|
on Health Economics |
| By: | Janet Currie (Yale University); W. Bentley MacLeod (Yale University); Kate Musen (Columbia University) |
| Abstract: | Doctors often treat similar patients differently, which affects health outcomes and medical spending. We assess the recent literature on doctor decision making through the lens of a model that incorporates diagnostic and procedural skills, beliefs, incentives, and differences in patient pools. Decision making is affected by beliefs, training, experience, peer effects, financial incentives, and time constraints. Interventions to improve decision making include providing information, guidelines, and technologies like electronic medical records and algorithmic decision tools. Economists have made progress in understanding doctor decision making, but applications of that knowledge to improving health care are still limited. |
| Date: | 2025–07–01 |
| URL: | https://d.repec.org/n?u=RePEc:cwl:cwldpp:2488 |
| By: | Bursztyn, Leonardo; Kolstad, Jonathan T.; Rao, Aakaash; Tebaldi, Pietro; Yuchtman, Noam |
| Abstract: | Politicising policies designed to address market failures can diminish their effectiveness. We document a pattern of ‘political adverse selection’ in the health insurance exchanges established under the Affordable Care Act (colloquially, ‘Obamacare’): Republicans enrolled at lower rates than Democrats and independents, a gap driven by healthier Republicans. This selection raised public subsidy spending by approximately $155 per enrollee annually (3.2% of average cost). We fielded a survey to show that this selection does not exist for other insurance products. Lower enrolment and higher costs are concentrated in more Republican areas, potentially contributing to polarised views of the policy. |
| Keywords: | political polarisation; ideology; adverse selection; health insurance; healthcare reform |
| JEL: | P00 H40 H51 |
| Date: | 2026–02–02 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:129368 |
| By: | Dhaval M. Dave; Jooyoung Kim; Nikolaos Prodromidis; Joseph J. Sabia |
| Abstract: | With the goal of curbing electronic nicotine delivery systems (ENDS) use among youths, 40 states and the District of Columbia have adopted restrictions on nicotine vaping at elementary and secondary (K-12) schools. This study is the first to estimate the effect of K-12 school vaping restrictions (SVRs) on ENDS use among youth. Using data from several nationally representative data sources and a generalized difference-in-differences approach, we find little evidence that school indoor vaping restrictions reduce youth ENDS use. With 95% confidence, we can rule out SVR-induced youth vaping declines of more than 3.5%. Descriptive evidence suggests that students may respond to SVRs by substituting to smaller vaping devices and vaping in school locations that are less easily detectable by school employees (e.g., bathrooms and locker rooms). In contrast, we find that comprehensive vaping restrictions covering school campuses, workplaces, restaurants, and drinking establishments are associated with a 1.5-2.6 percentage-point reduction in teen nicotine vaping. This result is concentrated on the initiation margin of use and is consistent with the hypothesis that broader place-based restrictions increase the costs of youth ENDS use. |
| JEL: | I0 I12 I18 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34805 |
| By: | Nicolau Martin-Bassols; Pietro Biroli; Elisabetta De Cao; Massimo Anelli; Stephanie von Hinke; Silvia Mendolia |
| Abstract: | The establishment of the UK National Health Service (NHS) in July 1948 was one of the most consequential health policy interventions of the twentieth century, providing universal and free access to medical care and substantially expanding maternal and infant health services. In this paper, we estimate the causal effect of the NHS introduction on early-life mortality and we test whether survival is selective. We adopt a regression discontinuity design under local randomization, comparing individuals born just before and just after July 1948. Leveraging newly digitized weekly death records, we document a significant decline in stillbirths and infant mortality following the introduction of the NHS, the latter driven primarily by reductions in deaths from congenital conditions and diarrhea. We then use polygenic indexes (PGIs), fixed at conception, to track changes in population composition, showing that cohorts born at or after the NHS introduction exhibit higher PGIs associated with contextually-adverse traits (e.g., depression, COPD, and preterm birth) and lower PGIs associated with contextually-valued traits (e.g., educational attainment, self-rated health, and pregnancy length), with effect sizes as large as 7.5% of a standard deviation. These results based on the UK Biobank data are robust to family-based designs and replicate in the English Longitudinal Study of Ageing and the UK Household Longitudinal Study. Effects are strongest in socioeconomically disadvantaged areas and among males. This novel evidence on the existence and magnitude of selective survival highlights how large-scale public policies can leave a persistent imprint on population composition and generate long-term survival biases. |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2602.03751 |
| By: | Charles J. Courtemanche; Joseph Garuccio |
