Download or read book Essays in Health Economics and Productivity written by Adam Jon Sacarny and published by . This book was released on 2014 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first chapter studies how incentives drive adoption by looking at a technology that generates revenue for hospitals: the practice of submitting detailed documentation about patients. After a 2008 reform, hospitals were able to raise their total Medicare revenue over 2% by always specifying a patient's type of heart failure. I find that hospitals only captured around half of this revenue. The key barrier to take-up is a principal agent problem, since doctors supply the valuable information but are not paid for it. Exploiting the fact that many doctors practice at multiple hospitals, I find that four-fifths of the dispersion in adoption reflects differences in the ability of hospitals to extract documentation from physicians. Hospital adoption is also robustly correlated with the ability to generate survival for heart attack patients and the use of inexpensive survival-raising standards of care. My results suggest that agency conflicts may drive disparities in health care performance more generally. The second chapter (co-authored with Amitabh Chandra, Amy Finkelstein, and Chad Syverson) challenges the conventional wisdom in health economics that large differences in average productivity across hospitals are the result of idiosyncratic, institutional features of the healthcare sector which dull the role of market forces. Strikingly, we find that productivity dispersion in heart attack treatment across hospitals is, if anything, smaller than in narrowly defined manufacturing industries such as ready-mixed concrete. We also find evidence against the conventional wisdom that the healthcare sector does not operate like an industry subject to standard market forces. In particular, we find that hospitals that are more productive at treating heart attacks have higher market shares at a point in time and are more likely to expand over time. These facts suggest that the healthcare sector may have more in common with "traditional" sectors than is often assumed. The third chapter explores whether hospitals change their treatment decisions when they are paid more for certain treatment approaches. I exploit a Medicare reform that altered payment rates depending on whether patients were relatively healthy or sick. Looking at three treatment approaches for lung cancer patients, I demonstrate economically significant own-price elasticities and right-signed cross-price elasticities - though these estimates sometimes lack statistical power and should be interpreted with caution due to concerns about endogeneity. These findings indicate that payment reforms, including movements toward capitation and away from fee-for-service, may have large effects on the intensity of care that patients receive in the hospital.
Download or read book Essays in the Economics of Health and Medical Care written by Victor R. Fuchs and published by New York : National Bureau of Economic Research distributed by Columbia University Press. This book was released on 1972 with total page 272 pages. Available in PDF, EPUB and Kindle. Book excerpt: Collection of essays on the economics of health and health services in the USA - covers supply and demand, budgetary resources, cost and objectives with regard to medical care, and considers wages and income distribution among medical personnel, effects of health care on labour productivity, etc. References and statistical tables.
Download or read book Three Essays in Health Economics written by Brett William Wendling and published by . This book was released on 2006 with total page 406 pages. Available in PDF, EPUB and Kindle. Book excerpt: As medical care becomes an increasingly large share of Gross Domestic Product, understanding the mechanisms for how and why medical care spending is rising becomes increasingly important. Such an evaluation should consider the productivity relationship between medical care and health. An evaluation of medical productivity involves the measurement of medical care input prices, disease treatment output prices, and the productive relationship between medical care inputs and disease treatment health outcomes. Medical care price measurement is complicated by the heterogeneity of services, the role of insurance in negotiating prices, rapid technological advancements in medical care and limited availability of transaction price data. Health outcome prices are difficult to construct because of the difficulty in measuring health outcomes, the heterogeneity of health outcomes, and the messy relationship between consumption goods and health. Finally, in addition to accurate input and output price measurement, a productivity assessment requires a measurable causal relationship between medical care services and health outcomes. To date, all of these requirements have been insurmountable hurdles to assessing the productivity of medical care for the entire United States economy. This dissertation uses the Medical care Expenditure Panel Survey to address the necessary requirements for evaluating the productivity of medical care. The second chapter constructs regional medical care price indices using transaction prices that control for service type heterogeneity. The data employed in the analysis associates the observed medical care spending with the diseases the spending is used to treat. This association is exploited in the third chapter, which constructs medical care treatment prices for twelve of the major health conditions in the United States. The fourth chapter compares the productivity of medical care services used to produce disease treatment health outcomes across insurance types.
