nep-hea New Economics Papers
on Health Economics
Issue of 2017‒12‒18
twenty-two papers chosen by
Yong Yin
SUNY at Buffalo

  1. Does hospital competition improve efficiency? The effect of the patient choice reform in England By Francesco Longo; Luigi Siciliani; Giuseppe Moscelli; Hugh Gravelle
  2. Pricing implications of non-marginal budgetary impacts in health technology assessment: a conceptual model By Daniel Howdon; James Lomas
  3. Commuting and Sickness Absence By Laszlo Goerke; Olga Lorenz
  5. Unmet Health Care and Health Care Utilization By Vicky Barham; Hana Bataineh; Rose Anne Devlin
  6. Quality and cost-effectiveness in long-term care and dependency prevention: the Polish policy landscape By Stanislawa Golinowska; Agnieszka Sowa-Kofta
  7. Points To Save Lives: The Effects of Traffic Enforcement Policies on Road Fatalities By Almunia, Miguel; Gaete, Gonzalo
  8. Health, Retirement and Consumption By Malene Kallestrup-Lamb; John Kennan; Bent Jesper Christensen
  9. How well targeted are soda taxes? By Dubois, Pierre; Griffith, Rachel; O'Connell, Martin
  10. Impact of acute health shocks on cigarette consumption By Antoine Marsaudon; Lise Rochaix
  11. Private Health Investments under Competing Risks: Evidence from Malaria Control in Senegal By Pauline Rossi; Paola Villar
  12. Premature deaths, accidental bequests and fairness By Marc Fleurbaey; Marie-Louise Leroux; Pierre Pestieau; Grégory Ponthière; Stephane Zuberk
  13. Ownership and Hospital Behaviour: Employment and Local Unemployment By Andrew E. Clark; Carine Milcent
  14. Gender longevity gap and socioeconomic indicators in developed countries By Fedotenkov, Igor; Derkachev, Pavel
  15. Physician heal thyself (Luke 4:23) By Hughes, Jamie Hacker; Rao, Amra Saleem; Dosanjh, Neelam; Cohen-Tovée, Esther; Clarke, Jeremy; Bhutani, Gita
  16. Decentralization of health and education in developing countries: a quality-adjusted review of the empirical literature By Channa, Anila; Faguet, Jean-Paul
  17. After the Demonstration: What States Sustained After the End of Federal Grants to Improve Children’s Health Care Quality By Henry T. Ireys; Cindy Brach; Grace Anglin; Kelly J. Devers; Rachel Burton
  18. Patients' Perspectives of Care Management: A Qualitative Study By Ann S. O’Malley; Deborah Peikes; Claire Wilson; Rachel Gaddes; Victoria Peebles; Timothy J. Day; Janel Jin
  19. Love the job... or the patient? Task vs. mission-based motiviations in healthcare By Sheheryar Banuri; Philip Keefer; Damien de Walque
  21. Mandating Access: Assessing the NIH's Public Access Policy By Staudt, Joseph
  22. Socioemotional Skills, Education, and Health-Related Outcomes of High-Ability Individuals By Peter Savelyev; Kegon Teng Kok Tan

  1. By: Francesco Longo (Centre for Health Economics, University of York, York, UK.); Luigi Siciliani (Department of Economics and Related Studies, University of York, York, UK.); Giuseppe Moscelli (Centre for Health Economics, University of York, York, UK.); Hugh Gravelle (Centre for Health Economics, University of York, York, UK.)
    Abstract: We use the 2006 relaxation of constraints on patient choice of hospital in the English NHS to investigate the effect of hospital competition on dimensions of efficiency including indicators of resource management (admissions per bed, bed occupancy rate, proportion of day cases, cancelled elective operations, proportion of untouched meals) and costs (cleaning services costs, laundry and linen costs, reference cost index for overall and elective activity). We employ a quasi difference-indifference approach and estimate seemingly unrelated regressions and unconditional quantile regressions with data on hospital trusts from 2002/03 to 2010/11. Our findings suggest that increased competition had mixed effects on efficiency. An additional equivalent rival increased admissions per bed and the proportion of day cases by 1.1 and 3.8 percentage points, and reduced the proportion of untouched meals by 3.5 percentage points, but it also increased the number of cancelled elective operations by 2.6%. Unconditional quantile regression results indicate that hospitals with low efficiency, as measured by few
    Keywords: competition, efficiency, choice, hospital, difference-in-difference
    JEL: C21 H51 I11 I18 L1
    Date: 2017–11
  2. By: Daniel Howdon (Department of Economics, Econometrics and Finance, University of Groningen, Netherlands.); James Lomas (Centre for Health Economics, University of York, York, UK.)