| Abstract: | Health care costs in the U.S. have grown dramatically over the past several decades, with one possible cause being physicians providing unnecessary services out of fear of being sued for malpractice – a phenomenon known as “defensive medicine”. States responded by enacting different types of tort reforms. This paper reviews the literature on the effects of these tort reforms on outcomes related to malpractice risk, quantity and quality of health care services, overall utilization and expenditures, physician supply, and patient affordability. We use Google Scholar to identify papers that fall into this scope and use either associational or quasi-experimental quantitative methods. The preponderance of evidence points towards non-economic damage caps reducing malpractice risk, quantity of services (aside from diagnostics and obstetrics), and overall health care utilization and expenditures while increasing physician supply and not having detrimental effects on patient outcomes. In general, the effects of other types of tort reforms are less clear. The literature would benefit from further research utilizing recent methodological advances related to combining machine learning with causal inference and eliminating bias from heterogeneous treatment effects in staggered-treatment-time models. |
| JEL: | I1 K13 L25 L51 |
| Date: | 2026–01 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34764 |
| By: | David C. Grabowski; Jonathan Gruber; Brian E. McGarry |
| Abstract: | We measure the impact of increased immigration on mortality among elderly Americans, who rely on the immigrant-intensive health and long-term care sectors. Using a shift-share approach we find a strong impact of immigration on the size of the immigrant care workforce: admitting 1, 000 new immigrants would lead to 142 new foreign healthcare workers, without evidence of crowd out of native health care workers. We also find striking effects on mortality: a 25% increase in the steady state flow of immigrants to the US would result in 5, 000 fewer deaths nationwide. We identify reduced use of nursing homes as a key mechanism driving this result. |
| JEL: | I18 J61 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34791 |
| By: | Emily Breza; Kevin Carney; Vijaya Raghavan; Kailash Rajah; Thara Rangaswamy; Gautam Rao; Frank Schilbach; Sobia Shadbar; James Stratton |
| Abstract: | In an RCT with college students in Chennai (N=340), we test how modest financial incentives and personalized feedback affect the uptake and targeting (by symptom severity) of free therapy. Despite 56% of students screening positive for at least mild depression or anxiety, only 3% in the control group took up therapy. A small cash incentive increased appointments by 9 percentage points (p = 0.06) on average without substantially affecting targeting. Personalized feedback and recommendations based on a mental health screening tool significantly improved targeting while keeping overall take-up largely unchanged. Combining these two treatments achieved both higher take-up and improved targeting, by increasing appointments among symptomatic individuals by 21 pp (p |
| JEL: | D03 I1 O10 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34819 |
| By: | Xinming Du; Benjamin Hansen; Shan Zhang; Eric Zou |
| Abstract: | Colombian coca cultivation fell dramatically between 2000 and 2015, a period that saw intense U.S.-backed eradication and interdiction efforts. That progress reversed in 2015, when peace talks and legal rulings in Colombia opened enforcement gaps. Coca plantation has since increased to record levels, which coincided with a sharp rise in cocaine-related overdose deaths in the U.S. We estimate how much of that rise can be causally attributed to Colombia’s new coca boom. Leveraging the unforeseen coca supply shock and cross-county differences in pre-shock cocaine exposure, we find that the surge in supply caused an immediate rise in overdose mortality in the U.S. Our analysis estimates on the order of 1, 000–1, 500 additional U.S. deaths per year in the late 2010s can be attributed to Colombia’s cocaine boom. Implicit annual loss in American statistical life values about $48, 000 per hectare of cultivation in Colombia. If left untamed, the current level of coca cultivation (over 230, 000 ha in 2022) may impose on the order of $10 billion per year in costs via overdose fatalities. |
| JEL: | D62 F14 F35 H87 I18 K42 O19 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34788 |
| By: | Aina, Carmen; Parisi, Lavinia; Picchio, Matteo |
| Abstract: | Gender-based violence (GBV) remains a critical threat to women's safety and equality worldwide, yet the role of climate and environmental stressors in shaping violence against women remains underexplored, particularly in developed countries. This study identifies the causal impact of short-run temperature fluctuations on GBV in Italy using ten years of province-level data (2013-2022) on helpline calls and femicides and a two-way fixed effects estimation strategy. We find that higher temperatures increase both help-seeking behavior and lethal GBV. Accounting for nighttime temperatures shows that elevated minimum temperatures are particularly consequential relative to daytime heat. Heterogeneity analyses indicate that temperature effects are not uniform across provinces, with evidence of differential responses along selected dimensions related to adaptation and socio-economic context. Overall, the results highlight the relevance of considering climate-related stressors within violence prevention and social protection frameworks, even in high-income countries. |