Download or read book Essays in Development and Health Economics written by Heather Schofield and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: In this collection of essays I study individuals' health related decision-making and the consequences of those decisions for health and labor market productivity.
Download or read book Essays in Health Economics written by Manhal Ali and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Essays in Health Economics written by Yiwei Chen and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The dissertation is a collection of three essays written on policy issues related to U.S. and Chinese healthcare systems. The first chapter, titled "User-generated Physician Ratings—Evidence from Yelp, " analyzes the effect of user-generated physician ratings from online sources on the healthcare market. They become increasingly popular among consumers, but since consumers typically lack the ability to evaluate clinical quality, it is unclear whether these ratings actually help patients. Using the universe of Yelp physician ratings matched with Medicare claims, I examine what information on physician quality Yelp ratings reveal, whether they affect patients' choices of physician, and how they influence physician behavior. Through text and correlational analysis, I show that although Yelp reviews primarily describe physicians' interpersonal skills, Yelp ratings are also positively correlated with various measures of clinical quality. Instrumenting physicians' average ratings with reviewers' "harshness" in rating other businesses, I find that a one-star increase in physicians' average ratings increases their revenue and patient volume by 1-2%. Using a difference-in-differences strategy, I test whether, in response to being rated, physicians order more substances that are desirable by patients but potentially harmful clinically. I generally do not find that physicians substantially over-prescribe. Overall, Yelp ratings seem to benefit patients—they convey physicians' interpersonal skills and are positively correlated with their clinical abilities, and they steer patients to higher-rated physicians. In the second chapter, titled "Consolidation of Primary Care Physicians and Healthcare Utilization, " (coauthored with Liran Einav, Jonathan Levin, and Jay Bhattacharya from Stanford University) we use administrative data from Medicare to document the massive consolidation of primary care physicians over the last decade, and its impact on patient healthcare utilization. Since patients' decisions to visit large or small organizations are likely endogenous, we employ two research designs that attempt to address this selection and isolate the causal effect of the physician organization size on patient healthcare utilization. The first takes advantage of the heterogeneity in the extent of primary care consolidation across healthcare markets, and the second exploits transitions of physicians across organizations. Our preferred specification suggests that visiting large physician organizations leads to a 16% reduction in the patient's healthcare utilization, and that this reduction is primarily driven by fewer primary care visits and lower number of inpatient admissions. In the third chapter, titled "Effects of Primary Care Management in Rural China, " (coauthored with Hui Ding and Karen Eggleston from Stanford University, Min Yu, Jieming Zhong, Ruying Hu, Xiangyu Chen from Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China, and Chunmei Wang, Kaixu Xie from Tongxiang Center for Disease Control and Prevention, Tongxiang, China) we turn our attention to the Chinese healthcare system. Health systems globally face increasing morbidity and mortality from chronic diseases, yet many—especially in low- and middle-income countries—lack strong primary care. We analyze China's efforts to promote primary care management for insured rural population with chronic disease using unique panel data for over 70,000 Chinese in 2011-2015. Utilizing plausibly exogenous variation in management intensity generated by administrative and geographic boundaries—villages within two kilometers distance but managed by different townships, we find that villagers with hypertension/diabetes residing in a township with more intensive primary care management had more primary care visits, fewer specialist visits, fewer hospital admissions, and lower inpatient spending. No such effects are evident in a placebo treatment year. Exploring the mechanism, we find that patients with more intensive primary care management exhibited better drug adherence. A back-of-the-envelope estimate suggests that the resource savings from avoided inpatient admissions substantially outweigh the costs of the program.
