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on Health Economics |
| By: | Arthur E. Attema (Erasmus School of Health Policy and Management |Rotterdam]); Matteo M Galizzi (LSE - London School of Economics and Political Science); Mona Groß (Universität zu Köln = University of Cologne); Heike Hennig-Schmidt (University of Bonn); Yassin Karay; Olivier L’haridon (CREM - Centre de recherche en économie et management - UNICAEN - Université de Caen Normandie - NU - Normandie Université - UR1 - Université de Rennes 1 - UNIV-RENNES - Université de Rennes - CNRS - Centre National de la Recherche Scientifique, IUF - Institut Universitaire de France - M.E.N.E.S.R. - Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche); Daniel Wiesen (Universität zu Köln = University of Cologne) |
| Abstract: | We study how patient-regarding altruism is formed by medical education. We elicit and structurally estimate altruistic preferences using experimental data from a large sample of medical students (N = 733) in Germany at different progress stages in their studies. The estimates reveal substantial heterogeneity in altruistic preferences of medical students. Patient-regarding altruism is highest for freshmen, significantly declines for students in the course of medical studies, and tends to increase again for last year students, who assist in clinical practice. Also, patient-regarding altruism is higher for females and positively associated to general altruism. Altruistic medical students have gained prior practical experience in healthcare, have lower income expectations, and are more likely to choose surgery and pediatrics as their preferred specialty. |
| Keywords: | Laboratory experiment, Medical education, Online experiment, Patient-regarding altruism, Specialty choice, Structural estimation |
| Date: | 2023–01 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-03980541&r=hea |
| By: | Elias Carroni; Giuseppe Pignataro; Luigi Siciliani |
| Abstract: | We revisit the physician-patient agency problem in a model where patients differ in their preferences for treatment and the physician decides whether to recommend a treatment based on the results of a diagnostic test. We show that, in equilibrium, some patients who could benefit from treatment remain untreated, while others receive unnecessary treatment. We explore several policy interventions. A policy that does not authorize tests with high false positives increases health and welfare. Instead, mandatory testing increases health but the effect on welfare is ambiguous. Last, financial incentives increase health by reducing the number of untreated patients but reduce welfare. |
| Keywords: | Medical tests; Medical Recommendation; Bayesian Persuasion; Health Policy. |
| JEL: | D82 D83 I10 I18 |
| Date: | 2023–02 |
| URL: | http://d.repec.org/n?u=RePEc:yor:yorken:23/01&r=hea |
| By: | Pinka Chatterji; Chun-Yu Ho; Xue Wu |
| Abstract: | This paper examines whether loss of locally available hospital-based obstetric services affects racial/ethnic disparities in intrapartum care access and birth outcomes in rural areas of the US. To conduct causal inference, we combine difference-in-difference and propensity score matching methods to control for observable and time-invariant unobservable heterogeneity across counties. Using data from Vital Statistics birth certificate records from 2005-2018 from rural counties in the mainland US, our empirical analysis reaches several findings. Women in counties that lost obstetric services are more likely to receive intrapartum care outside their counties of residence and to deliver in an urban county compared to women in matched counties. Nonetheless, there are no consistent effects of obstetric unit closure on maternal and infant health in the full sample. Among Black mothers, however, obstetric unit closure is not associated with delivering in an urban county, and there is a more consistent pattern of negative effects of closure on infant health. Importantly, the adoption of scope-of-practice laws for certified nurse midwives, the adoption of telehealth payment parity laws and the ACA Medicaid expansions have implications for narrowing racial/ethnic disparities in health in response to obstetric unit closures. |
| JEL: | I0 I1 I11 I14 |
| Date: | 2023–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:30986&r=hea |
| By: | Garcia-Gomez, Pilar (Erasmus University Rotterdam); Koning, Pierre (Vrije Universiteit Amsterdam); O'Donnell, Owen (Erasmus University Rotterdam); Herl, Carlos Riumallo (Erasmus University Rotterdam) |
