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on Health Economics |
| By: | Han Ye; Cristina Bellés Obrero; Sergi Jiménez-Martín |
| Abstract: | This paper studies the mortality effects of delaying retirement by leveraging the 1967 Spanish pension reform, which exogenously increased the earliest voluntary claiming age from 60 to 65 based on individuals' date of first contribution. Using Spanish administrative data, we find that removing access to early retirement delays age at last employment by 4 months and increases the probability of death between ages 60 and 69 by 11 percent. The mortality effects are concentrated among workers in physically demanding, high-psychosocial-burden, and low- skilled occupations, while men and women are affected similarly. Access to flexible retirement mitigates the adverse effects of delaying retirement. |
| Keywords: | delaying retirement, early retirement, heterogeneity, mortality, work conditions |
| JEL: | I10 I12 J14 J26 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:bge:wpaper:1528 |
| By: | Effrosyni Adamopoulou (ZEW, University of Mannheim, and IZA); Jeremy Greenwood (University of Pennsylvania); Nezih Guner (CEMFI and Banco de España); Karen Kopecky (FRB Cleveland and Emory University) |
| Abstract: | The role of friends in the US opioid epidemic is examined. Using data from the National Longitudinal Survey of Adolescent Health (Add Health), adults aged 25-34 and their high school best friends are focused on. An instrumental variable technique is employed to estimate peer effects in opioid misuse. Severe injuries in the previous year are used as an instrument for opioid misuse in order to estimate the causal impact of a person’s best friends’ opioid misuse on their own misuse. The estimated peer effects are significant: Having a best friend who misuses opioids following a serious injury increases the probability of own opioid misuse by around 7 percentage points in a population where 17 percent ever misuses opioids. The effect is concentrated among non-college graduates and peers with strong ties who are central in their friendship networks. Peer opioid misuse eventually leads to deteriorating health and opioid addiction. |
| Keywords: | Opioid, peer-group effects, friends, instrumental variables, Add Health, severe injuries. |
| JEL: | C26 D10 I12 J11 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:cmf:wpaper:wp2025_2520 |
| By: | Carine Milcent (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 - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - ENPC - École nationale des ponts et chaussées - IP Paris - Institut Polytechnique de Paris, 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 - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - ENPC - École nationale des ponts et chaussées - IP Paris - Institut Polytechnique de Paris) |
| Abstract: | This paper evaluates the effectiveness of the 2009 French Diagnosis-Related Group (DRG) classification reform, which introduced four severity levels within each DRG, ranging from low to very high, with corresponding increases in fixed-price reimbursements. Notably, the reform incorporates the Medicare Severity Diagnosis-Related Group (MS-DRG) system, first implemented in the United States in 2007, giving the French system international relevance. The French Public Health Insurance system (NHI) reimburses both public and private healthcare establishments through a DRG-based payment system. This study focuses on variations in hospital resource costs for four different health conditions. The paper begins by discussing the theoretical challenges of constructing DRG categories, particularly the trade-off between greater clinical detail (granularity) and the risk of distorting incentives for hospital efficiency. It then presents an empirical analysis of hospital resource cost variations both within and between DRGs for the same pathology or clinically meaningful group (DRG-root), using data from 2012 to 2019. Our findings suggest that a one-size-fits-all approach to severity classification is inadequate. In some cases, broader categories improve statistical validity, while in others, more granular distinctions are necessary. We conclude that a tailored, case-by-case approach is the most effective solution. Specifically, the analysis reveals significant overlap in confidence intervals for hospital resource costs across DRG severity levels, suggesting that the current classification system fails to effectively capture cost differences related to severity. Additionally, a large portion of cost variation within DRGs is driven by factors unrelated to severity, such as hospital-specific characteristics. Overall, the results underscore the need to revise the current DRG system in France in order to reduce financial discrepancies and to prevent incentives for patient selection, especially before implementing bundled payment models that include both inpatient and outpatient care. |