    Abstract: This paper introduces a framework by which to conceptualise the decision-making process in health technology assessment when the quantity of health forgone by acceptance is high enough such that the use of a single threshold based on the marginal productivity of the health care system is inappropriate, and draws out the implications of this for pharmaceutical pricing. Under the condition of perfect divisibility, a large budgetary impact of a new treatment may imply that optimal implementation may be partial rather than full, even at a given incremental cost effectiveness ratio (ICER) that would nevertheless mean the decision to accept the treatment in full would not lead to a net reduction in health. In a one-shot price setting game, this seems to give rise to horizontal equity concerns which may be more apparent than real. When the assumption of fixity of the ICER (arising from the assumed exogeneity of the manufacturer’s price) is relaxed, it can be shown that the threat of partial implementation may be sufficient to give rise to an ICER at which cost the entire potential population is treated, maximising health at an increased level, and with no contravention of the horizontal equity principle.
    Keywords: health technology assessment, economic evaluation, budgetary impact
    JEL: I10 I11 J18
    Date: 2017–11
  3. By: Laszlo Goerke (Institute for Labour Law and Industrial Relations in the European Union IAAEU), Trier University); Olga Lorenz (Institute for Labour Law and Industrial Relations in the European Union IAAEU), Trier University)
    Abstract: We investigate the causal effect of commuting on sickness absence from work using German panel data. To address reverse causation, we use changes in commuting distance for employees who stay with the same employer and who have the same residence during the period of observation. In contrast to previous papers, we do not observe that commuting distances are associated with higher sickness absence, in general. Only employees who commute long distances are absent about 20% more than employees with no commutes. We explore various explanations for the effect of long distance commutes to work and can find no evidence that it is due to working hours mismatch, lower work effort, reduced leisure time or differences in health status.
    Keywords: sickness absence, absenteeism, commuting, health, labour supply
    JEL: I10 J22 R2 R40
    Date: 2017–12
  4. By: Aysıt Tansel (Department of Economics, Middle East Technical University, Ankara, Turkey; Institute for the Study of Labor (IZA) Bonn, Germany; Economic Research Forum (ERF) Cairo, Egypt); Halil İbrahim Keskin (Department of Econometrics, Cukurova University, Saricam, Adana, Turkey)
    Abstract: The strong relationship between various health indicators and education is widely documented. However, the studies that investigate the nature of causality between these variables became available only recently and provide evidence mostly from developed countries. We add to this literature by studying the causal effect of education on days hospitalized and days out of work for health reasons. We consider two educational reforms. One is the educational expansion of the early 1960s and the other is the 1997 increase in compulsory level of schooling from five to eight years. However, due to the possibility of weak instruments we do not further pursue this avenue. We focus on individuals in two cohorts namely, 1945-1965 which is an older cohort and 1980-1980 which is a younger cohort. We estimate Tobit models as well as Double Hurdle models. The results suggest that an increase in years of education causes to reduce the number of days hospitalized for both men and women unambiguously and the number of days out of work only for men while an increase in education increases the number of days out of work for a randomly selected women.
    Keywords: Education, Days hospitalized, Days out of work, Education reform, Tobit model, Double Hurdle model, Gender, Turkey.
    JEL: I15 J16 J18 C34 C36
    Date: 2017–12
  5. By: Vicky Barham (University of Ottawa, ON, Canada); Hana Bataineh (University of Ottawa, ON, Canada); Rose Anne Devlin (University of Ottawa, ON, Canada)
    Abstract: Objective; To examine the causal effect of health care utilization on unmet health care needs. Methods; An instrumental variables approach deals with the endogeneity between the use of health care services and unmet health care. The presence of drug insurance and the number of physicians in each health region are used to identify the causal effect. The reasons for unmet health care needs are grouped into system and personal ones. We use four biennial confidential master files (2001-2010) of the Canadian Community Health Survey. Results; We find a clear and robustly negative relationship between health care use and unmet health care needs; a higher probability of unmet health care needs is attributable to a low use of health care services. One more visit to a medical doctor on average decreases the probability of having unmet health care needs by 0.028 points. If the unmet need is due to accessibility related reasons, this effect is 0.02 compared to only 0.015 point for personal related reasons. Conclusion; Health care use reduces the likelihood of reporting unmet health care. That the link between health care utilization and unmet health care needs is stronger for accessibility related reasons than for personal reasons, suggests that policies like increasing the coverage of public drug insurance, and increasing the number of physicians can reduce the likelihood of unmet health care.
