nep-hea New Economics Papers
on Health Economics
Issue of 2018‒02‒12
25 papers chosen by
Yong Yin
SUNY at Buffalo

  1. Trade Liberalization and Child Mortality: A Synthetic Control Method By Alessandro Olper; Daniele Curzi; Johan Swinnen
  2. Retired, at last? The short-term impact of retirement on health status in France By Thomas Barnay; Eric Defebvre
  3. Early-life correlates of later-life well-being: evidence from the Wisconsin Longitudinal Study By Clark, Andrew E.; Lee, Tom
  4. What drives political commitment for nutrition? A review and framework synthesis to inform the United Nations Decade of Action on Nutrition By Baker, P.; Hawkes, C.; Wingrove, K.; Demaio, A.; Parkhurst, Justin; Thow, A.M.; Walls, H.
  5. Surprise! Out-of-network billing for emergency care in the United States By Cooper, Zack; Scott Morton, Fiona; Shekita, Nathan
  6. The Effect of Affordable Care Act Medicaid Expansion on Post-Displacement Labor Supply among the Near-Elderly By Chichun Fang
  7. Medicaid Benefit Generosity and Labor Market Outcomes: Evidence from Medicaid Adult Vision Benefits By Boudreaux, Michel; Lipton, Brandy
  8. Closing the gap: A model for estimating the cost of eradicating stunting and micronutrient deficiencies By Martínez, Rodrigo; Palma, Amalia
  9. Temperature, Climate Change, and Mental Health: Evidence from the Spectrum of Mental Health Outcomes By Jamie Mullins; Corey White
  10. Quantifying Health Shocks Over the Life Cycle By Taiyo Fukai; Hidehiko Ichimura; Kyogo Kanazawa
  11. Formal education, malaria preventive behaviour, and children’s malarial status in Tanzania By Ninja Ritter Klejnstrup; Joel Silas Lincoln
  12. Does publicly provided health care affect migration? Evidence from Mexico By Mahé, Clotilde
  13. Does women’s empowerment affect the health of children? The case of Mozambique By Joseph Deutsch; Jacques Silber
  14. Effects of health insurance on labour supply: Evidence from the health care fund for the poor in Viet Nam By Le, Nga T.Q.; Groot, Wim; Tomini, Sonila; Tomini, Florian
  16. Reality Bites: How Canada’s Healthcare System Compares to its International Peers By Colin Busby; Ramya Muthukaran; Aaron Jacobs
  17. The effect of self-employment on health: Evidence from longitudinal social security data By Judite Goncalves; Pedro S. Martins
  18. The Medicaid Analytic eXtract 2004 Chartbook By Victoria Perez; Bob Schmitz; Audra T. Wenzlow; Kathy Shepperson; David Baugh; Susan Radke
  19. Labour migration in Indonesia and the health of children left behind By James Ng
  20. For better or worse? – The Effects of Physical Education on Child Development By Knaus, Michael C.; Lechner, Michael; Reimers, Anne K.
  21. An Analysis of Knowledge Management for the Development of Global Health By Mohajan, Haradhan
  22. Hyperbolic discounting can be good for your health By Strulik, Holger; Trimborn, Timo
  23. In Sickness and in Health: The Influence of State and Federal Health Insurance Coverage Mandates on Marriage of Young Adults in the USA By Barkowski, Scott; McLaughlin, Joanne Song
  24. The Impact of Health on Labor Supply Near Retirement By Richard Blundell; Jack Britton; Monica Costa Dias; Eric French
  25. Healthy business? Managerial education and management in healthcare By Bloom, Nicholas; Lemos, Renata; Sadun, Raffaella; Reenen, John Van

  1. By: Alessandro Olper; Daniele Curzi; Johan Swinnen
    Abstract: We study the causal effect of trade liberalization on child mortality by exploiting 41 policy reform experiments in the 1960-2010 period. The Synthetic Control Method for comparative case studies allows to compare at the country level the trajectory of post-reform health outcomes of treated countries (those which experienced trade liberalization) with the trajectory of a combination of similar but untreated countries. In contrast with previous findings, we find that the effect of trade liberalization on health outcomes displays a huge heterogeneity, both in the direction and the magnitude of the estimated effect. Among the 41 investigated cases, 19 displayed a significant reduction in child mortality after trade liberalization. In 19 cases there was no significant effect, while in three cases we found a significant worsening in child mortality after trade liberalization. Trade reforms in democracies, in middle income countries and which reduced taxation in agriculture reduce child mortality more.