| Keywords: | Hospital resource costs, Cost analysis, Hospital costs, Healthcare payment, Diagnosis, Cost variation, Cost variability drivers |
| Date: | 2025–10–30 |
| URL: | https://d.repec.org/n?u=RePEc:hal:journl:hal-05339350 |
| By: | Jonathan Gruber; Núria Mas; Judit Vall Castelló; Jaume Vives-i-Bastida |
| Abstract: | Most nations in the world have side-by-side private and public health care systems. Policymakers worry that “dual practice” across sectors might reduce care to the public sector. This concern led regions in Spain to offer “exclusivity bonuses” to physicians who practice exclusively in the public sector. We show theoretically that the impact of these bonuses on the public sector is ambiguous. We demonstrate empirically that the bonuses backfired: they did increase exclusive participation in the public sector, but significantly reduced hours of work. When regions added offsetting bonuses for dual practice, they were largely ineffective. |
| JEL: | I18 J30 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34433 |
| By: | Aipoh, Godwin |
| Abstract: | Much is known about gaining health insurance, but little is known about losing it. This study investigates how losing public health insurance impacts mental health, using Tennessee’s 2005 TennCare disenrollment as a natural experiment. When the state abruptly cut Medicaid coverage for nearly 200, 000 low-income, childless adults, it created a rare opportunity to examine the effects of coverage loss at scale. Drawing on individual-level data from the Behavioral Risk Factor Surveillance System (BRFSS) between 2000 and 2010, I apply a difference-in-differences approach, comparing trends in Tennessee to 38 control states that maintained stable Medicaid eligibility rules. The analysis finds that losing coverage led to a significant 17.5 percentage point increase in poor mental health, a nearly 80% rise relative to baseline. The effects were most severe among women, older adults, the unemployed, and those without a college degree. Mechanism analyses show that coverage loss reduced insurance rates, increased cost-related barriers to care, and decreased preventive service use. This study offers the first causal evidence linking large-scale public insurance loss to worsening mental health and highlights important implications for health policy and Medicaid program. |
| Keywords: | Insurance, Access to care, BRFSS, Health coverage loss, Health inequities, Health policy, Medicaid disenrollment, Mental health, Public health insurance, Tennessee, TennCare |
| JEL: | H41 H51 I11 I12 I13 I14 I15 I18 I3 I38 |
| Date: | 2025–05 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:126531 |
| By: | Jayani Jayawardhana; Jialin Hou; Johanna Catherine Maclean |
| Abstract: | Cannabis legalization has increased substantially in the past two decades with state-level policies that permit possession this product. A potential concern with cannabis legalization and the corresponding increase in consumption is that – because smoking is the most common consumption mode – respiratory health could worsen. In this study, we offer new evidence on the impact of recreational cannabis laws on asthma outcomes. To do so, we combine commercial health insurance claims and survey data over the period 2008 to 2022 with difference-in-differences and event-study methods. Our findings suggest that asthma diagnoses do not change following legalization of recreational cannabis, while asthma-related dispensed prescription medications decline, and asthma-related outpatient visits and inpatient hospitalizations are stable. An analysis of changes in use of smoked and non-smoked cannabis post-law suggests that, on net, the increase in overall cannabis use attributable to legalization is driven by use of non-smoked cannabis, which may explain why we find limited evidence that asthma outcomes worsen post-law. Collectively, these results suggest that expanded access to legal cannabis has not worsened respiratory health overall, and hint that some patients may use cannabis to manage asthma symptoms. |
| JEL: | I1 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34435 |
| By: | Jesús Bueren (European University Institute); Josep Pijoan-Mas (CEMFI, Centro de Estudios Monetarios y Financieros); Dante Amengual (CEMFI, Centro de Estudios Monetarios y Financieros) |