Download or read book Essays in Health Economics written by and published by . This book was released on 2015 with total page 220 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation consists of three essays in health economics related issues. In the first chapter, I estimated health insurance expansion's effects on young adults' employment using MEPS. In 2010 young adults were allowed to stay on their parent's health insurance plan until the age of 26 by a policy change under the ACA. I used a difference-in-differences model to estimate labor supply effects of this policy on young adults. 23-25-year-olds are in the treatment group, and 26-30-year-olds are in the control group. Additionally, I estimated heterogeneity of the policy's labor supply effect by socio-economic groups. I found that extensive and intensive labor supply decreased among males. The effect is greater among men in higher socio-economic group. In the second chapter, I analyzed whether internet use has an effect on patients' mental health using BRFSS data. Over the last decade internet use has become universal. It provides various health related tools and information sources which may affect patients' distress levels in several ways, and health related distress can have large impacts on quality of life. I used variation across states' "right of way" policies during the broadband boom period of 2001-2005. Using rights of way rules' easiness as a proxy for broadband penetration rates, I investigated whether patients' mental health levels changed differently in states with more lenient rights of way rules. I found that among men internet use improves patients' mental health. In the third chapter, I studied labor market effects of the early Medicaid expansions under the ACA in 2010 using data from Current Population Survey. The ACA extends public insurance coverage to low income childless adults, yet we know very little about the effect of a public health insurance extension on childless adults' labor supply. The ACA allowed states to extend Medicaid and a number of states opted in early and extended Medicaid in 2010. I utilized this variation among states to evaluate whether the policy had any effect on childless adults' employment. I found that the policy had no effect on labor supply of the overall population. I found evidence that the policy mainly affected near-retirement-aged childless.
Download or read book Three Essays in Health Economics written by and published by . This book was released on 2004 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation examines topics in health economics. The first study examines the relationship between access to retiree health insurance (RHI) and the decision to leave oneÃØâ'Ơâ"Øs career job. In this paper a Cox Proportional Hazard Model with time varying covariates is utilized to estimate the probability that an individual disengages from their career job, given they have not yet done so. Results indicate that those with access to RHI are significantly more likely to leave their career employer in all time periods than identical individuals without RHI. The second examines the relationship between a householdÃØâ'Ơâ"Øs Food Stamp Program participation, and child overweight and obesity. This paper considers a dynamic process for weight gainÃØâ'Ơ†explicitly modeling the role last periodÃØâ'Ơâ"Øs weight plays in determining this periodÃØâ'Ơâ"Øs weight. Results suggest that FSP participation does not significantly affect the deviation of a childÃØâ'Ơâ"Øs current BMI from the ideal level, indicating that FSP participation does not contribute to child overweight. The results also suggest that children tend toward their medically ideal weight. The third essay considers a related issue. There is a wide body of literature that examines the effect of FSP participation on obesity outcomes for adults and a smaller body of work that examines the same relationship for children. The literature focusing on adults finds that FSP participation is positively related to obesity in women, while work focusing on children fails to find a similar effect. This creates an interesting economic puzzle as most children live in the same household as their mother, and as such, the foods they consume and the effect of that food on their weight are expected to be similar. This paper directly addresses this puzzle, and examines the relationship between a motherÃØâ'Ơâ"Øs Food Stamp Program (FSP) participation, and obesity. Empirical results suggest that motherÃØâ'Ơâ"Øs are less likely to becom.
Download or read book Essays in Health Economics and Health Policy written by Eun Young Kim and published by . This book was released on 2011 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation is a compilation of three essays. The first essay critiques a recent paper by Wilper et al. (2009) for its inappropriate model calibration in analyzing the association of health insurance and mortality. Using the individual-level data from a nationwide survey with more recent mortality follow-up information, it shows that the privately-insured do not significantly fare better in mortality risk compared to the uninsured. Moreover, hazard ratio estimate for the Medicaid suggests that public provision of insurance increases mortality. The second essay addresses the role of income in explaining the differential public health outcomes across developed countries. Noting that the growing arguments for socioeconomic gradient in health are based mostly on cross-sectional studies, panel analyses of five different public health outcomes are conducted. Results demonstrate that economic development remains critical in explaining health improvements at the aggregate level. The third essay analyzes the association of income and health care spending at the aggregate level. Using a large panel data from 24 industrialized nations for more than three decades, the close relationship between income and health care spending is established. In contrast to earlier cross-sectional studies, the panel analysis suggests that health expenditure growth is not as rapid as income growth in almost all nations.
