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on Health Economics |
| By: | Kayleigh Barnes; Sherry A. Glied; Benjamin R. Handel; Grace Kim |
| Abstract: | Medical provider price transparency is often touted as a way to lower health care spending. But the impact of price transparency is theoretically ambiguous: it could lower health care spending via increased consumer price shopping or improved insurer bargaining but could also raise health care prices via improved provider bargaining or provider collusion. We conduct a randomized-controlled trial to examine the impact of a state-wide medical charge transparency tool in outpatient provider markets in New York State. In the experiment, individual providers’ billed charges (list prices) were released randomly at the level of the procedure and three-digit zipcode. We use a comprehensive commercial claims database to assess the impact of this intervention and find that it leads to a small increase in overall billed charges (+0.75%). This effect is concentrated among low-priced providers in markets with low out-of-network spending, suggesting that the transparency tool improves provider pricing information. We find no evidence of quantity effects. Results do not vary consistently across specialty groups, market concentration, frequency of service use, or frequency of website use. These results are consistent with price transparency having a minimal effect on consumer shopping while slightly improving provider information about competitors’ charges. |
| JEL: | I11 L1 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32580&r= |
| By: | Zarek Brot-Goldberg; Zack Cooper; Stuart V. Craig; Lev R. Klarnet; Ithai Lurie; Corbin L. Miller |
| Abstract: | We analyze the economic consequences of rising health care prices in the US. Using exposure to price increases caused by horizontal hospital mergers as an instrument, we show that rising prices raise the cost of labor by increasing employer-sponsored health insurance premiums. A 1% increase in health care prices lowers both payroll and employment at firms outside the health sector by approximately 0.4%. At the county level, a 1% increase in health care prices reduces per capita labor income by 0.27%, increases flows into unemployment by approximately 0.1 percentage points (1%), lowers federal income tax receipts by 0.4%, and increases unemployment insurance payments by 2.5%. The increases in unemployment we observe are concentrated among workers earning between $20, 000 and $100, 000 annually. Finally, we estimate that a 1% increase in health care prices leads to a 1 per 100, 000 population (2.7%) increase in deaths from suicides and overdoses. This implies that approximately 1 in 140 of the individuals who become fully separated from the labor market after health care prices increase die from a suicide or drug overdose. |
| JEL: | I11 J30 L4 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32613&r= |
| By: | Kaveh Danesh; Jonathan T. Kolstad; Johannes Spinnewijn; William D. Parker |
| Abstract: | The rich live longer than the poor, but relatively little is known about the evolution of health inequality across the lifecycle. Using rich administrative data from the Netherlands, we develop an index of chronic disease burden based on the projected contribution to old-age mortality. Chronic conditions account for one-third of the mortality gap in old age. Using our index we demonstrate that health inequality arises much earlier in life; by age 35, the bottom half of the income distribution has the same disease burden as those age 50 in the top half. Approximately 60% of the divergence across income groups is due to low-income individuals developing chronic illness at a faster rate, rather than chronically ill individuals sorting into lower-income groups. Using linked health survey data, we then examine the contributions of various mediators to the incidence of chronic diseases over the life cycle. Socioeconomic and geographic factors explain most of the variation, while individual health behaviors play a moderate role. Our findings align with calls to target health policies toward early-life social determinants of health. |
| JEL: | I1 I12 I14 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32577&r= |
| By: | Monsees, Daniel; Westphal, Matthias |