| Abstract: | We study the effect of lifestyles on the education gradient of life expectancy. We use panel data on health behavior and health outcomes to estimate latent lifestyle types and their impact on health dynamics. We find that the higher frequency of health-protective lifestyles among the more educated individuals explains almost 1/2 of the education gradient in life expectancy. To understand lifestyle formation, we build a life cycle model where lifestyles and education are jointly chosen early in life. These two investments are complementary because of the more educated’s higher income and the higher yield of their health-protective behavior. Importantly, with these complementarities, individuals with lower costs of healthier lifestyles self-select into higher education. Quantitatively, we find the three mechanisms similarly important in explaining the correlation between education and healthy lifestyles. We also find that the increase in the college wage premium over the last decades has widened the education gradient in lifestyles, resulting in a one-year increase in the education gradient of life expectancy across cohorts born in the 1930s and 1970s. Of this increase, 40% is driven by the direct effect of wage changes and 60% by the induced changes in the composition of college graduates and high school dropouts. |
| Keywords: | Health inequality, healthy lifestyles, education, latent types. |
| JEL: | E21 D15 I12 I14 I24 C38 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:cmf:wpaper:wp2025_2526 |
| By: | Johannes Geyer; Peter Haan; Mia Teschner |
| Abstract: | The price of institutional long-term care is a key determinant of the demand for both formal and informal long-term care. In this paper, we examine how the regional unemployment rate as a proxy for macroeconomic conditions influences these prices. Our analysis draws on administrative data that provide detailed information on all nursing homes and ambulatory care services, as well as all recipients of long-term care benefits in Germany. For identification, we exploit variation in macroeconomic conditions - measured by district-level unemployment rates over time - using a panel data approach with facility and time fixed effects. Our empirical findings indicate that higher unemployment rates lead to increased prices for permanent long-term care, including accommodation and meal costs in nursing homes. We provide evidence for the mechanisms underlying these price effects. While we find no significant impact of macroeconomic conditions on employment, working hours, or quality of care in nursing homes, our results suggest that higher unemployment rates raise nursing home prices through changes in the composition of patients. Specifically, economic downturns trigger a shift from recipients with lower levels of impairment to those requiring more labor-intensive care. Additionally, we observe a substitution effect, whereby low-impairment patients increasingly opt for ambulatory and informal home care instead of institutional care. |
| Keywords: | Long-Term Care, Nursing Home Prices, Unemployment Rate, Macroeconomic Conditions, Informal Care |
| JEL: | E32 I11 J20 |
| Date: | 2025–10–28 |
| URL: | https://d.repec.org/n?u=RePEc:bdp:dpaper:0080 |
| By: | Shooshan Danagoulian; Monica Deza; Johanna Catherine Maclean; Alberto Ortega |
| Abstract: | The 911 system, a vital component of public safety, responds to over 210 million emergency calls each year. We examine the effect of small exogenous public health stressors – pollen emissions – on the operation of the 911 call system in Seattle, Washington. Leveraging daily variation in pollen levels, we evaluate pollen’s impact on the volume of 911 calls. We find that a 100% increase in pollen levels – the modal day-over-day variation we observe in our data – results in six additional 911 calls per day. We further show that elevated pollen levels influence the quality of emergency and non-emergency response. The 911 system responds to increased strain by prioritizing more urgent calls – and as a result, increasing response time to non-urgent calls. Though all calls are connected to a dispatcher, there are increased missed connections – canceled emergency response, missing records of response, and false reports. Despite the prioritization of urgent calls, these additional daily calls lead to reallocation of resources in ways that potentially impede service quality. Thus, our findings suggest that common and small shocks may lead to under-provision of valuable services to communities across the U.S. |
| JEL: | I1 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34428 |
| By: | Francesco Agostinelli; Zach Weingarten |