Download or read book Three Essays in Health Economics written by Anna Choi and published by . This book was released on 2015 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation contains three essays in the field of health economics and health policy. The first essay studies the effects of legalizing medical use of marijuana on marijuana use and other risky health behaviors. I examine the restricted-use data from the National Survey of Drug Use and Health (NSDUH), which is a repeated cross sectional data set with state identifiers from 2004 to 2012. During this period, 9 states and Washington D.C. allowed patients with medical conditions to use marijuana. I estimate difference-in-differences (DID) models to examine the impacts of these policy changes on risky health behaviors. Allowing medical use of marijuana does not lead to higher marijuana use among the overall population and the youth. However, I find that medical marijuana laws (MMLs) are positively and significantly associated with marijuana use among males and heavy pain reliever users. The second essay is a joint work with John Cawley and tests a novel hypothesis: that these health disparities across education are to some extent due to differences in reporting error across education. We use data from the pooled National Health and Nutrition Examination Survey (NHANES) Continuous for 1999-2012, which include both self-reports and objective verification for an extensive set of health behaviors and conditions, including smoking, obesity, high blood pressure, high cholesterol and diabetes. We find that better educated individuals report their health behaviors more accurately. This is true for a wide range of behaviors and conditions, even socially stigmatized ones like smoking and obesity. We show that the differential reporting error across education leads to underestimates of the true health disparities across education that average 19.3%. The third essay is a joint work with Rachel Dunifon and studies how state regulations related to the quality of child care centers-such as teachers' education and degree requirements, staff to child ratios, maximum group size, and unannounced inspection compliance requirement-are predictive of children's health, developmental and cognitive outcomes. State level policies that are related to improving the productivity of child care center teachers by having a higher staff to child ratios and advanced schooling requirement are predictive of child's weight related outcomes and cognitive outcomes.
Download or read book Three Essays on Health Economics written by Mojisola O. A. Tayo and published by . This book was released on 2016 with total page 241 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation consists of three essays examining topics in health economics. The first essay examines the impact of education on 10-year mortality rates of minorities in the United States. I use the states' compulsory education laws to instrument the level of education in my cohort study of the effect of education on the mortality rates of minority groups (Blacks, Asians and Hispanics) born in the early twentieth century. I find that an increase in years of education significantly decreases the mortality rates for the White and Black populations, but not for the Asian and Hispanic populations. The second essay explores the effect of education on adult self-reported health (SRH), health behaviors (smoking, seatbelt use, and exercise), and health outcomes (body mass index (BMI), hypertension, and heart attack) by race and ethnicity using Medical Expenditure Panel Survey (MEPS) data from 2001-2011. I find racial and ethnic disparities in the education gradient on SRH that remain significant after controlling for income and other economic factors. I explore the pathway through which education influences health using three different econometric methods to estimate a causal effect. I find that education directly affects health behaviors and that health behaviors directly affect health outcomes including SRH, leading to an indirect impact of education on SRH. My third essay is written in collaboration with my adviser, Dr. Virginia Wilcox-Gok. We use the National Comorbidity Survey Baseline (NCS-1) dataset from 1990-1992 and O*NET (Occupational Information Network) to explore whether individuals diagnosed with depression before age 22 self-select as adults into occupations that accommodate their depressive disorders. Depressive disorder is a health problem that can start very early on in life, so it often limits educational attainment and adult earning. It is also a disorder that can be helped if diagnosed early. Because individuals with chronic depression may need more flexibility and less stress in the workplace to cope with their disorder, their adult occupational choice may depend on how accommodating the occupation's characteristics are to this disorder. We find that women with early-onset depressive disorder are more likely to be employed full time than men, while both men and women are likely to choose self-employment. Men with more frequent depressive episodes are less likely than women to choose occupations requiring higher levels of education, experience, and training. In contrast, women with early onset depressive disorder are more likely than men to take jobs in the service sector.