| Abstract: | We study the effects of general practitioners' (GPs') resignations on their patients' healthcare utilization, diagnoses, and mortality in an event-study setting. Using claims data from a large German statutory health insurance, we find that after physicians leave, their former patients persistently reduce their primary care utilization, only partially substituting it with specialist visits and hospital care. Because patients find a new GP already 1.1 quarters after the old resigns, on average, the persistent effects must be explained through the new GP. Indeed, we find that the new GP serves more patients but performs less diagnostic testing. While we do not find evidence for mortality, our results reveal a substantial decrease in diagnoses of chronic conditions (such as congestive heart failure and diabetes), suggesting that disruptions may have adverse consequences for the efficiency of the healthcare system. This indicates that continuity in primary care is pivotal and shows that the GP has an important role in healthcare delivery. |
| Abstract: | Wir untersuchen die Auswirkungen des Ausscheidens von Hausärzten aus der Patientenversorgung auf die Inanspruchnahme des Gesundheitswesens, Neudiagnosen und die Sterblichkeit ihrer Patienten im Rahmen einer Event-Study. Anhand von Abrechnungsdaten einer großen deutschen gesetzlichen Krankenkasse stellen wir fest, dass nach dem Ausscheiden von Ärzten die Inanspruchnahme der hausärztlichen Versorgung ihrer ehemaligen Patienten dauerhaft reduziert ist und nur teilweise durch Facharztbesuche und Krankenhausbehandlung ersetzt wird. Da die Patienten im Durchschnitt bereits 1, 1 Quartale nach dem Ausscheiden des alten Arztes einen neuen Hausarzt finden, müssen diese anhaltenden Effekte durch den neuen Hausarzt bedingt sein. In der Tat stellen wir fest, dass der neue Hausarzt mehr Patienten betreut, aber weniger diagnostische Tests durchführt. Während wir keine Belege für die Sterblichkeit finden, zeigen unsere Ergebnisse einen erheblichen Rückgang der Diagnosen chronischer Erkrankungen (wie Herzinsuffizienz und Diabetes), was darauf hindeutet, dass Unterbrechungen negative Auswirkungen auf die Effizienz des Gesundheitssystems haben können. Dies zeigt, dass die Kontinuität in der Primärversorgung von zentraler Bedeutung ist und dass der Hausarzt eine wichtige Rolle in der Gesundheitsversorgung spielt. |
| Keywords: | Healthcare utilization, healthcare expenditure, general practitioners, primary care |
| JEL: | I11 I12 I18 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:rwirep:298849&r= |
| By: | Malavasi, Chiara (ZEW Mannheim); Ye, Han (University of Mannheim) |
| Abstract: | We estimate the effect of additional pension income on mortality outcomes by exploring the eli- gibility criteria of a German program subsidizing the pensions of low-wage workers. Using novel administrative data, we find that eligibility leads to a 2-month delay in age at death (censored at 75). Survey evidence suggests that additional pension income improves both mental and physical health. In addition, individuals feel less financially constrained and are more optimistic about their future. Heterogeneity analysis indicates that the results are mainly driven by men. |
| Keywords: | mortality, health, income, pension subsidy, retirement |
| JEL: | I10 I12 J14 J26 |
| Date: | 2024–05 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17024&r= |
| By: | Arntz, Melanie; Findeisen, Sebastian; Maurer, Stephan; Schlenker, Oliver |
| Abstract: | This study quantifies the relationship between workplace digitalization, i.e., the increasing use of frontier technologies, and workers' health outcomes using novel and representative German linked employer-employee data. Based on changes in individual-level use of technologies between 2011 and 2019, we find that digitalization induces similar shifts into more complex and service-oriented tasks across all workers, but exacerbates health inequality between cognitive and manual workers. Unlike more mature, computer-based technologies, frontier technologies of the recent technology wave substantially lower manual workers' subjective health and increase sick leave, while leaving cognitive workers unaffected. We provide evidence that the effects are mitigated in firms that provide training and assistance in the adjustment process for workers. |
| Keywords: | health, inequality, technology, machines, automation, tasks, capital-labor substitution |
| JEL: | I14 J21 J23 J24 O33 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:zewdip:300006&r= |
| By: | Susan J. Méndez (Melbourne Institute: Applied Economic & Social Research, The University of Melbourne); Daniel Avdic (Deakin University); Johannes S. Kunz (Centre for Health Economics, Monash University); Maria Wiśniewska (Centre for Health Economics, Monash University) |