| Abstract: | The longstanding debate over whether human capabilities and skills are shaped more by “nature” or “nurture” has been revitalized by recent advances in genetics, particularly in the use of polygenic scores (PGSs) to proxy for genetic endowments. Yet, we argue that PGSs embed not only direct genetic effects but also indirect environmental influences, raising questions about their validity for causal analysis. We show that these conflated measures can mislead studies of gene–environment interactions, especially when parental behavior responds to children’s genetic risk. To address this issue, we construct a new latent measure of genetic risk that integrates individual genotypes with diagnostic symptoms, using data from the National Longitudinal Study of Adolescent to Adult Health linked to restricted individual SNP-level genotypes from dbGaP. Exploiting multiple sources of variation—including the Mendelian within-family genetic randomization among siblings—we find consistent evidence that parents compensate by investing more in children with higher genetic risk for ADHD. Strikingly, these compensatory responses disappear when genetic risk is proxied by the conventional ADHD PGS, which also yields weaker—and in some cases reversed—predictions for long-run outcomes. Finally, we embed our latent measure of genetic endowments into a standard dynamic structural model of child development. The model shows that both parental investments and latent genetic risk jointly shape children’s cognitive and mental health development, underscoring the importance of modeling the dynamic interplay between genes and environments in the formation of human capital. |
| JEL: | D10 H0 I1 I2 I20 J01 J1 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34427 |
| By: | Dennis Egger; Killeen Grady; Edward Miguel; Nick Shankar; Michael Walker |
| Abstract: | We estimate the impacts of large-scale unconditional cash transfers on child survival. One-time transfers of USD 1000 were provided to over 10, 500 poor households across 653 randomized villages in Kenya. We collected census data on over 100, 000 births, including on mortality and cause of death, and detailed data on household health behaviours. Unconditional cash transfers (accounting for spillovers) lead to 48% fewer infant deaths before age one and 45% fewer child deaths before age five. Detailed data on cause of death, transfer timing relative to birth, and the location of health facilities indicate that unconditional cash transfers and access to delivery care are complements in generating mortality reductions: the largest gains are estimated in neonatal and maternal causes of death largely preventable by appropriate obstetric care and among households living close to physician-staffed facilities and those who receive the transfer around the time of birth, and treatment leads to a large increase in hospital deliveries (by 45%). The infant and child mortality declines are concentrated among poorer households with below median assets or predicted consumption. The transfers also result in a substantial decline of 51% in female labour supply in the three months before and the three months after a birth, and improved child nutrition. Infant and child mortality largely revert to pre-program levels after cash transfers end. Despite not being the main aim of the original program, we show that unconditional cash transfers in this setting may be a cost-effective way to reduce infant and child deaths. |
| JEL: | I15 O1 O15 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:csa:wpaper:2025-10 |
| By: | Andrea Modena; Luca Regis; Giorgio Rizzini |
| Abstract: | In this paper, we invesstigate how mortality risk affects agents optimal decisions and asset prices within a general equilibrium framework. In our model, risk averse households facing a stochastic mortality rate allocate their net worth among consumption, risky capital production, and risk-free bonds to maximise intertemporal utility. In this setting, we show that a negative and time-varying correlation exists between mortality and risky asset prices, even when production and mortality risks are mutually independent. The correlation arises because higher mortality rates reduce the incentive to save for the future, leading to increased current consumption and decreased capital investment. As a result, higher mortality lowers the prices of risky capital and raises the risk-free rate in equilibrium. Calibrated simulations suggest that endogenous price effects account for the largest share of welfare gains and losses following sharp changes in mortality, such as pandemics or rapid increases in longevity. |
| Keywords: | equilibrium; mortality risk; portfolio choice; stochastic optimal control |
| JEL: | C6 G11 G52 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:bon:boncrc:crctr224_2025_709 |
| By: | Mariia Vasiakina (Max Planck Institute for Demographic Research, Rostock, Germany); Christian Dudel (Max Planck Institute for Demographic Research, Rostock, Germany) |