| Abstract: | Variation in assessor stringency in awarding benefits leaves applicants exposed to uninsured risk that could be systematic if discretion were exercised selectively. We test for this using administrative data on applications to the Dutch disability insurance program. We find that discretion is more often exercised in favor of lower-waged applicants. Pre-disability wages drop discontinuously just above disability thresholds for entitlement to partial benefits. Assessors are more likely to discard the highest-paying algorithm-generated job matches that determine earnings capacity and entitlement when evaluating lower-waged applicants. While these applicants benefit on average, they are exposed to greater risk from between assessor variation. |
| Keywords: | disability insurance, screening |
| JEL: | D73 H42 H55 |
| Date: | 2023–02 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15928&r=hea |
| By: | Blanchflower, David G. (Dartmouth College); Bryson, Alex (University College London) |
| Abstract: | Although yet to be clearly identified as a clinical condition, there is immense concern at the health and wellbeing consequences of long COVID. Using data collected from nearly half a million Americans in the period June 2022-December 2022 in the US Census Bureau's Household Pulse Survey (HPS), we find 14 percent reported suffering long COVID at some point, half of whom reported it at the time of the survey. Its incidence varies markedly across the United States – from 11 percent in Hawaii to 18 percent in West Virginia – and is higher for women than men, among Whites compared with Blacks and Asians, and declines with rising education and income. It peaks in midlife in the same way as negative affect. Ever having had long COVID is strongly associated with negative affect (anxiety, depression, worry and a lack of interest in things). The effect is larger among those who currently report long COVID, especially if they report severe symptoms. In contrast, those who report having had short COVID report higher wellbeing than those who report never having had COVID. Long COVID is also strongly associated with physical mobility problems, and with problems dressing and bathing. It is also associated with mental problems as indicated by recall and understanding difficulties. Again, the associations are strongest among those who currently report long COVID, while those who said they had had short COVID have fewer physical and mental problems than those who report never having had COVID. Vaccination is associated with lower negative affect, including among those who reported having had long COVID. |
| Keywords: | Long COVID, negative affect, anxiety, depression, mobility problems, mental health, vaccine, COVID-19 |
| JEL: | I1 I31 |
| Date: | 2023–02 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15967&r=hea |
| By: | Seth Freedman; Kelli Marquardt; Dario Salcedo; Kosali Simon; Coady Wing |
| Abstract: | We study how the societal disruptions of the Covid-19 pandemic impacted diagnosis of a prevalent childhood mental health condition, Attention Deficit Hyperactivity Disorder (ADHD). Using both nationwide private health insurance claims and a state’s comprehensive electronic health records, we compare children exposed to the pandemic to same aged children prior to the pandemic. We find the pandemic reduced new ADHD diagnoses by 8.6% among boys and 11.0% among girls nationwide through February 2021. We further show that higher levels of in-person schooling in fall 2020 dampened the decline for girls but had no moderating effect for boys. |
| Keywords: | child mental health; adhd; education; pandemic |
| JEL: | I10 I18 I20 |
| Date: | 2023–01 |
| URL: | http://d.repec.org/n?u=RePEc:fip:fedhwp:95630&r=hea |
| By: | Claudia Senik (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, SU - Sorbonne Université); Guglielmo Zappalà (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Carine Milcent (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Chloé Gerves-Pinquié (IRSRPL - Institut Recherche en Santé Respiratoire des Pays de la Loire); Patricia Dargent-Molina (INSERM - Institut National de la Santé et de la Recherche Médicale) |