| Keywords: | Climate change, gender-based violence, temperatures, femicide, violence prevention |
| JEL: | J12 J16 Q51 Q54 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1713 |
| By: | Siy Van, Vanessa T.; Casas, Lyle Daryll D.; Sigua, Jemar Anne V.; Uy, Jhanna; Ulep, Valerie Gilbert T. |
| Abstract: | Hospital readmissions are often used to measure quality and continuity of care within health systems. In 2024, the Philippine Health Insurance Corporation (PhilHealth) removed its Single Period Confinement (SPC) Rule, a longstanding policy that denied reimbursements for readmissions within 90 days for the same primary case rate or diagnosis. Originally intended to deter unnecessary admissions, the SPC Rule drew criticism for hampering access and reducing financial protection. This study presents the first empirical analysis of PhilHealth’s readmission policy using inpatient claims from 2018 to 2023 to assess the magnitude and cost of all-cause, planned, and avoidable hospital readmissions in the Philippines. Readmission trends were compared across hospital levels and ownership, as well as among patient groups. Findings indicate that readmission rates were significantly lower than those observed in other countries. The rates of avoidable and complication-related readmissions remained stagnant over the five years for all hospital levels, indicating a lack of significant changes in provider service delivery. Instead, the policy exposed the most vulnerable Filipinos to greater financial risk, as elderly and indigent Filipinos had the highest share of avoidable readmissions. The removal of the SPC Rule presents an opportunity to systematically redesign how readmissions in the Philippines are measured, monitored, and minimized, and to shift to a provider payment system that integrates quality assessments in payment determination. PhilHealth must distinguish planned or routine readmissions from unplanned and avoidable readmissions that may indicate hospital-acquired complications. A robust readmission monitoring system can inform value-based purchasing decisions that ensure quality and complete care for Filipinos without excessive financial risk. Finally, readmission policies must be supported by programs that bridge the continuum of care prior to and after patient discharge. Without these, PhilHealth will continue to reward avoidable readmissions that come at great cost to patients’ health and financial status. Comments to this paper are welcome within 60 days from the date of posting. Email publications@pids.gov.ph. |
| Keywords: | PhilHealth, hospital readmissions, single period of confinement, health policy, avoidable readmissions, quality of care, value-based purchasing, HEFP |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:phd:dpaper:dp_2025-61 |
| By: | Hong Beng Lim; Mengyi Xu; Kenneth Q. Zhou |
| Abstract: | Extant literature on fair pricing methods for actuarial contexts has primarily focused on the regression setting. While such approaches are well-suited to short-term products, it is unclear how they generalize to long-term products, whose pricing essentially relies on estimating transition rates in multi-state models. To address this gap, we propose a unified framework that recasts the estimation of any given multi-state transition model as a set of Poisson regression problems. This reformulation enables the direct application of existing fair pricing methods, which together constitute our proposed methodology. As an illustration, we apply the framework to a fair pricing exercise for a stylized long-term care insurance product using data from the University of Michigan Health and Retirement Study (HRS), focusing on a post-processing approach. We further explain how the framework readily accommodates pre-processing and in-processing fairness methods. |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2602.04791 |
| By: | Marco Francesconi; Stephanie von Hinke; Emil N. S{\o}rensen |
| Abstract: | This paper shows that the mid-20th century was characterised by a considerable reduction in breastfeeding rates, reducing from over 80% in the late 1930s to just over 40% only three decades later. We investigate how maternal breastfeeding during this period has shaped offspring health and human capital outcomes in the UK. We use a within-family design, comparing children who were breastfed to their sibling(s) who were not. Our results show that breastfeeding increases adult height, as well as fluid intelligence, but does not affect educational attainment, nor adult BMI. In further analyses, we examine whether and how this impact varies with individuals' genetic "predisposition" for these outcomes, proxied by the outcome-specific polygenic index. We find that the "height-returns" to breastfeeding are larger among those genetically predisposed to be taller, with no genetic heterogeneity for the other outcomes, though we note that power in the within-family GxE analysis is more limited. Overall, our estimates suggest that breastfeeding plays a non-negligible role in child development. |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2602.03221 |