| Abstract: | The ongoing economic transformation driven by automation has significant social implications, particularly for the health and well-being of workers who face the risk of job displacement and the pressure to acquire new skills and qualifications. However, the specific pathways through which exposure to automation risk affects health outcomes remain poorly understood, and the relative contribution of each potential mechanism is still unclear. In this study, we examine the nature of the relationship between high workplace exposure to automation risk and a range of subjective health outcomes – including self-reported health, anxiety, and both physical and mental component summary scores from the SF-12 Health Survey – among workers in Germany. Using data from the German Socio-Economic Panel (SOEP) linked with administrative records from the Occupational Panel for Germany (2014–2022), we apply the Karlson-Holm-Breen (KHB) mediation analysis method to assess whether broader indicators of economic uncertainty, alongside automation-specific factors, mediate the relationship between high automation risk and workers’ health. Our results indicate that the negative impact of high automation risk on health in Germany primarily operates through indirect pathways (related to mediators) for both genders, with the exception of physical health among male workers, where a direct negative effect is also evident. Economic concerns – particularly job insecurity and worries about one’s future financial situation – emerge as more significant mediators than automation-specific factors. Overall, our findings suggest that the mechanisms linking high automation risk to health are gender- and context-sensitive, and are shaped by broader economic conditions and workplace environments. |
| Keywords: | Germany, automation, health, risk exposure, technological change |
| JEL: | J1 Z0 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:dem:wpaper:wp-2025-032 |
| By: | Jinho Cha; Justin Yu; Junyeol Ryu; Eunchan Daniel Cha; Hyeyoung Hwang |
| Abstract: | This study introduces an inverse behavioral optimization framework that integrates QALY-based health outcomes, ROI-driven incentives, and adaptive behavioral learning to quantify how policy design shapes national healthcare performance. Building on the FOSSIL (Flexible Optimization via Sample-Sensitive Importance Learning) paradigm, the model embeds a regret-minimizing behavioral weighting mechanism that enables dynamic learning from heterogeneous policy environments. It recovers latent behavioral sensitivities (efficiency, fairness, and temporal responsiveness T) from observed QALY-ROI trade-offs, providing an analytical bridge between individual incentive responses and aggregate system productivity. We formalize this mapping through the proposed System Impact Index (SII), which links behavioral elasticity to measurable macro-level efficiency and equity outcomes. Using OECD-WHO panel data, the framework empirically demonstrates that modern health systems operate near an efficiency-saturated frontier, where incremental fairness adjustments yield stabilizing but diminishing returns. Simulation and sensitivity analyses further show how small changes in behavioral parameters propagate into measurable shifts in systemic resilience, equity, and ROI efficiency. The results establish a quantitative foundation for designing adaptive, data-driven health incentive programs that dynamically balance efficiency, fairness, and long-run sustainability in national healthcare systems. |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2510.22518 |
| By: | Thurik, Roy (Erasmus School of Economics); Kato, Masatoshi (Kwansei Gakuin University); van der Zwan, Peter (Leiden University); Kageura, Chihiro |
| Abstract: | Numerous studies deal with the link between daily recovery experiences (DRE) and mental health for employees. Hardly any studies exist for small business owners. This is surprising given that their health is not just important for themselves but also for their environment (such as employees, clients, suppliers, networks). In the present study we analyse if this link also works for some 2, 400 Japanese small business owners. Next to overall DRE, four dimensions of DRE are distinguished (detachment, relaxation, mastery, and control). Mental health is captured using well-being (psychological well-being and job satisfaction) and ill-being (burnout and stress). First, we compare our DRE levels with many other (employee) studies. Second, controlling for many phenomena including participating in nomikai (a typical Japanese custom of getting together after office hours), we show that the quality of overall DRE is positively linked to well-being, and negatively to ill-being. Third, like the quality of overall DRE, nomikai activities of the owner are positively linked to their psychological well-being and job satisfaction, and negatively to burnout and stress. Its role seems to be independent of that of the quality of DRE. |
| Keywords: | well-being, Nomikai, daily recovery experiences, entrepreneurs, small business owners/managers, job satisfaction, burnout, stress, Japan |
