-EU transition countries. If one believes in equity benefits from access to public health care for all compared to private out-of-pocket expenditures these results also demonstrates a clear benefit of EU membership.
    Keywords: public-private health care, mixed financing, transition countries, difference-in-difference
    JEL: H44 I1 O57
    Date: 2017–08–18
  24. By: Elisabet Rodriguez Llorian (University of Manitoba); Janelle Mann (University of Manitoba)
    Abstract: This presentation examines the link between healthcare expenditure and GDP in Latin American and Caribbean countries using the Stata command xtwest to estimate the error-correction-based cointegration tests for panel data featured in The Stata Journal (Persyn and Westerlund, 2008). Extensions of unit root and cointegration tests to a panel data-approach allow investigation of the dynamics for developing countries, which tend to have shorter available time series. I employ several unit-root tests coded as xtunitroot to determine whether the panel is stationary and Westerlund (2007) coded as xtwest to analyze the relationship and dynamics between health expenditure (total, private, and public) and income. Cointegration tests for panel data have increased power properties over traditional tests because of increased degrees of freedom and the inclusion of heterogeneous cross-country information. Results suggest that all categories of health expenditure move to maintain a stable long-run equilibrium. This presentation is an interesting case study of the use of Stata commands within economics. All empirical analysis was conducted in Stata and will highlight several recent developments within time-series techniques applied to panel data that have yet to be coded within Stata to make said tools accessible to researchers.
    Date: 2017–09–20

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