| By: | Paul Rodríguez-Lesmes (Universidad del Rosario); Mayra Sáenz-Amaguaya (Universidad del Rosario); Luis Fernando Gómez (Pontificia Universidad Javeriana); Mercedes Mora Plazas (Pontificia Universidad Javeriana); Norman Maldonado (Banco Mundial); Juan Nicolás Rico (Universidad del Rosario); Lindsey Smith Taillie (University of North Carolina) |
| Abstract: | This paper examines the short-term labor market effects of Colombia’s 2022–2024 health-related reforms, which combined (i) an excise tax on ultraprocessed sugary drinks and ultra-processed foods, and (ii) an octagonal front-of-package warning label on processed and ultra-processed food and beverage products high in sugar, sodium, saturated fat, or calories. Using nationally representative labor force data and three complementary identification strategies—interrupted time series, difference-in-differences, and synthetic control—we evaluate effects on employment, income, hours worked, and informality in directly and indirectly affected sectors. Results show no statistically significant short-run changes in employment, income, or informality. The only robust adjustment occurs along the intensive margin: workers in the non-alcoholic beverage sector increased their weekly hours by roughly one hour on average. This effect is concentrated among white-collar, rural, and female workers, suggesting that firms adapted to the new regulations by adjusting workloads rather than employment levels. Overall, the evidence indicates that Colombia’s fiscal and labeling policies did not disrupt labor markets during their initial implementation. The results align with findings from Mexico, Chile, and Peru, supporting the view that well-designed “high-in” food policies can advance public health objectives without undermining employment or income stability. These findings contribute to the growing evidence base on the economic effects of food-related fiscal and informational measures in middle-income countries, offering reassurance to policymakers balancing health and labor market goals. |
| Keywords: | Employment; Labor income; Colombia; Food policy; Labeling; Taxes; Processed foods |
| Date: | 2025–12–02 |
| URL: | https://d.repec.org/n?u=RePEc:col:000092:022160 |
| By: | Virginia Sánchez-Marcos; Javier Fernández-Blanco |
| Abstract: | Social Security retirement programs are designed to provide full insurance against longevity risks through a progressive scheme. In line with previous work on earnings and race, we document, using HRS data, 2.5- and 5.5-year life-expectancy gaps by wealth and health at age 56, respectively. Such significant differences in life expectancy reduce the progressivity feature of the program. We examine the welfare costs of ignoring life expectancy conditional on wealth and health at the claiming age in a parsimonious way, by adding a wealth- or health-based correction factor to the current program. We build a rich life-cycle model in which married men decide their savings, labor supply and benefits-claiming age, and are heterogeneous in many dimensions, in particular in their fixed health type. We find that the welfare losses of ignoring differences in life expectancy by wealth and health at the claiming age are equivalent to a permanent consumption fall of 2.22% and 0.30%, respectively. Moreover, the effects are very heterogeneous across health types. |
| Keywords: | health, labor force participation, Life Expectancy, retirement benefits, Wealth |
| JEL: | J22 I14 |
| Date: | 2026–01 |
| URL: | https://d.repec.org/n?u=RePEc:bge:wpaper:1556 |
| By: | Hernan Bajerano (Center for Economic Research and Teaching (CIDE) and Economic Science Institute, Chapman University); Matias Busso (Inter-American Development Bank); Juan Francisco Santos (Inter-American Development Bank) |
| Abstract: | We study how individuals in six Latin American countries value public versus private provision of education and healthcare using a survey experiment. Respondents were randomly assigned to vignettes that vary income, service quality, and provider type. Reported service quality is the main driver of choices: the probability of selecting a private provider roughly doubles when reported quality of the public option falls from 80 to 20 percent, while income has a smaller effect. Higher institutional trust lowers the likelihood of switching to private providers but does not affect willingness to pay once individuals choose private provision. |
| Keywords: | Stated preferences; Willingness to pay; Public versus private provision; Service quality; Latin America |
| JEL: | D12 H42 I21 I18 O54 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:chu:wpaper:26-01 |
| By: | Fu, Wei; Qian, Yuting; Karimi, Seyed; Zarei, Hamid; Chen, Xi |