Download or read book Contemporary Health Economics Essays written by Shastri Pandey and published by . This book was released on 2023-08-11 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Contemporary Health Economics Essays" by Shastri Pandey offers a comprehensive exploration of the dynamic intersection between economics and modern healthcare systems. With a meticulous blend of insightful analysis and empirical research, Pandey delves into the pressing issues that shape health economics in today's world. This collection of essays presents a thought-provoking journey through topics such as healthcare policy reform, cost-effectiveness analysis, insurance market dynamics, and the role of technology in shaping healthcare delivery. Pandey's incisive writing elucidates the intricate relationships between economic principles, public health, and healthcare outcomes, shedding light on the challenges and opportunities faced by policymakers, practitioners, and researchers. Through rigorous examination and lucid exposition, Pandey navigates the reader through the complexities of health economics, unraveling its impact on healthcare accessibility, affordability, and quality. Drawing from a rich array of data and contemporary case studies, the author stimulates critical thinking about the choices and trade-offs inherent in healthcare resource allocation. "Contemporary Health Economics Essays" is an indispensable resource for students, scholars, and professionals seeking a deep understanding of the evolving landscape of health economics. Shastri Pandey's authoritative voice provides fresh perspectives, paving the way for informed discussions and evidence-based decisions that shape the future of healthcare worldwide.
Download or read book Essays in the Economics of Health Policies written by Yves Arrighi and published by . This book was released on 2013 with total page 143 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation aims at improving our understanding of the links between health and wealth, and between health programs and macroeconomic outcomes. Because the former might be bi-directional, it seemed sensible to tackle this issue for each direction of the causality. In the 1st paper, I examine using microsimulation the financial solvability of alternative policies against HIV. Health improvements at the individual level generate productivity gains which translate into an economic surplus that outweighs programs' costs. In the 4th paper, I examine the relationship between child health and social background using an international survey. Analysis reveals a substantial gradient in health: across the globe, poorer children have worse health. Yet, the effect of wealth is moderated by country-level income and health-supply variables. The two other papers focus on rather methodological issues raised by the fact that curative programs save lives but increase the prevalence of the disease. One study highlights that average income could fall if treatments cannot guarantee a sufficient level of productivity among sick workers. Despite this adverse effect, the microsimulation model demonstrates that treatment policies can raise per capita income in the context of HIV. The 3rd paper of the thesis extends this message to welfare measurement. By restricting attention to the living population, standard indicators of welfare ignore the fact that individuals who would otherwise be dead can be kept alive through treatment, but with a lower than average welfare. Cross-country comparisons based on indicators that are made invariant to the population size may therefore be biased.
Download or read book Essays in Health Economics written by Gabriel Alejandro Facchini Palma and published by . This book was released on 2017 with total page 73 pages. Available in PDF, EPUB and Kindle. Book excerpt: This aims at better understanding the drivers behind the volume-outcome relationship found in many studies in the medical and health-economics literature. In the first chapter I investigate the relationship between workload and choice of treatment. Using detailed microdata on childbirth, I exploit a quasi-random assignment of patients attempting to have a natural delivery to different ratios of patients-to-midwives and compare their likelihood of changing delivery method. I find that women who face a ratio higher than 1.33 are 34% more likely to give birth by cesarean section (C-sections). This effect is larger for patients who were already admitted with a higher risk of C-section, since provision of proper and timely care matters more for these patients. Because C-sections are faster than vaginal deliveries, the medical team may find it appealing to do more C-sections when time constrained. Using civil status as a proxy for bargaining power -assuming single women are on average more likely to be alone -, I find that only single patients are subjected to unnecessary surgery. The second chapter documents the existence of `learning-by-doing' effects in physicians' performance. More specifically, I test whether cesarean-section surgeons who have performed more procedures in the recent-past observe an improvement in performance. By using data from the Italian health care system, where patients are not allowed to choose a physician, I eliminate concerns regarding possible bias from selective referral -a problem in previous studies. Using four years of birth certificates data from one large hospital I find that, for emergent cases, performing one additional procedure reduces the likelihood of neonatal intensive care unit admission by nearly 1.2 percentage points (5.5%) and of being born with a low Apgar Score by about 1.1 percentage points (10%), all else equal.