    Keywords: Trade liberalization, Child Mortality, Synthetic Control Method.
    JEL: Q18 O24 O57 I15 F13 F14
    Date: 2017
  2. By: Thomas Barnay; Eric Defebvre
    Date: 2018
  3. By: Clark, Andrew E.; Lee, Tom
    Abstract: We here use data from the Wisconsin Longitudinal Study (WLS) to provide one of the first analyses of the distal (early-life) and proximal (later-life) correlates of older-life subjective well-being. Unusually, we have two distinct measures of the latter: happiness and eudaimonia. Even after controlling for proximal covariates, outcomes at age 18 (IQ score, parental income and parental education) remain good predictors of well-being over 50 years later. In terms of the proximal covariates, mental health and social participation are the strongest predictors of both measures of well-being in older age. However, there are notable differences in the other correlates of happiness and eudaimonia. As such, well-being policy will depend to an extent on which measure is preferred
    Keywords: life-course; well-being; eudaimonia; health; happiness
    JEL: I31 I38
    Date: 2017–11–01
  4. By: Baker, P.; Hawkes, C.; Wingrove, K.; Demaio, A.; Parkhurst, Justin; Thow, A.M.; Walls, H.
    Abstract: Introduction: Generating country-level political commitment will be critical to driving forward action throughout the United Nations Decade of Action on Nutrition (2016-2025). In this review of the empirical nutrition policy literature we ask: what factors generate, sustain and constrain political commitment for nutrition, how, and under what circumstances? Our aim is to inform strategic ‘commitment-building’ actions. Method: We adopted a framework synthesis method and realist review protocol. An initial framework was derived from relevant theory and then populated with empirical evidence to test and modify it. Five steps were undertaken: initial theoretical framework development; search for relevant empirical literature; study selection and quality appraisal; data extraction, analysis and synthesis; and framework modification. Results: 75 studies were included. We identified 18 factors that drive commitment, organized into five categories: actors; institutions; political and societal contexts; knowledge, evidence and framing; and capacities and resources. Irrespective of country-context, effective nutrition actor networks, strong leadership, civil society mobilization, supportive political administrations, societal change and focusing events, cohesive and resonant framing, and robust data systems and available evidence, were commitment drivers. Low and middle-income country studies also frequently reported international actors, empowered institutions, vertical coordination, and capacities and resources. In upper-middle and high-income country studies private sector interference frequently undermined commitment. Conclusion: Political commitment is not something that simply exists or emerges accidentally; it can be created and strengthened over time through strategic action. Successfully generating commitment will likely require a ‘core set’ of actions with some context-dependent adaptations. Ultimately, it will necessitate strategic actions by cohesive, resourced and strongly-led nutrition actor networks that are responsive to the multi-factorial, multi-level and dynamic political systems in which they operate and attempt to influence. Accelerating the formation and effectiveness of such networks over the Nutrition Decade should be a core task for all actors involved
    Keywords: nutrition; undernutrition; micronutrient deficiencies; obesity; noncommunicable diseases; politics; policy; priority; commitment
    JEL: N0
    Date: 2018–01–10
  5. By: Cooper, Zack; Scott Morton, Fiona; Shekita, Nathan
    Abstract: Using insurance claims data capturing 8.9 million emergency episodes, we show that in 22% of cases, patients attended in-network hospitals, but were treated by out-of-network physicians. We find that out-of-network billing is concentrated in a small group of primarily for-profit hospitals. Within 50% of hospitals in our sample, fewer than 5% of patients saw out-of-network physicians. In contrast, at 15% of hospitals, more than 80% of patients saw out-of-network physicians. Out-of-network billing allows physicians to substantially increase their payment rates relative to what they would be paid for treating in-network patients and significantly improve their outside option when bargaining over in-network payments. Because patients cannot avoid out-of-network physicians during an emergency, physicians have an incentive to remain out-of-network and receive higher payment rates. Hospitals incur costs when out-of-network billing occurs within their facilities. We illustrate in a model and confirm empirically via analysis of two leading physician-outsourcing firms that physicians offer transfers to hospitals to offset the hospitals’ costs of allowing out-of-network billing to occur within their facilities. We find that a New York State law that introduced binding arbitration between physicians and insurers to settle surprise bills reduced out-of-network billing rates.