| Abstract: | Failure to account for the full complexity and costs of high-need populations in the risk-adjusted capitated payment model for Medicare Advantage (MA) plans may create financial disincentives for plans to invest in comprehensive care for affected beneficiaries, potentially exacerbating health disparities. This paper leverages the reinstatement of Alzheimer's Disease and Related Dementias (ADRD) hierarchical condition category (HCC) into the MA risk-adjusted payment model in 2020 as a quasi-natural experiment to study how risk-adjustment model affects access, affordability, and quality of care. Using MA beneficiaries in the Medicare Current Beneficiary Survey (2015-2022), we perform a difference-in-differences analysis by comparing beneficiaries with ADRD with those without ADRD but with similar neurologic conditions. We find that the revised risk-adjusted payment model is associated with a 6.6 percentage-point decrease in reporting any troubles accessing needed care and a 9.2 percentage-point decrease in reporting any medical financial burden among MA beneficiaries with ADRD. Its effects on satisfaction with access to specialists and satisfaction with overall quality of care are not notable. These findings suggest that refining risk adjustment to better capture the costs of chronic and complex conditions can help align MA plan incentives with the needs of vulnerable populations and promote equity in care. |
| Keywords: | Medicare Advantage, Risk Adjustment, ADRD, Care Experiences |
| JEL: | I13 I12 I18 I14 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1716 |
| By: | Hesham Mohamed Hagag, Sarah Reem D.; Rodriguez, Henrietta Marie M.; Ulep, Valerie Gilbert T. |
| Abstract: | This report estimated the utilization of outpatient benefits from the Philippine Health Insurance Corporation and examined variations across local governments. Utilization patterns were analyzed based on key socio-demographic and economic characteristics to better understand healthcare inequalities. The findings reveal several key insights. First, outpatient utilization rates exhibit significant geographic variation, with disparities reaching up to fivefold, indicating persistent inequities in access to care. Second, about 70 percent of outpatient claims are attributed to kidney-related conditions, largely driven by the rapid expansion of hemodialysis benefits in recent years. Third, regarding Konsulta, the comprehensive primary care benefit package under the UHC Law has registered participation from only about a quarter of the population, with fewer than 2 percent profiled through a First Patient Encounter. These results highlight critical inefficiencies and inequities in the delivery of outpatient services and the need for policy reforms to strengthen outpatient and primary healthcare to improve overall health system performance. Comments to this paper are welcome within 60 days from the date of posting. Email publications@pids.gov.ph. |
| Keywords: | PhilHealth, outpatient care, HEFP |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:phd:dpaper:dp_2025-62 |
| By: | Arlette Simo Fotso (INED - Institut national d'études démographiques); Jacob Martin (INED - Institut national d'études démographiques); Florian Bonnet (INED - Institut national d'études démographiques) |
| Abstract: | The World Health Organization estimates that that the highest prevalence of disability among individuals below age 60 is observed in sub-Saharan Africa. Yet, knowledge of disability remains limited in the region, which is partly due to the lack of robust and comparable measurements of disability. In Sub-Saharan Africa, sub-national and comparable estimates of disability prevalence are limited. This paper aims to use comparable sources of data to estimate and construct an atlas of sub-regional disability prevalence. We take data from the Demographic and Health Surveys (DHS) and the Multiple Indicator Cluster Surveys (MICS) which use the Washington Group on Disability Statistics (WG) short set of questions, which is designed to be a 'culturally neutral' disability screening tool. The questionnaire assesses limitations across six functional domains (seeing, hearing, walking, cognition, communication and self-care). We have data for a total of 26 Sub-Saharan African countries which were collected between 2016 and 2022. We aim to estimate the age-specific prevalence of functional limitation in the population aged 18-49 at the second subnational administrative division level in each country. Given the instability of direct estimates at the subnational level, we use recently developed small area estimation techniques that borrow strength over age and space. From our estimates we compute age standardized prevalences of limitation to facilitate comparison between regions and countries. Preliminary results show large heterogeneity between and within countries, but the amount of within-country differences varies from country to country. Overall, we found 682 subnational entities with age standardized disability prevalence significantly above 2.5%, 233 above 5%, and 31 above 10%. Areas with prevalence significantly above 10% are mainly located along the Ghana-Togo border, the CAR-DRC border, the south of DRC, and parts of Madagascar, underscoring the need for both national and global policymakers to focus efforts on these zones. |
| Date: | 2025–07–13 |
| URL: | https://d.repec.org/n?u=RePEc:hal:journl:hal-05458425 |
| By: | Laetitia Lebihan (CEMOI - Centre d'Économie et de Management de l'Océan Indien - UR - Université de La Réunion) |
| Abstract: | The American Rescue Plan Act of 2021 temporarily provided unconditional monthly cash benefits to most households with children to reduce child poverty during the COVID-19 pandemic. Using the American Time Use Survey and Well-Being Supplement, we examine the effects of the 2021 Child Tax Credit (CTC) expansion on well-being and time-use activities of households with children. We find that the CTC expansion was associated with improved parental well-being and health. The analysis also shows a significant increase in the time the parent spends with the child. The results are robust to several robustness checks and consistent with existing evidence. |