| Abstract: | Happier Elderly Residents The positive impact of physical activity on objective and subjective health condition of elderly people in nursing homes. Evidence from a multi-site randomized controlled trial. We explore the effects of adapted physical exercise programs in nursing homes, in which some residents suffer from dementia and/or physical limitations and other do not. We use data from 452 participants followed over 12 months in 32 retirement homes in four European countries. Using a difference-in-difference with individual random effects model, we show that the program has exerted a significant impact on the number of falls and the self-declared health and health-related quality of life of residents (EQ-5D). The wide scope of this study, in terms of sites, countries, and measured outcomes, brings generality to previously existing evidence. A simple computation, in the case of France, suggests that such programs are highly cost-efficient. |
| Keywords: | Physical activity, Retirement homes, Impact study, Falls, Subjective health |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-03966677&r=hea |
| By: | Beatrice Baaba Tawiah (Paderborn University) |
| Abstract: | This paper analyses the causal effect of having children on parents' health. I consider men and women from ages 50 to 90 with at least two children in the German Socio-Economic Panel data. Twin birth at second birth and same sex of first two children are used as instruments to exogenously determine the number of children. I find negative effects on the BMI of women, and negative effects on the mental and physical health of men. Looking at the effects over the life-cycle, I find that the BMI of women increases until age 64. Mental health starts to decline from age 75. The effect on physical health fluctuates over the life-cycle. The results show that children negatively affect parental health and the effects are not constant over the life-cycle. |
| Keywords: | Childbirth; Health; Instrumental variables |
| JEL: | I10 J13 C21 C36 |
| Date: | 2023–03 |
| URL: | http://d.repec.org/n?u=RePEc:pdn:dispap:103&r=hea |
| By: | Victor A. Luque de Haro (University of Almeria, Almeria, Spain) |
| Abstract: | This paper presents a state of the art on the theories about the evolution of social differences in adult mortality throughout development and offers an interpretation of the available evidence. The importance of the different determinants of social inequalities in mortality has been changing during the last centuries due to the advances in medical and health knowledge. Therefore, the diverse rates of growth experienced by the different economies, the disparities in education, the role of the state in the provision of certain services, as well as the way in which production has been distributed, have conditioned the evolution of social differences in mortality in each of the processes of developing. These elements help to explain the heterogeneity of results at the international level and provide some explanatory keys about the European north-south pattern that is observed when comparing the available evidence. |
| Keywords: | health inequality, death determinants, standard of living, adult mortality, 19th century, Europe |
| JEL: | N33 I14 I18 J18 |
| Date: | 2023–02 |
| URL: | http://d.repec.org/n?u=RePEc:ahe:dtaehe:2302&r=hea |
| By: | Kumar, Santosh (University of Notre Dame); Nahlen, Bernard (University of Notre Dame) |
| Abstract: | Using nationally representative data, we estimate intergenerational persistence in health in India. Results from the instrumental variable method show that children of anemic mothers are more likely to be anemic, with an intergenerational health correlation of 0.26. Results are robust to the inclusion of confounding factors including the mother's height. We find that the correlation between mothers' anemic status and children's anemic status differs by wealth quintile, indicating that economic status may play a role in the persistence of poor health across generations in developing countries. |
| Keywords: | intergenerational mobility, health, anemia, India |
| JEL: | I10 I14 O15 |
| Date: | 2023–02 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15938&r=hea |
| By: | Carine Milcent (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement) |
| Abstract: | Electronic health records (EHRs) are intended to reduce healthcare costs and improve the quality of care. Nevertheless, usability issues common to EHRs have been identified. In this paper, we investigate these usability issues for social vulnerability codes. Using the acute care EHR and the rehabilitation care EHR databases, hospital stays of 800'000 patients are studied. This article highlights the differences in coding processes between public and private institutions observed when there are different incentives to code. Furthermore, it shows that the differences in coding are not random but depend on the coding strategy. This article emphasises that the reuse of data leads to biases in interpretation. Using the example of social vulnerability alerts policymakers to the need to consider these differences in coding processes when decisions are based on EHR information. Otherwise, this process of coding differences in social vulnerability may exacerbate social inequalities rather than reduce them. |