| Abstract: | We study how the diffusion of telemedicine technology impacted the quality and rates of antibiotic prescriptions using Australian survey data from primary care physicians linked to administrative records on their service provision. We classify physicians based on their relative use of telemedicine consultations in response to the introduction of government-subsidised telemedicine during the COVID-19 pandemic and relate their rates of antibiotic prescriptions to indicators of prescribing quality before and after lockdown periods in a difference-indifferences design. Our results suggest that more frequent users of telemedicine prescribe relatively fewer antibiotics while keeping prescribing quality largely unchanged. We interpret these findings as evidence that telemedicine can enhance efficiency of service provision in primary care settings. |
| Keywords: | telemedicine, practice style, quality of care, antibiotics, difference-indifferences, technology diffusion |
| JEL: | H44 H51 I11 I18 O33 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:iae:iaewps:wp2024n09&r= |
| By: | Francis W. Graham (Monash University, Centre for Health Economics); Sonja de New (Monash University, Centre for Health Economics); Suzanne Nielsen (Monash University, Monash Addiction Research Centre); Dennis Petrie (Monash University, Centre for Health Economics) |
| Abstract: | The proliferation of the high-dose prescription opioid product OxyContin has been identified as a major contributing factor to rising rates of opioid-involved harm throughout the early stages of the US opioid epidemic. Furthermore, after OxyContin was reformulated with abuse-deterrent properties in 2010, many people previously engaging in extramedical OxyContin use substituted to illicit substitutes, initiating a wave of heroin- and later synthetic opioid-involved deaths. Using event studies similar to those employed in previous OxyContin-related studies, we provide evidence that the OxyContin reformulation also induced substitution to another high-dose extended release (ER) prescription opioid product marketed under the brand name Opana ER. We show that the steady continued growth in prescription opioid-involved mortality after the OxyContin reformulation is nearly entirely explained by substitution from OxyContin to Opana ER. Furthermore, we show that when Opana ER itself was reformulated in February 2012, there was another wave of substitution to heroin previously attributed solely to OxyContin. Our estimates imply that if the Opana ER pathway were shut down at the time of the OxyContin reformulation, heroin-involved mortality from 2009 to 2016 in the US would have been as much as 33% lower, synthetic opioid-involved mortality as much as 38% lower, and total opioid-involved mortality as much as 44% lower. This study provides new evidence of the harms posed by high-dose prescription opioid products throughout the US opioid epidemic, as well as the unintended consequences of supply disruptions in the presence of both licit and illicit substitutes. |
| Keywords: | opioid epidemic, OxyContin, Opana ER, heroin |
| JEL: | I12 I18 |
| Date: | 2023–11 |
| URL: | https://d.repec.org/n?u=RePEc:mhe:chemon:2023-09&r= |
| By: | Dehos, Fabian; Paul, Marie; Schäfer, Wiebke; Süß, Karolin |
| Abstract: | This paper combines German claims and survey data to provide a comprehensive picture of the health dynamics surrounding the transition into motherhood. Event-study estimates reveal good mental health around birth, but declines afterward, as reflected by increasing mental illness diagnoses and antidepressant and psychotherapy use during the first four years of motherhood. Painkillers, headaches, obesity, and other potentially stress-related physical illnesses, as well as survey evidence on well-being, show a similar pattern. A sustained reduction in sleep, sports, and other leisure activities, coupled with childcare obligations and possible psychosocial distress, may contribute to the long-term adverse effects of motherhood. |
| Abstract: | Das vorliegende Diskussionspapier kombiniert deutsche Abrechnungs- und Umfragedaten, um ein umfassendes Bild der Gesundheitsdynamik rund um die Mutterschaft darzustellen. Event-Study-Schätzungen zeigen eine gute psychische Gesundheit unmittelbar vor und nach der Geburt, gefolgt vor einer anschließenden Verschlechterung, die sowohl durch die Zunahme von Diagnosen psychischer Erkrankungen als auch die verstärkte Nutzung von Antidepressiva und Psychotherapie in den ersten vier Jahren der Mutterschaft gekennzeichnet ist. Schmerzmittel, Kopfschmerzen, Fettleibigkeit und andere potenziell stressbedingten körperlichen Erkrankungen sowie Befragungen zum Wohlbefinden zeigen ein ähnliches Muster. Eine anhaltende Reduktion von Schlaf, Sport und anderen Freizeitaktivitäten, verbunden mit erhöhter Kinderbetreuung und möglichem psychosozialen Stress, könnte zu den langfristigen negativen Auswirkungen der Mutterschaft beitragen. |