    Keywords: Unmet health care needs; Health care utilization; Instrumental Variables (IV); Canada.
    Date: 2017
  6. By: Stanislawa Golinowska; Agnieszka Sowa-Kofta
    Abstract: With the population ageing the development of sustainable long-term care institutions is of great importance in many European countries. In Poland, currently dominant, traditional and family based care will become insufficient with increasing cohorts of older people. Presented paper discusses recent developments in long-term care policy in the country. Long-term care institutions are separated in the two sectors, with little field for cooperation and coordination of activities. Over the past years policy addressing ageing related problems was developed, focusing on the active ageing instruments. Dependency prevention and active ageing are among goals of national policies formulated separately in the health and social sector. Information policy and monitoring long-term care services’ provision remains insufficient. Coordination of activities mainly takes place at the local level. Local governments and non-governmental organizations, often cooperating with representatives of older people, are active in providing services to older people in community and often incorporating innovative solutions in care.
    Keywords: long-term care policy, long-term care institutions, informal care, dependency prevention, ageing, older people
    JEL: I10 I18 I31 I38
    Date: 2017
  7. By: Almunia, Miguel (University of Warwick); Gaete, Gonzalo (University of Warwick)
    Abstract: Traffic accidents cause more than one million annual deaths worldwide and yield substantial economic costs to society. This paper studies the effects of a penalty points system (PPS) introduced in Spain in 2006. We find a 20% decrease in cumulative road fatalities in the five years after the reform, compared to a synthetic control group constructed using a weighted average of other European countries. Using estimates of the value of a statistical life, we calculate that the PPS yielded a net economic benefit of €4.6 billion ($6 billion) over this period, equivalent to 0.43% of Spain’s GDP.
    Keywords: road fatalities; traffic enforcement; penalty points system (PPS); synthetic control; Spain. JEL Classification: I18, R41, K32.
    Date: 2017
  8. By: Malene Kallestrup-Lamb (University of Aarhus); John Kennan (University of Wisconsin Madison); Bent Jesper Christensen (Aarhus University)
    Abstract: The paper analyzes consumption decisions of retired workers, using Danish register data. A major puzzle, which motivates much of the analysis below, is that wealth actually increases for a large fraction (roughly half) of the people in our data. One would expect that wealth accumulated before retirement would be used to augment consumption in later life, with the implication that wealth should decline over time. The risk of large out-of-pocket medical expenditures is negligible in Denmark, so although explanations associated with such expenditures might explain similar patterns in U.S. data, these explanations are not plausible for Denmark (and therefore also questionable for the U.S.) Our analysis instead attempts to explain wealth paths using a model that emphasizes health-related fluctuations in the marginal utility of consumption.
    Date: 2017
  9. By: Dubois, Pierre; Griffith, Rachel; O'Connell, Martin
    Abstract: Soda taxes aim to reduce excessive sugar consumption. Their effectiveness depends on whether they target individuals for whom the harm of consumption is largest. We estimate demand and account for supply-side equilibrium pass-through. We exploit longitudinal data to estimate individual preferences, which allows flexible heterogeneity that we relate to a wide array of individual characteristics. We show that soda taxes are effective at targeting young consumers but not individuals with high total dietary sugar; they impose the highest monetary cost on poorer individuals, but are unlikely to be strongly regressive if we account for averted future costs from over consumption.