| Keywords: | Database, Hospitals, quality, efficiency, ownership, social vulnerability, inequity |
| Date: | 2023–01–27 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:hal-03960584&r=hea |
| By: | Pablo Garcia Sanchez (Banque centrale du Luxembourg, Département Economie et Recherche); Luca Marchiori (Banque centrale du Luxembourg, Département Economie et Recherche); Olivier Pierrard (Banque centrale du Luxembourg, Département Economie et Recherche) |
| Abstract: | Long-term care (LTC) expenditures of the elderly are high in developed countries and will grow further with population aging. In addition, LTC costs are heterogeneous across individuals and unknown early in life. In this paper, we add uncertainty over the arrival and magnitude of future LTC costs into a life-cycle model with endogenous aging, and we analyze how this affects the optimal behavior of agents. We show that uncertainty boosts precautionary savings, lowers investment in preventive care, and weakens the effectiveness of subsidies to encourage prevention. Our results therefore suggest that uncertainty should not be ignored in models that study positive or normative aspects of health investment. |
| Keywords: | health; long-term care costs; uncertainty; stochastic model |
| JEL: | C60 D15 D81 I12 I18 |
| Date: | 2023–01 |
| URL: | http://d.repec.org/n?u=RePEc:ctl:louvir:2023006&r=hea |
| By: | Nicolas Roche (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, Service de pneumologie [CHU Cochin] - Hôpital Cochin [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP), IC UM3 (UMR 8104 / U1016) - Institut Cochin - INSERM - Institut National de la Santé et de la Recherche Médicale - CNRS - Centre National de la Recherche Scientifique - UPCité - Université Paris Cité); Rachel Nadif (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay); Caroline Fabry-Vendrand; Laura Pillot; Gabriel Thabut; Clément Teissier; Stéphane Bouée; Marcel Goldberg (CONSTANCES - Cohortes épidémiologiques en population - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay - UPCité - Université Paris Cité); Marie Zins (CONSTANCES - Cohortes épidémiologiques en population - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay - UPCité - Université Paris Cité) |
| Abstract: | Background: Data on health care consumption and costs of asthma in the French population are scarce. Objectives: The study objective was to describe the burden of asthma according to GINA treatment steps in the CONSTANCES cohort. Methods: Data from 162, 725 participants included between 2012 and 2019 were extracted. Participants were considered as current asthmatics if asthma was reported at inclusion and asthma symptoms and/or treatments were reported in 2019. Participants were classified in three categories according to GINA treatment steps. The results were compared to non-asthmatic participants matched with a propensity score calculated on age, sex, region of residence, precariousness score and year of inclusion. Results: Among 162, 725 participants aged 18–69 years, 6783 asthmatics (1566 not treated for asthma, 2444 + 251 GINA steps 1 + 2, 1054 + 1315 GINA steps 3 + 4, and 153 GINA step 5) were matched with 6783 controls. Average annual ambulatory cost and average annual hospitalization cost were respectively €1925 and €719 for asthmatics versus €1376 and €511 for participants without asthma (p |
| Keywords: | Asthma, Burden of disease, CONSTANCES, Economic evaluation, France, GINA, SNDS, Treatment steps |
| Date: | 2023 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-03949592&r=hea |
| By: | Büttner, Nicolas (ETH Zurich); Grimm, Michael (University of Passau); Günther, Isabel (ETH Zurich); Harttgen, Kenneth (ETH Zurich); Klasen, Stephan (University of Göttingen) |