| Keywords: | Maternal health, mental health, claims data |
| JEL: | J13 I10 I12 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:rwirep:298846&r= |
| By: | Badii, Jerry |
| Abstract: | Excise duty on tobacco products is a significant policy tool used to reduce tobacco consumption and its associated health and economic burden on society. This study analyses the implications of increasing excise duty on tobacco products on the Ghanaian Economy. Increasing excise duty leads to higher prices for tobacco products, which can reduce consumption, hence improving public health outcomes and increasing productivity. The government can generate additional revenue from higher excise duties, which can be allocated to healthcare services and public welfare programs. |
| Date: | 2024–06–21 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:8wr6p&r= |
| By: | Derksen, Laura (University of Toronto); Kerwin, Jason (University of Minnesota); Reynoso, Natalia Ordaz (Bocconi University); Sterck, Olivier (University of Oxford) |
| Abstract: | We show that ordinary appointments can act as effective substitutes for hard commitment devices and increase demand for a critical healthcare service, particularly among those with self-control problems. We show this using an experiment that randomly offered HIV testing appointments and hard commitment devices to high-risk men in Malawi. Appointments more than double testing rates, with effects concentrated among those who demand commitment. In contrast, most men who take up hard commitments lose their investments. Appointments overcome commitment problems without the potential drawback of commitment failure, and have the potential to increase demand for healthcare in the developing world. |
| Keywords: | appointments, commitment devices, self-control, health, HIV |
| JEL: | D81 I15 O12 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17070&r= |
| By: | Katherine Michelmore; Anna Wiersma Strauss; Emily E. Wiemers |
| Abstract: | Families provide substantial care to older adults with functional limitations. Policies that incentivize work have the potential to reduce this valuable care. This study uses the Health and Retirement Study (HRS) and a simulated instrument approach to examine the consequences of increases in the generosity of the Earned Income Tax Credit (EITC), a work-contingent cash benefit, for the care that parents receive from their EITC-eligible daughters. We find that increases in EITC generosity reduce the care that parents receive from their EITC-eligible daughters, especially older parents and those with functional limitations. To assess the full effect of this reduction in caregiving, we examine whether financial transfers increase as a substitute for reduced care, whether other adult children fill the care gap left by EITC-eligible daughters, and whether paid caregiving increases in response to declines in family care. We find no evidence of increased financial transfers and care gaps remain for older parents that are not filled by other children or paid care providers. We conclude that an unintended consequence of the EITC is that the older parents of EITC recipients receive less care from their children overall in response to increased EITC benefit generosity. |
| JEL: | H24 I38 J22 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32583&r= |
| By: | Haruo Kakehi (Graduate School of Economics, Keio University); Ryo Nakajima (Faculty of Economics, Keio University) |
| Abstract: | This study investigates how pharmacists dispense generic drugs by considering patients' brand preferences. While the literature shows that pharmacists, as experts, underestimate brand premiums, our data show that they frequently dispense brandidentical generics, known as authorized generics. We model patients' generic drug choices and pharmacies' dispensing decisions to explain how patients' brand preferences vary across pharmacies and to determine for-profit pharmacists' heterogeneous dispensing behavior. Using Japanese pharmacists' dispensing data, our empirical results show significant variations in patients' brand preferences and perceived differences in the quality of antibiotics. Furthermore, our findings show that one of the factors behind these differences is the provision of information by pharmacists. |
| Keywords: | generic pharmaceuticals, authorized generic, brand premiums, pharmacist behavior, information provision |
| JEL: | D12 I11 I18 L65 |
| Date: | 2024–06–17 |
| URL: | https://d.repec.org/n?u=RePEc:keo:dpaper:2024-015&r= |