    JEL: I11 I18 L14
    Date: 2017–12–01
  6. By: Chichun Fang (University of Michigan)
    Abstract: Expanded health insurance coverage under the Affordable Care Act (ACA) provides alternative channels to obtain health insurance coverage outside employment, which in theory may affect whether people want to work, how much they work, and the sorting of individuals into jobs. Although health insurance exchanges are available in all states, ACA Medicaid expansion is only available in states that chose to expand Medicaid coverage. The state-level variation in timing of Medicaid expansion provides a quasi-experiment setting that can be used to examine how health insurance coverage affected labor supply. In this paper, I study how Medicaid expansion affects the labor supply and re-employment outcomes of displaced (involuntarily unemployed) workers who are near-elderly, low-income, non-married, childless, and non-disabled. Data from 2011-2016 waves of monthly Current Population Survey (CPS) as well as 2010-2016 waves of Displaced Workers Survey (DWS) are used. Results from a discrete-choice model using the CPS suggest that, some displaced workers in expansion states became less likely to exit unemployment to employment while some other became more likely to exit unemployment to not-in-labor-force immediately following Medicaid expansion. While robustness tests suggest this may partly be attributed to state-level idiosyncrasies, my results reject large and persistent effect of Medicaid expansion on unemployment exits. The DWS does not have enough statistical power to identify the difference in reemployment outcomes between displaced workers in expansion and non-expansion states.
    Date: 2017–09
  7. By: Boudreaux, Michel; Lipton, Brandy
    Abstract: Previous work suggests that Medicaid eligibility expansions may lead to declines in labor market activity. This paper explores the related, but novel question of whether variation in Medicaid benefit generosity alters employment outcomes. We consider adult vision benefits as a case study. Our findings suggest that vision benefits have a net positive effect on intensive margin measures including hours worked and occupational skill requirements, but no significant effect on the likelihood of being employed. These results indicate that Medicaid’s effect on labor market activity is sensitive to the set of covered services.
    Keywords: Health insurance, Medicaid, Employment, Vision care
    JEL: H75 I13 I18 J22
    Date: 2018–01–12
  8. By: Martínez, Rodrigo; Palma, Amalia
    Abstract: The Economic Commission for Latin America and the Caribbean (ECLAC) and the World Food Programme (WFP), both agencies of the United Nations System, have agreed to carry out a study to estimate the costs related to adopting more effective actions to fight stunting and micronutrient deficiencies in vulnerable populations. This document proposes a methodology for performing this analysis that can be replicated in various countries in the region.
    Date: 2017–12–31
  9. By: Jamie Mullins (Department of Economics, University of Massachusetts, Amherst); Corey White (Department of Economics, California Polytechnic State University)
    Abstract: This paper characterizes the link between ambient temperatures and a broad set of mental health measures. We find that the realization of low temperatures leads to fewer self-reported days of poor mental health, fewer mental-health related emergency department visits, and fewer suicides. Conversely, exposure to more hot days is associated with more days of self-reported poor mental health, more mental health-related emergency department visits, and higher rates of suicide. We consider the efficacy of a number of potential mitigating factors including access to mental health services and residential penetration of air conditioning, among others. We find that the identified relationship is insensitive to all considered modulating factors and has not moderated over time, suggesting a lack of effective adaptation. We offer evidence for sleep quality as the mechanism by which temperatures impact mental health and discuss the implications of our findings in light of climate change.
    Keywords: Mental Health, Weather, Climate, Suicide, Health
    JEL: I10 I12 I18 Q50 Q51 Q54
    Date: 2018
  10. By: Taiyo Fukai; Hidehiko Ichimura; Kyogo Kanazawa
    Abstract: We first show (1) the importance of investigating health expenditure process using the order two Markov chain model, rather than the standard order one model, which is widely used in the literature. Markov chain of order two is the minimal framework that is capable of distinguishing those who experience a certain health expenditure level for the first time from those who have been experiencing that or other levels for some time. In addition, using the model we show (2) that the probability of encountering a health shock first de- creases until around age 10, and then increases with age, particularly, after age 40, (3) that health shock distributions among different age groups do not differ until their percentiles reach the median range, but that above the median the health shock distributions of older age groups gradually start to first-order dominate those of younger groups, and (4) that the persistency of health shocks also shows a U-shape in relation to age.