    Keywords: discrete choice demand; Pass-Through; preference heterogeneity; soda tax
    JEL: D12 H31 I18
    Date: 2017–12
  10. By: Antoine Marsaudon (PSE - Paris-Jourdan Sciences Economiques - CNRS - Centre National de la Recherche Scientifique - ENPC - École des Ponts ParisTech - EHESS - École des hautes études en sciences sociales - INRA - Institut National de la Recherche Agronomique - ENS Paris - École normale supérieure - Paris, Hospinnomics (PSE – École d’Économie de Paris, Assistance Publique Hôpitaux de Paris – AP-HP) - PSE - Paris School of Economics, Université Paris1 - Panthéon-Sorbonne); Lise Rochaix (CES - Centre d'économie de la Sorbonne - UP1 - Université Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique, Hospinnomics (PSE – École d’Économie de Paris, Assistance Publique Hôpitaux de Paris – AP-HP) - PSE - Paris School of Economics, Université Paris1 - Panthéon-Sorbonne)
    Abstract: This paper investigates the relationship between an acute health shock, namely the first onset of an accident requiring medical care, and cigarette consumption, using the French Gazel panel data. To identify the causal effect of such shocks, we use a difference-indifferences approach combined with a propensity score. Results suggest that there is a significant effect running from the shock to the number of cigarettes smoked with impact duration of eight years after the shock. Individuals subject to such a shock smoke, on average, 2 cigarettes less (per week) than those not exposed to such a shock. Further, the findings show heterogeneous effects among smokers: heavy smokers are more likely to reduce tobacco consumption than occasional smokers.
    Keywords: health shock,panel data,France,lifestyles,propensity score matching,Cigarette consumption
    Date: 2017–10–30
  11. By: Pauline Rossi (UvA - University of Amsterdam [Amsterdam]); Paola Villar (INED - Institut national d'études démographiques, PSE - Paris School of Economics, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique)
    Abstract: This study exploits the introduction of high subsidies for anti-malaria products in Senegal in 2009 to investigate if malaria prevents parents to invest in child health. Building upon the seminal paper of Dow et al. (1999), we develop a simple model of health investments under competing mortality risks, in which people allocate expenses to equalize lifetime across all causes of death. We predict that private health investments to fight malaria as well as other diseases should increase in response to anti-malaria public interventions. To test this prediction, we use original panel data from a Senegalese household survey combined with geographical information on malaria prevalence. Our strategy is to compare the evolution of child health expenditures before and after anti-malaria interventions, between malarious and non-malarious regions of Senegal. We find that health expenditures in malarious regions catch up with non-malarious regions, at the extensive and intensive margins, and both in level and in composition. The same result holds for parental health-seeking behavior in case of other diseases like diarrhea. We provide evidence that these patterns cannot be explained by differential trends in total income or access to healthcare or child morbidity between malarious and non-malarious regions. Our results suggest that behavioral responses to anti-malaria campaigns magnify their impact on all-cause mortality for children.
    Keywords: Health expenses,Malaria,Africa,Human capital,Competing risks
    Date: 2017–11
  12. By: Marc Fleurbaey (Princeton University); Marie-Louise Leroux (UQAM - Université du Québec à Montréal - UQAM - Université du Québec à Montréal); Pierre Pestieau (CORE - Center of Operation Research and Econometrics [Louvain] - UCL - Université Catholique de Louvain, PSE - Paris School of Economics, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique); Grégory Ponthière (PSE - Paris School of Economics, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique, ERUDITE - Equipe de Recherche sur l’Utilisation des Données Individuelles en lien avec la Théorie Economique - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12 - UPEM - Université Paris-Est Marne-la-Vallée); Stephane Zuberk (PSE - Paris School of Economics)
    Abstract: While little agreement exists regarding the taxation of bequests in general, there is a widely held view that accidental bequests should be subject to a confi…scatory tax. We propose to reexamine the optimal taxation of accidental bequests in an economy where individuals care about what they leave to their offspring in case of premature death. We show that, whereas the conventional 100 % tax view holds under the standard utilitarian social welfare criterion, it does not hold under the ex post egalitarian criterion, which assigns a strong weight to the welfare of unlucky short-lived individuals. From an egalitarian perspective, it is optimal not to tax, but to subsidize accidental bequests. We examine the robustness of those results in a dynamic OLG model of wealth accumulation, and show that, whereas the sign of the optimal tax on accidental bequests depends on the form of the joy of giving motive, it remains true that the 100 % tax view does not hold under the ex post egalitarian criterion.