| By: | Dhaval M. Dave; Bilge Erten; David W. Hummel; Pinar Keskin; Shuo Zhang |
| Abstract: | The opioid crisis generates broader societal harms beyond direct health and economic effects, impacting non-users through adverse spillovers on children, families, and communities. We study the spillover effects of a supply-side policy aimed at reducing the over-prescribing of opioids on women’s wellbeing by examining its effects on intimate partner violence (IPV). Using administrative data on incidents reported to law enforcement, in conjunction with quasi-experimental variation in the adoption of stringent mandatory access prescription drug monitoring programs, we find that these policies have generated a downstream benefit for women by significantly reducing their overall exposure to IPV and IPV-involved injuries by 9 to 10 percent. Strongest effects are experienced by groups with higher rates of opioid consumption at baseline, including non-Hispanic Whites. However, we also find a significant uptick in heroin-involved IPV incidents, suggesting substitution into illicit drug consumption. Our results highlight the need to identify high-risk groups prone to switching to illicit opioids and to address this risk through evidence-based policies. Accounting for effects on IPV adds to the estimated societal burden of the opioid epidemic. |
| JEL: | H0 I12 I18 J12 J16 K0 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32563&r= |
| By: | Martínez Villarreal, Déborah; Rojas Méndez, Ana María; Scartascini, Carlos; Simpser, Alberto |
| Abstract: | Can societies be nudged to adopt beneficial behaviors? Publicizing how people behave on average descriptive-norms nudging has emerged as a key tool for increasing the adoption of desirable behaviors. While nudging, by describing social norms, has proven effective in one-shot interventions in small samples (marginal-effect designs), nudging on an ongoing basis at the population level may not necessarily lead to higher compliance and can give rise to major challenges. We use a simple model to show that social adjustment dynamics can drive a populations behavior in unanticipated directions. We propose a general approach to estimating equilibrium behavior and apply it to a study of mask-wearing during the COVID-19 pandemic. Our empirical findings align with the analytical approach and indicate that publicizing mask-wearing rates on an ongoing basis could have backfired, as initially high rates would have settled into substantially lower equilibrium rates of the behavior. In other words, if scaled up, positive marginal-effect designs do not necessarily translate into full compliance with the intervention. |
| Keywords: | COVID-19;Social norms;Social distancing;Normative expectations;Empirical expectations;Compliance;Social Dynamics;Collective Health |
| JEL: | D91 I18 H41 |
| Date: | 2024–03 |
| URL: | https://d.repec.org/n?u=RePEc:idb:brikps:13461&r= |
| By: | Lin, Zhuoer (Yale University); Ye, Justin (Yale University); Allore, Heather (Yale University); Gill, Thomas M. (Yale University); Chen, Xi (Yale University) |
| Abstract: | Given the critical role of neurocognitive development in early life, this study assesses how racial differences in early-life circumstances are collectively and individually associated with racial disparities in late-life cognition. Leveraging uniquely rich information on life history from the U.S. Health and Retirement Study for non-Hispanic White (White) and non-Hispanic Black (Black) Americans 50 years or older, we employ the Blinder-Oaxaca method to decompose racial gaps in cognitive outcomes into early-life educational experiences, cohort, regional, financial, health, trauma, family relationship, demographic and genetic factors. Overall, differences in early-life circumstances are associated with 61.5% and 82.3% of the racial disparities in cognitive score and impairment, respectively. Early-life educational experience is associated with 35.2% of the disparities in cognitive score and 48.6% in cognitive impairment. Notably, school racial segregation (all segregated schooling before college) is associated with 28.8%-39.7% of the racial disparities in cognition. Policies that improve educational equity have the potential to reduce racial disparities in cognition into older ages. Clinicians may leverage early-life circumstances to promote the screening, prevention, and interventions of cognitive impairment more efficiently, thereby promoting health equity. |
| Keywords: | early life circumstances, life course, school segregation, quality of education, racial disparity, cognition |
| JEL: | J15 I14 J13 J14 I20 H75 |