| Abstract: | Despite the recent economic growth in many countries on the African continent, the region has seen a slow fertility transition. In this study, we explore whether the lack of structural economic change can explain this slow fertility transition. We create a unique panel data set combining Demographic and Health Surveys, Household Income Surveys, and nighttime light intensity data, as an indicator for industrialization, from 57 countries at the sub-national regional level over three decades to analyze the driving forces of fertility transitions across low- and middle-income countries. Our results confirm that household wealth, reduced child mortality, and female basic education are crucial for fertility reductions. Yet, our analysis also highlights the important role of increased female labor force participation in the formal sector, industrialization, increased female secondary education, and the expansion of health insurance coverage. Urbanization appears to have a limited, if any, effect. Our simulations indicate that if high-fertility countries in sub-Saharan Africa had experienced similar structural economic change as low- and middle-income countries with low fertility, their fertility levels could be up to 50% lower. |
| Keywords: | demographic transition, fertility, structural change, human capital, sub-Saharan Africa |
| JEL: | D13 J11 J13 J22 O12 |
| Date: | 2023–02 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15966&r=hea |
| By: | Letizia Gremillet (AMU SMPM MED - Aix-Marseille Université - École de médecine - AMU SMPM - Aix-Marseille Université - Faculté des sciences médicales et paramédicales - AMU - Aix Marseille Université, LA CONCEPTION - Hôpital de la Conception [CHU - APHM]); Antoine Netter (AMU SMPM MED - Aix-Marseille Université - École de médecine - AMU SMPM - Aix-Marseille Université - Faculté des sciences médicales et paramédicales - AMU - Aix Marseille Université, IMBE - Institut méditerranéen de biodiversité et d'écologie marine et continentale - AU - Avignon Université - AMU - Aix Marseille Université - Institut de recherche pour le développement [IRD] : UMR237 - CNRS - Centre National de la Recherche Scientifique); Irène Sari-Minodier (IMBE - Institut méditerranéen de biodiversité et d'écologie marine et continentale - AU - Avignon Université - AMU - Aix Marseille Université - Institut de recherche pour le développement [IRD] : UMR237 - CNRS - Centre National de la Recherche Scientifique, TIMONE - Hôpital de la Timone [CHU - APHM]); Laura Miquel (AMU SMPM MED - Aix-Marseille Université - École de médecine - AMU SMPM - Aix-Marseille Université - Faculté des sciences médicales et paramédicales - AMU - Aix Marseille Université, LA CONCEPTION - Hôpital de la Conception [CHU - APHM]); Arnaud Lacan (KEDGE Business School [Marseille], AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique); Blandine Courbiere (AMU SMPM MED - Aix-Marseille Université - École de médecine - AMU SMPM - Aix-Marseille Université - Faculté des sciences médicales et paramédicales - AMU - Aix Marseille Université, IMBE - Institut méditerranéen de biodiversité et d'écologie marine et continentale - AU - Avignon Université - AMU - Aix Marseille Université - Institut de recherche pour le développement [IRD] : UMR237 - CNRS - Centre National de la Recherche Scientifique, LA CONCEPTION - Hôpital de la Conception [CHU - APHM]) |
| Abstract: | The objective of this study was to explore and describe the specificities of the occupational life of infertile endometriotic women treated by in vitro fertilization. We conducted a qualitative monocentric study between December 2020 and June 2021. Twelve semi-structured in-depth interviews using a theme-based interview guide with open questions were undertaken with infertile women with deep infiltrating endometriosis. Data analysis was conducted using an inductive approach according to the grounded theory method. Three main themes emerged from the interviews: (i) barriers to reconciling illness and work life, (ii) facilitating factors for well-being at work, and (iii) consequences and outlooks. It appeared that the time of infertility treatment represents a particular period of change in the working lives of women with endometriosis. For most women, these changes are experienced negatively, often with a renunciation of goals. For others, this is the time to communicate the difficulties linked to their illness to their professional entourage. There is a long path ahead to finally achieving recognition of endometriosis in the context of professional life. |
| Keywords: | Endometriosis, Qualitative study, In vitro fertilization |
| Date: | 2023 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-03991237&r=hea |
| By: | Beatrice Baaba Tawiah (Paderborn University); Valentin Schiele (University of Paderborn) |
| Abstract: | This paper replicates the analysis of Schneeweis et al. (2014) using their sample as well as an extended sample. Schneeweis et al. (2014) use the Survey of Health, Ageing and Retirement in Europe (SHARE) dataset and exploit compulsory schooling reforms implemented in six European countries to analyse the impact of education on cognitive functioning decades after leaving school. They find a positive effect of education on memory scores and some evidence of a protective effect of education on the decline in verbal fluency. Our results support their findings when we use the same waves as they do, but also when we extend the sample by including more countries and interview waves and use different variables for years of education. |