    Keywords: mortality,accidental bequests,optimal taxation,egalitarianism,OLG models
    Date: 2017–11
  13. By: Andrew E. Clark (PSE - Paris School of Economics, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique); Carine Milcent (PSE - Paris School of Economics, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique)
    Abstract: We here use 2006-2010 French panel data to ask i) how hospital employment changes with local unemployment, according to the type of hospital ownership, and ii) whether this relationship changed after the implementation of a pro-competitive reform that made hospitals more similar. Our panel data allows us to consider within-hospital employment changes. We first find that higher local unemployment is associated with greater employment in State-owned hospitals, but not for any other hospital ownership type: French local authorities then seem to respond to depressed local labour markets by increasing employment in State -owned hospitals. After the full implementation of the pro-competitive reform hospital funding became based only on activity and no longer on some historical budget. Theoretically, the new reimbursement system should break the relationship between public-hospital employment and local unemployment. Our results reveal that the reform worked as expected in less-deprived areas: reducing employment and eliminating the correlation between local unemployment and State-owned hospital employment. However, in higher-unemployment areas, public-hospital employment remains counter-cyclical.
    Keywords: Hospitals,Management,Competition,Public Employment,Unemployment
    Date: 2017–11
  14. By: Fedotenkov, Igor; Derkachev, Pavel
    Abstract: In most countries, women live longer than men. Differences in longevities are country-specific and change over time. We perform a cross-country panel data analysis in developed countries (OECD and EU) to study the gender-longevity gap dependence on various socio-economic indicators and test a number of contradicting theories. We show that a lower gender longevity gap is associated with a higher real GDP per capita, a higher level of urbanization, lower income inequality, lower per capita alcohol consumption and a better ecological environment. An increase in women's aggregate unemployment rate and a decline in men's unemployment are associated with a higher gap in life expectancies. The effect of the share of women in parliaments in the gender-longevity gap is estimated to have a U-shape; it has a better descriptive efficiency if taken with a 5-years lag, which approximately corresponds to the length of political cycles.
    Keywords: Gender longevity gap, inequality, cross-country analysis, life expectancy
    JEL: J11 J14 J16 J71
    Date: 2017–12–08
  15. By: Hughes, Jamie Hacker; Rao, Amra Saleem; Dosanjh, Neelam; Cohen-Tovée, Esther; Clarke, Jeremy; Bhutani, Gita
    Abstract: The performance culture of the health service means that the psychological wellbeing of staff is becoming paramount in maintaining the workforce and in sustaining psychological health and morale. A Charter for Psychological Staff Wellbeing and Resilience is introduced which puts the onus on us and on employers to make the necessary adjustments to their workplace cultures and encourage professionals – us – to break through the barrier of stigma.
    JEL: R14 J01
    Date: 2016–12–01
  16. By: Channa, Anila; Faguet, Jean-Paul
    Abstract: We review empirical evidence on the ability of decentralization to enhance preference matching and technical efficiency in the provision of health and education in developing countries. Many influential surveys have found that the empirical evidence of decentralization's effects on service delivery is weak, incomplete, and often contradictory. Our own unweighted reading of the literature concurs. However, when we organize quantitative evidence first by substantive theme, and then—crucially—by empirical quality and the credibility of its identification strategy, clear patterns emerge. Higher-quality evidence indicates that decentralization increases technical efficiency across a variety of public services, from student test scores to infant mortality rates. Decentralization also improves preference matching in education, and can do so in health under certain conditions, although there is less evidence for both. We discuss individual studies in some detail. Weighting by quality is especially important when quantitative evidence informs policy-making. Firmer conclusions will require an increased focus on research design, and a deeper examination into the prerequisites and mechanisms of successful reforms.
    Keywords: decentralization; school-based management; education; health; service delivery; developing countries; preference matching; technical efficiency
    JEL: H41 H75 H77 O1
    Date: 2016–08–01
  17. By: Henry T. Ireys; Cindy Brach; Grace Anglin; Kelly J. Devers; Rachel Burton
    Abstract: Under the CHIPRA Quality Demonstration Grant Program, CMS awarded $100 million through 10 grants that 18 state Medicaid agencies implemented between 2010 and 2015.
    Keywords: Sustainability , Child health , Demonstration grants , CHIPRA , Quality
    JEL: I
  18. By: Ann S. O’Malley; Deborah Peikes; Claire Wilson; Rachel Gaddes; Victoria Peebles; Timothy J. Day; Janel Jin
    Abstract: Risk-stratified care management is a cornerstone of patient-centered medical home models, but studies on patients’ perspectives of it are scarce. We explored patients’ experiences with care management, what they found useful, and what needs improvement.