| Date: | 2024–05 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17040&r= |
| By: | Pablo GARCIA SANCHEZ (Banque Centrale du Luxembourg); Luca MARCHIORI (Banque Centrale du Luxembourg); Olivier PIERRARD (Banque Centrale du Luxembourg) |
| Abstract: | We propose a two-period overlapping generation economy that incorporates health investment in preventive measures during youth. These preventive measures contribute to increased longevity and reduced frailty, which influence old-age dependency and pension costs. As these costs are partly funded through pay-as-you-go social security contributions, investment in prevention creates externalities for the next generation. We analytically determine the optimal level of prevention and characterize the optimal health policy that a government should implement to achieve it. Our findings reveal that the optimal subsidy to long-term care exceeds the optimal subsidy to preventive measures. Furthermore, both subsidies are inversely related to the generosity of the public pension scheme. We explore the robustness of our results through various extensions and demonstrate their consistency with several patterns observed in cross-country OECD data. |
| Keywords: | Health, Prevention, Optimal Ramsey policy, Overlapping generations |
| JEL: | H23 I18 O41 |
| Date: | 2024–06–10 |
| URL: | https://d.repec.org/n?u=RePEc:ctl:louvir:2024008&r= |
| By: | Stillman, Sarah; Rozo, Sandra V; Tamim, Abdulrazzak; Palmer, I Bailey; Smith, Emma; Miguel, Edward |
| Abstract: | This paper presents descriptive statistics from the first wave of the Syrian Refugee Life Study (S-RLS), which began in 2020. S-RLS is a longitudinal study that tracks a representative sample of approximately 2, 500 registered Syrian refugee households in Jordan. It collects comprehensive data on sociodemographic variables, health and well-being, preferences, social capital, attitudes, and safety and crime perceptions. We use these data to document sociodemographic characteristics of Syrian refugees in Jordan and compare them to representative populations in the 2016 Jordan Labor Market Panel Survey (JLMPS). Our findings point to lags in basic service access, housing quality, and educational attainment for Syrian refugees relative to non-refugees. The impacts of the pandemic may partially explain these disparities. The data also show that most Syrian refugees have not recovered economically after Covid-19 and have larger gender disparities in income, employment, prevalence of child marriage, and gender attitudes than their non-refugee counterparts. Finally, mental health problems were common for Syrian refugees in 2020, with depression indicated among more than 45 per cent of the phone survey sample and 61 per cent of the in-person survey sample. |
| Keywords: | Economics, Banking, Finance and Investment, Applied Economics, Commerce, Management, Tourism and Services, Behavioral and Social Science, Mental Health, Basic Behavioral and Social Science, Coronaviruses, Social Determinants of Health, Good Health and Well Being, refugees, Syria, Jordan, sociodemographics, Econometrics, Banking, finance and investment, Applied economics |
| Date: | 2022–09–15 |
| URL: | https://d.repec.org/n?u=RePEc:cdl:econwp:qt6hr6f3wx&r= |
| By: | Kumar B, Pradeep; M P, Abraham; Kumar A, Ajai; Lawrence, Shalini Lawrence |
| Abstract: | Disabled persons living below poverty line are victims of dual disadvantages of disability and poverty which influence each other. Disability along with poverty has its negative effects on employment, health and livelihood earnings. The activity status of the disabled persons is broadly classified into non-economic status and economic status. The first category does not belong to labour force (out of labour force) whereas the second category belongs to labour force (both employed and unemployed). This study has found that in India the number of disabled people in rural area is higher than that in urban area and the number of disabled males is higher than the number of disabled females both in rural area and urban area. It appears that the prevalence of disability varies with age, and there is significant difference between the Labour Force Participation Rate (LFPR) of disabled males and females both in rural and urban area. |
| Keywords: | Disability, self-employment, usual status, multiple disabilities, poverty line, labour force participation rate, Worker Population Ratio, and unemployment rate. |
| JEL: | I15 |
| Date: | 2024–04–14 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:121147&r= |