    Date: 2018–01
  11. By: Ninja Ritter Klejnstrup; Joel Silas Lincoln
    Abstract: In this study, we assess formal education as a causal determinant of women’s malaria preventive behaviour, as well as children’s risk of malaria infection. For identification, we rely on exogenous variation in educational attainment generated by educational reforms during the 1970s. We use data from a total of four rounds of either Demographic and Health Surveys or Malaria Indicator Surveys, which allows us to explore variation in relationships over time. In the earliest survey rounds (2004–05 and 2007–08), our results indicate that each additional year of schooling increased women’s probability of using malaria prophylaxis during pregnancy by between 3.7 and 14.5 percentage points, and their children’s probability of sleeping under an insecticide-treated bed net (ITN) by between 1.8 and 3.0 percentage points. Results for both women’s use of ITN and children’s malaria status are inconclusive across all survey rounds. We argue that differences in magnitude and strength of evidence of causality between effect estimates for women’s use of malaria prophylaxis and women’s and children’s use of ITN is likely due to differences in the mechanisms linking these outcomes to education, with the latter being mediated by income to a higher degree than the former.
    Date: 2018
  12. By: Mahé, Clotilde (UNU-MERIT, Maastricht University)
    Abstract: Do social policies affect migration? To answer this question, I exploit the random expansion of a publicly provided health care programme in Mexico, as well as the panel dimension and the timing of the Mexican Family Life Survey. Non-contributory health care is found to increase internal migration by freeing up care (time) constraints and strengthening household economic resilience in the face of health- related shocks. However, the alleviation of financial and time constraints is not significant enough to alter international migration, more costly by nature. Results point to the relevance of including both resident and non-resident household members in assessing the effects of social policies on labour market behaviours. They suggest that publicly provided health care complements, rather than substitutes, informal livelihood strategies in that relaxing binding financial and time constraints enables labour force detachment of working-age members in afiliated households.
    Keywords: Health insurance, migration, Mexico, occupational choice
    JEL: I13 I15 I18 I38 J21 O15
    Date: 2017–11–27
  13. By: Joseph Deutsch; Jacques Silber
    Abstract: In developing countries, women’s decisions concerning their children’s health depend on ‘empowerment’ concerning decision-making, husband/partner’s use of violence, woman’s attitude towards this violence, available information, and resources. We derive an empowerment indicator using the ‘fuzzy sets’ and Alkire and Foster approaches to multidimensional poverty measurement. The health of children is a latent variable; their height and weight are observed health indicators. We apply the ‘MIMIC’ approach to the 2009 Mozambique Demographic and Health Survey. Children’s health is better when the woman opposes her partner’s violence, the higher her education and body mass index, among female children, and in urban areas.
    Date: 2017
  14. By: Le, Nga T.Q. (UNU-MERIT, Maastricht University); Groot, Wim (TIER and CAPHRI School for Public Health and Primary Care, Maastricht University,); Tomini, Sonila (UNU-MERIT, Maastricht University); Tomini, Florian (TIER, Maastricht University, and Amsterdam School of Economics, University of Amsterdam,)
    Abstract: The expansion of health insurance in emerging countries raises concerns about unintended negative effects of health insurance on labour supply. This paper examines the labour supply effects of the Health Care Fund for the Poor (HCFP) in Vietnam in terms of the monthly number of work hours and the probability of employment. Employing Difference-in- Differences Matching methods on the Vietnam Household Living Standard Survey 2002-2006, we show that HCFP, which aims to provide poor people and disadvantaged minority groups with free health insurance, has a positive labour supply effect in the short run. However, in the longer run, the net effect becomes negative due to the income effect. This is manifested in both average work hours per month and the probability of employment albeit the effect on the latter is statistically insignificant. Interestingly, the finding of the income effect is mainly driven by the non-poor recipients living in rural areas. This raises the question of targeting strategy of the programme to avoid unintended labour supply distortion.
    Keywords: health insurance, human resources, labour supply, health care funding, welfare, Vietnam
    JEL: I13 J22 O15
    Date: 2017–12–04
  15. By: Jason M. Fletcher
    Abstract: This paper provides new evidence of the impacts of early life exposure to the 1918 pandemic with old-age mortality by analyzing data from the National Longitudinal Mortality Study (n ~ 220,000). The specifications used year and quarter of birth indicators to assess the effects of timing of pandemic exposure and used Cox proportional hazard models for all-cause mortality outcomes. The findings suggest evidence of excess all-cause mortality for cohorts born during 1918 and mixed evidence for cohorts born in 1917 and 1919. Therefore, contrary to some existing research, the results suggest no consistent evidence of the importance of specific windows of exposure by gestation period.