| JEL: | I12 I31 L26 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18227 |
| By: | Hamidou Diallo (World Bank); Anne-Sophie Robilliard (IRD, LEDa-DIAL (IRD, CNRS, and PSL Research University), France) |
| Abstract: | Using 37 years of longitudinal data on over 60, 000 children, we examine how rainfall affects child survival in rural Senegal. Two contrasting effects are likely to be at play: a beneficial effect from increased rainfall stemming from improved income and nutrition, and a detrimental effect resulting from a more adverse disease environment. To assess the effects of rainfall on child survival rates, we use highresolution rainfall data matched with discrete-time event data at the person-month level. Our analysis uses two distinct measures of rainfall deviations: one representing rainfall deviations during the previous rainy season, and another for current rainfall deviations. Additionally, we explore the heterogeneity of the impact over different groups. Next, we make use of causes of death data to try and support the interpretation of our main results and, finally, present some tentative simulation results. Our results confirm that the rates of child mortality are influenced by fluctuations in income and nutrition related to rainfall, as well as by the seasonality of the burden of disease. This burden escalates notably during the rainy season, compounded by food scarcity in lean periods. The severity of this stress amplifies when rainfall in the preceding rainy season has been insufficient. We also present simulations of child mortality under different rainfall scenarios, providing a policyrelevant perspective on how future climate variability may affect child survival in semi-arid, rain-fed agricultural settings. |
| Keywords: | Rainfall, Child mortality, Gender, HDSS, Rural Senegal |
| JEL: | I15 J16 Q54 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:dia:wpaper:dt202508 |
| By: | Anand Bhardwaj; Samer Faraj |
| Abstract: | In high stakes organizational contexts like healthcare, artificial intelligence (AI) systems are increasingly being designed to augment complex coordination tasks. This paper investigates how the ethical stakes of such systems are shaped by their epistemic framings: what aspects of work they represent, and what they exclude. Drawing on an embedded study of AI development for operating room (OR) scheduling at a Canadian hospital, we compare scheduling-as-imagined in the AI design process: rule-bound, predictable, and surgeon-centric, with scheduling-as-practiced as a fluid, patient-facing coordination process involving ethical discretion. We show how early representational decisions narrowed what the AI could support, resulting in epistemic foreclosure: the premature exclusion of key ethical dimensions from system design. Our findings surface the moral consequences of abstraction and call for a more situated approach to designing healthcare process-specialized artificial intelligence systems. |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2510.21843 |
| By: | Quivine Ndomo; Elif Naz Kayran; Ilona Bontenbal; Simona Brunnerová; Sarah Tornberg; Mirjam Pot; Selma Kadi; Martin Kahanec |
| Abstract: | This article investigates how migrant labour regimes shape long-term care (LTC) work in Austria, Finland, and Slovakia, amid rising demographic pressures and EU-wide care workforce shortages. Drawing on 39 qualitative interviews with migrant care workers and stakeholders, we apply a layered theoretical framework combining labour process theory and migrant labour regime theory centred on legal dualism, transnationalism, and labour agency to analyse the lived experiences of migrant LTC work. The study reveals how migration, industrial relations, and welfare regimes interact with labour agency to produce segmented and structurally marginal care roles for migrants. Despite divergent pathways into LTC including circular self-employment in Austria, education-based integration in Finland, and informal agency recruitment in Slovakia, all three regimes converge in their reliance on precarious, undervalued migrant labour. Migrant workers navigate these conditions through individualised strategies of resilience and reworking, with limited access to collective representation. Our findings highlight the emergence of niche migrant labour regimes that sustain care provision while reinforcing exclusion from core labour protections. The article contributes to industrial relations scholarship by theorising migrant LTC work as a labour process shaped by legal differentiation, constrained agency, and multi-scalar governance, raising critical questions about equity and sustainability in European care systems. |
| Date: | 2025–10–29 |
| URL: | https://d.repec.org/n?u=RePEc:cel:dpaper:74 |