Download or read book Three Essays in Health Economics written by Abraham Abebe Asfaw and published by . This book was released on 2017 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation constitutes three separate essays in health economics. The first essay examines whether Medicare Part D led to changes in the health behaviors that are essential to manage chronic diseases. Using data from the Medical Expenditure Panel Survey, I find that the implementation of Medicare Part D reduces the probability of engaging in physical exercise. The effect on dieting is inconsistent across different specifications and the effect on cigarette smoking is not statistically significant. The negative physical exercise effect of Medicare Part D is more pronounced among patients with low educational attainment. The second essay looks into whether early health shocks persist to cause health inequality across generations. Linking the Ethiopian Socioeconomic Survey with the 1984 Ethiopian Census, I show that in utero and early childhood( age 0-3) exposure to the 1983-85 Ethiopian famine increases the probability of stunting and reduces the height-for-age z-score of the next generation. Estimates that account for the fertility response, infant and fetal culling effects of famine indicate that the baseline estimate represents the lower bound of the total effect of the famine. Linking a village-level interpolated rainfall data to a child-level longitudinal survey--- the Ethiopian Rural Household Survey--the final essay explores whether the child health effects of drought vary across child health distribution. The correlated random effect (CRE) quantile regression for panel data model estimates shows that negative mean deviation from district-level long-term average rainfall reduces the weight-for-height and weight-for-age z-scores of children at the lower end of the anthropometric distributions. Examination of the channel of transmission indicates that the incidence of drought increases the incidence of illness and reduces per-capita consumption expenditure, and the time spent on domestic work among poor households.
Download or read book Essays in Health Economics microform written by Julia Catherine Witt and published by Library and Archives Canada = Bibliothèque et Archives Canada. This book was released on 2005 with total page 258 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Determinants of Health written by Michael Grossman and published by Columbia University Press. This book was released on 2017-08-08 with total page 811 pages. Available in PDF, EPUB and Kindle. Book excerpt: This collection of Michael Grossman’s most important papers adds essential background and depth to his work on economic determinants of public health. Each of the book’s four sections includes an introduction that contextualizes the issues and addresses the larger stakes of his work. An afterword discusses the significance of Grossman’s approach for subsequent research on health economics, as well as the work others have done to advance and extend his innovative perspective. Determinants of Health explains how the economic choices people make influence health and health behaviors. It begins with a section on the theoretical underpinnings and empirical results of Grossman’s groundbreaking health economics model, first introduced in the 1970s, followed by essays on the relationship between health and schooling; determinants of infant health, with a special emphasis on public policies and programs; and the economics of unhealthy behaviors. Grossman treats health as a form of human capital. He shows that public policies and programs that determine the price and availability of key inputs have critical effects on outcomes ranging from birth weight and infant mortality to cigarette smoking, alcohol abuse, illegal drug use, and obesity. Grossman’s approach has led to a major stream of literature in the field, sparking contributions by the world’s leading health economists, including Joseph Newhouse, Jonathan Gruber, Amy Finkelstein, Michael Greenstone, and David Cutler. His clarity on the role that economics play in people’s good and bad health choices is immensely valuable to the debate over how we legislate and spend on health.