| Keywords: | Replication; Education; Cognitive abilities;Compulsory schooling |
| JEL: | I21 D91 J14 |
| Date: | 2023–03 |
| URL: | http://d.repec.org/n?u=RePEc:pdn:dispap:102&r=hea |
| By: | Casoria, Fortuna (GATE, University of Lyon); Galeotti, Fabio (CNRS, GATE); Villeval, Marie Claire (CNRS, GATE) |
| Abstract: | We combined a natural experiment (the occurrence of the COVID-19 pandemic in 2020) with the tools of laboratory experiments to study whether and how an unprecedented shock on social interactions (the introduction and abrogation of a nationwide lockdown) affected the evolution of individuals' social preferences, and willingness to trust others. In a longitudinal online incentivized experiment during the first lockdown in France, we elicited the same participants' preferences for prosociality, trust and trustworthiness every week for three months. Despite the exposure to long-lasting social distancing, prosocial preferences and the willingness to reciprocate the trust of others remained stable during the whole period under study. In contrast, the lockdown had an immediate negative effect on trust, which remained at lower levels til after the lifting of such measures but recovered its initial level nine months later. The decline in trust was mainly driven by individuals who experienced financial hardship, a lack of outward exposure, and higher anxiety during the lockdown. |
| Keywords: | social preferences, trust, trustworthiness, pandemic, COVID-19, social distancing |
| JEL: | C92 K1 I18 |
| Date: | 2023–02 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15929&r=hea |
| By: | Carine Milcent (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Saad Zbiri (UVSQ - Université de Versailles Saint-Quentin-en-Yvelines) |
| Abstract: | BACKGROUND: Prior to the COVID-19 pandemic, teleconsultation were seldom used in France. The sanitary crisis has brought with it a great need for the use of teleconsultation and other interventions using digital technology. OBJECTIVE: Indentify how has French teleconsultation for obstetrics and gynecology care services been used prior and during this sanitary crisis. METHODS: We first described the global picture of the teleconsultation context prior to the sanitary crisis and then during the first quarantine and lockdown measures. We set up three aspects, namely: 1-use of teleconsultation as regards to providers' ability; 2- use of teleconsultation as regards to technology features; 3- use of teleconsultation for which type of healthcare. Second, we studied the determinant factors of teleconsultation use and those of provider's satisfaction with teleconsultation practice. RESULTS: We show the central role of training, the importance of some main digital technology benefits including improving public health, responding to patient's request and facilitating healthcare access, as well as the importance of some main digital technology drawbacks including lack of convenience and lack of veracity (truthfulness). CONCLUSIONS: Our results guide the regulator on the suppliers' motivation and needs for teleconsultation adoption. They highlight the conditions for an efficient use of teleconsultation. |
| Keywords: | Teleconsultation, Obstetrics and gynecology, Training, Technology features |
| Date: | 2021–03 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-03966661&r=hea |
| By: | Carozzi, Felipe; Roth, Sefi |
| Abstract: | We study the effect of urban density on the exposure of city dwellers to air pollution using data from the United States urban system. Exploiting geological features to instrument for density, we find an economically and statistically significant pollution-density elasticity of 0.14. We assess the health implications of these estimates and find that increased density in an average city leads to sizeable mortality costs. Our findings highlight the possible trade-off between reducing global greenhouse gas emissions, which is associated with denser cities according to prior empirical research, and preserving local air quality and human health within cities. |
| Keywords: | air pollutiuon; cities; density; health; UK Cities’ seed fund |
| JEL: | Q53 R11 |
| Date: | 2023–03–01 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:117385&r=hea |