| By: | Katherine Milkman; Sean Ellis; Dena Gromet; Youngwoo Jung; Alex Luscher; Rayyan Mobarak; Madeline Paxson; Ramon Silvera Zumaran; Robert Kuan; Ron Berman; Neil Lewis Jr; John List; Mitesh Patel; Christophe Van den Bulte; Kevin Volpp; Maryann Beauvais; Jonathon Bellows; Cheryl Marandola; Angela Duckworth |
| Abstract: | Encouraging routine COVID-19 vaccinations will probably be a crucial policy challenge for decades to come. To avert hundreds of thousands of unnecessary hospitalizations and deaths, adoption will need to be higher than it was in the autumn of 2022 or 2023, when less than one-fifth of Americans received booster vaccines. One approach to encourage vaccination is to eliminate the friction of transportation hurdles. Previous research has shown that friction can hinder follow-through and that individuals who live farther from COVID-19 vaccination sites are less likely to get vaccinated. However, the value of providing free round-trip transportation to vaccination sites is unknown. Here we show that offering people free round-trip Lyft rides to pharmacies has no benefit over and above sending them behaviourally informed text messages reminding them to get vaccinated. We determined this by running a megastudy with millions of CVS Pharmacy customers in the United States testing two effects: free round-trip Lyft rides to CVS Pharmacies for vaccination appointments, and seven different sets of behaviourally informed vaccine reminder messages. Our results suggest that offering previously vaccinated individuals free rides to vaccination sites is not a good investment in the United States, which is contrary to the high expectations of both expert and lay forecasters. Instead, people in the United States should be sent behaviourally informed COVID-19 vaccination reminders, which increased the 30-day COVID-19 booster uptake by 21% (1.05 percentage points) and spilled over to increase 30-day influenza vaccinations by 8% (0.34 percentage points) in our megastudy. More rigorous testing of interventions to promote vaccination is needed to ensure that evidence-based solutions are deployed widely and that ineffective but intuitively appealing tools are discontinued. |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:feb:natura:00790&r= |
| By: | Luiz Brotherhood; Philipp Kircher; Cezar Santos; Michèle Tertilt |
| Abstract: | This paper investigates the importance of the age composition for pandemic policy design. To do so, it introduces an economic framework with age heterogeneity, individual choice, and incomplete information, emphasizing the value of testing. Calibrating the model to the US Covid-19 pandemic reveals an 80% reduction in death toll due to voluntary actions and the lockdown implemented in the US. The optimal lockdown, however, is more stringent than what was implemented in the US. Moreover, the social planner follows an asymmetric approach by locking down the young relatively more than the old. We underscore the importance of testing, showing its impact on reduced deaths, lower economic costs and laxer lockdown. We use the framework to provide systematic insights into pandemics caused by different viruses (among others the Spanish flu), and underline the influence of economic conditions on optimal policies. |
| JEL: | D62 D63 E17 I10 I11 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32558&r= |
| By: | Viral V. Acharya; Zhengyang Jiang; Robert J. Richmond; Ernst-Ludwig Von Thadden |
| Abstract: | We analyze international trade and health policy coordination during a pandemic by developing a two-economy, two-sector trade model integrated into a micro-founded SIR model of infection dynamics. Disease transmission intensity can differ by goods (manufactured versus services and domestic versus foreign). Governments can adopt containment policies to suppress infection spread domestically, and levy import tariffs to prevent infection from abroad. The globally coordinated policy dynamically adjusts both policy instruments heterogeneously across sectors. The more-infected country aggressively contains the pandemic, raising tariffs and tilting the terms of trade in its favor, while the less-infected country lowers tariffs to share its economic pain. In contrast, in the Nash equilibrium of uncoordinated policies the more infected country does not internalize the global spread of the pandemic, lowering tariffs and its terms of trade, especially in the contact-intensive services sector, while the less infected country counters the spread by raising tariffs. Coordination therefore matters: the health-cum-trade war leads to less consumption and production, as well as smaller health gains due to inadequate global diversification of infection curves. |
| JEL: | F1 F3 I1 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32566&r= |