    Date: 2018–01
  16. By: Colin Busby (C.D. Howe Institute); Ramya Muthukaran (C.D. Howe Institute); Aaron Jacobs (C.D. Howe Institute)
    Abstract: Canadian provincial healthcare systems fare poorly compared to peer countries according to new research from the C.D. Howe Institute. In “Reality Bites: How Canada’s Healthcare System Compares to its International Peers,” authors Colin Busby, Ramya Muthukaran and Aaron Jacobs examine how the provinces, the major healthcare deliverers in Canada, fare compared to other nations in healthcare provision.
    Keywords: Health Policy; Provincial Comparisons
    JEL: I10 I18
  17. By: Judite Goncalves; Pedro S. Martins
    Abstract: The growth of novel flexible work formats raises a number of questions about their effects upon health and the potential required changes in public policy. However, answering these questions is hampered by lack of suitable data. This is the first paper that draws on comprehensive longitudinal administrative data to examine the impact of self-employment in terms of health. It also considers an objective measure of health -hospital admissions- that is not subject to recall or other biases that may affect previous studies. Our findings, based on a representative sample of over 100,000 individuals followed monthly from 2005 to 2011 in Portugal, indicate that the likelihood of hospital admission of self-employed individuals is about half that of wage workers. This finding holds even when accounting for a potential self-selection of the healthy into self-employment. Similar results are found for mortality rates.
    Keywords: Self-employment; hospitalization; sick leave; mortality
    JEL: I18 J24
    Date: 2018–01
  18. By: Victoria Perez; Bob Schmitz; Audra T. Wenzlow; Kathy Shepperson; David Baugh; Susan Radke
    Keywords: Medicaid eXtract chart book , Health
    JEL: I
  19. By: James Ng
    Abstract: Economic research on labour migration in the developing world has traditionally focused on the role played by the remittances of overseas migrant labour in the sending country’s economy. Recently, due in no small part to the availability of rich microdata, more attention has been paid to the effects of migration on the lives of family members left behind. This paper examines how the temporary migration of parents for the sole purpose of work affects the health outcomes of children left behind using longitudinal data from the Indonesian Family Life Survey (IFLS). The anthropomorphic measure of child health used, height-for-age, serves as a proxy for stunting. The evidence suggests that whether parental migration is beneficial or deleterious to child health depends on which parent moved. In particular, migration of the mother has an adverse effect on child height-for-age, reducing height-for-age Z-score by 0.5 standard deviations. This effect is not seen for father’s migration.
    Date: 2018
  20. By: Knaus, Michael C.; Lechner, Michael; Reimers, Anne K.
    Abstract: This study analyzes the effects of regular physical education at school on cognitive skills, non-cognitive skills, motor skills, physical activity, and health. It is based on a very informative data set, the German Motorik-Modul, and identifies the effect by using variation in the required numbers of physical education lessons across and within German federal states. The results show improvements in cognitive skills. Boys’ non-cognitive skills are adversely affected driven by increased peer relation problems. For girls, the results suggest improvements in motor skills and increased extra-curricular physical activities. Generally, we find no statistically significant effects on health parameters.
    Keywords: Physical education, cognitive skills, non-cognitive skills, motor skills, physical activity, health
    JEL: I12
    Date: 2018–01
  21. By: Mohajan, Haradhan
    Abstract: Recently knowledge management (KM) has become very important part of the everyday work in healthcare practices. The KM transforms a health organization into a learning organization able to generate new knowledge, create knowledge systems and base organizational actions on knowledge in healthcare. It makes the close and long-term relationship among healthcare providers and patients to create a greater mutual understanding, trust, and patient involvement in decision making. The paper discusses telemedicine, information technology, efficient nursing system, medical errors and reduction of these errors, healthcare cooperation among different healthcare providers in healthcare systems. It briefly discusses healthcare strategy in four developed and developing countries. This paper investigates the creation, sharing, storing and utilization of knowledge in medical science. The aim of this study is to apply the concept of KM and to investigate the use of KM to the health sector. An attempt has been taken here to discuss overview of KM, its methods and techniques, and applications of efficient KM in health sector.