| Keywords: | Child tax credit, Well-being, Health, Time use |
| Date: | 2025–12 |
| URL: | https://d.repec.org/n?u=RePEc:hal:journl:hal-05509374 |
| By: | Francisca Castro; Tilman Brück; Hadi Jaafar; Wolfgang Stojetz |
| Abstract: | When refugees flee abroad, they carry the legacy of their traumatic experiences across borders. While there are over 43 million refugees worldwide, the long-term effects of conflict exposure on their well-being remain poorly understood. This paper examines how pre-displacement exposure to violent conflict and environmental stressors shapes the long-term social well-being of Syrian refugees in Jordan, focusing on life satisfaction, social trust, and social safety nets. |
| Keywords: | Refugees, Conflict, Climate, Wellbeing, Mental health, Syria, Jordan |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:unu:wpaper:wp-2026-5 |
| By: | Oana M. Enache; Sherri Rose |
| Abstract: | Time-to-event estimation (i.e., survival analysis) is common in health research, most often using methods that assume proportional hazards and no competing risks. Because both assumptions are frequently invalid, estimators more aligned with real-world settings have been proposed. An effect can be estimated as the difference in areas below the cumulative incidence functions of two groups up to a pre-specified time point. This approach, restricted mean time lost (RMTL), can be used in settings with competing risks as well. We extend RMTL estimation for use in an understudied health policy application in Medicare. Medicare currently supports healthcare payment for over 69 million beneficiaries, most of whom are enrolled in Medicare Advantage plans and receive insurance from private insurers. These insurers are prospectively paid by the federal government for each of their beneficiaries' anticipated health needs using an ordinary least squares linear regression algorithm. As all coefficients are positive and predictor variables are largely insurer-submitted health conditions, insurers are incentivized to upcode, or report more diagnoses than may be accurate. Such gaming is projected to cost the federal government $40 billion in 2025 alone without clear benefit to beneficiaries. We propose several novel estimators of coding intensity and possible upcoding in Medicare Advantage, including accounting for unreliable reporting. We demonstrate estimator performance in simulated data leveraging the National Institutes of Health's All of Us study and also develop an open source R package to simulate realistic labeled upcoding data, which were not previously available. |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2602.04092 |
| By: | Ahmed, Ribal |
| Abstract: | Despite Pakistan’s high tuberculosis burden, BCG vaccination coverage remains suboptimal (71.8%) with pronounced urban-rural disparities. This study analyses IPUMS-MICS6 data (2017-2020; n=17, 872 children aged 0-24 months) using survey weighted logistic regression and average marginal effects to quantify the influence of child, maternal, educational and socioeconomic determinants on BCG receipt, stratified by urban and rural residence. Maternal higher education demonstrated the highest absolute association with vaccination probability (21.3 percentage-point increase), followed by strong wealth gradients in rural populations (up to 13.1pp increase). Pre-term birth was associated with substantially higher predicted uptake in urban settings (14.5pp increase), with no comparable effect in rural areas, indicating contextual heterogeneity in access pathways. These findings reveal structurally patterned inequalities in early life immunisation focused on BCG receipt, highlighting persistent barriers to equitable EPI coverage. Policy response should priorities integrated social protection and health system strategies with education-focused interventions and demand-side support for targeting rural and socioeconomically disadvantaged households. |
| Date: | 2026–02–12 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:g8de4_v1 |
| By: | Pamplona de Uña, Carmen |
| Abstract: | This study analyzes the impact of teleworking on subjective well-being, mental health, and work-life balance in Portugal. Using Linear Probability and Logit models, the research demonstrates that full-time teleworking significantly improves work-life reconciliation. However, the results reveal a gender gap: while the benefits are robust for men, they are statistically insignificant for women. Furthermore, the study identifies a correlation between depression among Portuguese workers and their total workload (number of hours worked). The study concludes that teleworking is not a neutral tool and requires specific policies and shared responsibility to ensure an equitable impact. |
| Keywords: | Teletrabajo (Teleworking), Conciliación (Work-life balance), Salud mental (Mental health), Brecha de género (Gender gap), Portugal |
| JEL: | J16 J17 J21 J22 J28 J81 |
| Date: | 2026–01–25 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:127847 |