    Keywords: Care Management, Patient perspectives
    JEL: I
  19. By: Sheheryar Banuri (University of East Anglia); Philip Keefer (Inter-American Development Bank); Damien de Walque (The World Bank)
    Abstract: A booming literature has argued that mission-based motives are a central feature of mission-oriented labor markets. We shift the focus to task-based motivation and find that it yields significantly more effort than mission-based. Moreover, in the presence of significant task motivation, mission motivation has no additional effect on effort. The evidence emerges from experiments with nearly 250 medical and nursing students in Burkina Faso. The students exert effort in three tasks, from boring to interesting. In addition, for half of the students, mission motivation is present: their effort on the task generates benefits for a charity. Two strong results emerge. First, task motivation has an economically important effect on effort, more than doubling effort. Second, mission motivation increases effort, but only for mundane tasks and not when the task is interesting. Even for mundane tasks, moreover, the effects of mission motivation appear to be less than those of task motivation.
    Keywords: public sector reform, civil service, intrinsic motivation, extrinsic motivation, performance
    JEL: C91 H83 J45
    Date: 2017–11
  20. By: Daniel Kardefelt Winther; UNICEF Office of Research - Innocenti
    Abstract: Based on an evidence-focused literature review, the first part of this paper examines existing knowledge on how the time children spend using digital technology impacts their well-being across three dimensions; mental/psychological, social and physical. The evidence reviewed here is largely inconclusive with respect to impact on children’s physical activity, but indicates that digital technology seems to be beneficial for children’s social relationships. In terms of impact on children’s mental well-being, the most robust studies suggest that the relationship is U-shaped, where no use and excessive use can have a small negative impact on mental well-being, while moderate use can have a small positive impact. In the second part of the paper, the hypothetical idea of addiction to technology is introduced and scrutinized. This is followed by an overview of the hypothetical idea that digital technology might re-wire or hijack children’s brains; an assumption that is challenged by recent neuroscience evidence. In conclusion, considerable methodological limitations exist across the spectrum of research on the impact of digital technology on child well-being, including the majority of the studies on time use reviewed here, and those studies concerned with clinical or brain impacts. This prompts reconsideration of how research in this area is conducted. Finally, recommendations for strengthening research practices are offered.
    Keywords: information technology; mental health; social behaviour;
    Date: 2017
  21. By: Staudt, Joseph
    Abstract: In 2008, the National Institutes of Health (NIH) mandated that the full text of NIH-supported articles be made freely available on PubMed Central (PMC) -- the largest and most commonly used repository of biomedical literature. This paper examines how this "PMC mandate" impacted publishing patterns in biomedicine and researcher access to the biomedical literature. Using ~1 million NIH articles and several matched comparison samples, I find that NIH articles are more likely to be published in traditional subscription-based journals (as opposed to "open access" journals) after the mandate. This indicates that the mandate did not induce widespread discrimination, by subscription-based journals, against NIH articles. I also find that the mandate did not increase the number of forward citations to NIH articles published in subscription-based journals. This is consistent with researchers having widespread access to the biomedical literature prior to the mandate, leaving little room for the mandate to increase access.
    Keywords: economics of science, open access, nih, nih public access policy, policy evaluation
    JEL: O31 O34 O38
    Date: 2017–11
  22. By: Peter Savelyev (The College of William & Mary); Kegon Teng Kok Tan (University of Rochester)
    Abstract: We use the high IQ Terman sample to estimate relationships between education, socioemotional skills, and health-related outcomes that include health behaviors, lifestyles, and health measures across the lifecycle. By both focusing on a high IQ sample and controlling for IQ in regression models, we mitigate ability bias due to cognitive skill. In addition, we control for detailed personality measures to account for socioemotional skills. We model skills using factor analysis to address measurement error and adopt a powerful stepdown procedure to account for multiple hypothesis testing. We find that among high IQ subjects, education is linked to better health-related outcomes, in contrast to previous evidence. Conscientiousness, Openness, Extraversion, and Neuroticism are linked to various health-related outcomes across the lifecycle. Furthermore, we find that accounting for a comprehensive set of skills, measurement error, and multiple hypothesis testing not only provides greater confidence in several established relationships but also generates novel results.
    Keywords: college education, Big Five, health behavior, lifestyle
    JEL: I12 J24
    Date: 2017–12

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