    Keywords: Knowledge, Knowledge Management, Healthcare, Health Information, Health Organizations, Healthcare Cost, Nursing, Medical Errors
    JEL: I1 I15 M12
    Date: 2016–07–16
  22. By: Strulik, Holger; Trimborn, Timo
    Abstract: It has been argued that hyperbolic discounting of future gains and losses leads to time-inconsistent behavior and thereby, in the context of health economics, not enough investment in health and too much indulgence of unhealthy consumption. Here, we challenge this view. We set up a life-cycle model of human aging and longevity in which individuals discount the future hyperbolically and make time-consistent decisions. This allows us to disentangle the role of discounting from the time consistency issue. We show that hyperbolically discounting individuals, under a reasonable normalization, invest more in their health than they would if they had a constant rate of time preference. Using a calibrated life-cycle model of human aging, we predict that the average U.S. American lives about 4 years longer with hyperbolic discounting than he would if he had applied a constant discount rate. The reason is that, under hyperbolic discounting, experiences in old age receive a relatively high weight in life time utility. In an extension we show that the introduction of health-dependent survival probability motivates an increasing discount rate for the elderly and, in the aggregate, a u-shaped pattern of the discount rate with respect to age.
    Keywords: discount rates,present bias,health behavior,aging,longevity
    JEL: D03 D11 D91 I10 I12
    Date: 2018
  23. By: Barkowski, Scott; McLaughlin, Joanne Song
    Abstract: We study the effects of state and federal dependent health insurance mandates on marriage rates of young adults, ages 19 to 25. Motivated by low rates of coverage among this age group, state governments began mandating health insurers in the 1970s to allow adult children to stay on their parents’ insurance plans. These state level efforts successfully increased insurance coverage rates, but also came with unintended implications for the marriage decisions of young adults. Almost all state mandates explicitly prohibited marriage as a condition of eligibility, thereby directly discouraging marriage. Additionally, by making access to health insurance through parents easier, the mandates made access through spouses’ employers relatively less attractive. To the extent that young adults were altering their marriage plans to gain access through potential spouses, they no longer needed to do so under the mandates, thereby implicitly discouraging marriage. When the dependent coverage mandate of the Affordable Care Act (ACA) was enacted, it effectively ended the state-based marriage restrictions, thereby encouraging marriage among young adults previously eligible for state mandates. On the other hand, for those who were not eligible for state mandates, the ACA represented an attractive new path to obtain coverage, thereby discouraging marriage for these young adults, just as the state mandates had implicitly done previously for others. Thus, the separate efforts at the state and federal level to address low coverage rates for young adults ended up interacting and influencing incentives for marriage in opposite directions. We study these interaction effects on marriage empirically using a new dataset we compiled on state-level dependent coverage mandates. Consistent with theoretical arguments, we find that, before the implementation of the ACA, state mandates lowered marriage rates by about 2 percentage points, but this pattern reversed upon the passage of the ACA. We also find that state mandates increased the probability of out-of-wedlock births among state-mandate-eligible women as compared to ineligible ones, but the ACA reversed this trend as well. Our study provides an important example where fundamental understanding of the effects of the ACA dependent coverage mandate can only be had with full consideration of the pre-existing state laws.
    Keywords: Marriage, Dependent Health Insurance Mandates, ACA, Health Insurance
    JEL: I13 I18 J11 J12 J13
    Date: 2018–01–20
  24. By: Richard Blundell (University College London); Jack Britton (Institute for Fiscal Studies); Monica Costa Dias (Institute for Fiscal Studies); Eric French (University College London)
    Abstract: Estimates of effect of health on employment differ from study to study due to differences in methods, data, institutional background and health measure. We assess the importance of these differences, using a unified framework to interpret and contrast estimate for the US and England. We find that subjective and objective health measures, and subjective measures instrumented by objective measures produce similar estimates but only if a sufficiently large number of objective measures is used. Otherwise, objective measures produce downward biased estimates. Failure to account for initial conditions produces upward biased estimates. We find that a single subjective health index yields similar estimates to multiple measures. Overall, declines in health explain up to 15% of the decline in employment between ages 50 and 70. The effects drop with education and are larger in the US than in England. Cognition has little added explanatory power once we control for health.
    Date: 2017–09
  25. By: Bloom, Nicholas; Lemos, Renata; Sadun, Raffaella; Reenen, John Van
    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: I1 M1
    Date: 2017–09–01

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