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 Essays on the Economics of Healthcare and Health written by Laia Bosque Mercader and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Essays in the Economics of Healthcare and Health Insurance written by Bradley Thomas Howells and published by . This book was released on 2011 with total page 218 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation contributes in two distinct ways to our understanding of the economics of healthcare and health insurance. Chapter 2 studies the decision process by which physicians allocate medical treatments to heart attack patients. The approach provides insight into the sources of well documented, but unexplained, disparities across demographic dimensions in health care utilization rates and health outcomes. In the model medical providers know how treatment alternatives affect patient-specific probabilities of three final health outcomes - death, readmission, and survival without readmission - and assign implicit values to each outcome that vary by patient age. The model does well in explaining the joint variation in treatments and outcomes, especially when including unobserved patient heterogeneity. Using decomposition methods, I show that a substantial fraction of gender differences in the use of intensive treatment is explained by a combination of the differences in the relative efficacy of treatment options for female patients, and the smaller implicit weight given to final outcomes of older patients. Chapter 3 explores how reforms to cash-assistance welfare programs in the United States in the mid 1990s acted as a structural shift in the health insurance and employment environment of lower income single mothers and find there may have been unintended consequences for this population's access to health insurance. With a more structured approach than is common in the literature, I estimate short and long run employment and insurance dynamics before and after the reforms. I show that reform reduced use of cash-assistance and increased the probability of employment, but created a less stable employment and health insurance environment. After the reform low income single mothers were less likely to retain the same employment and insurance status over a four month period. Although policy did not target Medicaid eligibility, individuals were less likely to retain Medicaid enrollment over the short and longer run after reform.

Download or read book A Quest for Certainty written by Clarence Rufus Rorem and published by . This book was released on 1982 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book contains essays from the 1930s to 1970s on medical economics and describe efforts to achieve certainty in the costs and quality of health care, especially through group practice, group payment and areawide planning.

Download or read book Medicine and Social Justice written by Rosamond Rhodes and published by Oxford University Press. This book was released on 2012-07-16 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Because medicine can preserve life, restore health and maintain the body's functions, it is widely acknowledged as a basic good that just societies should provide for their members. Yet, there is wide disagreement over the scope and content of what to provide, to whom, how, when, and why. In this unique and comprehensive volume, some of the best-known philosophers, physicians, legal scholars, political scientists, and economists writing on the subject discuss what social justice in medicine should be. Their contributions deepen our understanding of the theoretical and practical issues that run through the contemporary debate. The forty-two chapters in this reorganized second edition of Medicine and Social Justice update and expand upon the thirty-four chapters of the 2002 first edition. Eighteen chapters from the original volume are revised to address policy changes and challenging issues that have emerged in the intervening decade. Twenty-two of the chapters in this edition are entirely new. The treatment of foundational theory and conceptual issues related to access to health care and rationing medical resources have been expanded to provide a more comprehensive and nuanced discussion of the background concepts that underlie distributive justice debates, with global perspectives on health and well-being added. New additions to the section on health care justice for specific populations include chapters on health care for the chronically ill, soldiers, prisoners, the severely cognitively disabled, and the LGBT population. The section devoted to dilemmas and priorities addresses an array of topics that have recently become especially pressing because of new technologies or altered policies. New chapters address questions of justice related to genetics, medical malpractice, research on human subjects, pandemic and disaster planning, newborn screening, and justice for the brain dead and those with profound neurological injury. Reviews of the first edition: "This compilation brings a variety of perspectives, national settings, and disciplinary backgrounds to the topic and provides a unique survey of theoretical and applied thinking about the connections between health care and social justice... Physicians and others interested in this field will find this book an engaging introduction to the theoretical and practical challenges pertaining to social justice and health care." New England Journal of Medicine "Although much work in bioethics has focused on clinical encounters, there has been a current of discussion about questions of social justice for decades-at least since the allocation of access to dialysis was widely understood in the 1960s to be a matter of justice, not of medical judgment. This volume will facilitate heightened awareness and deeper discussion of such issues." JAMA "Impressively, the editors have chosen an array of essays that explore the philosophical and bioethical foundations of distributive justice; review the current practice of rationing and patients' access to care in a number of different countries; highlight the issues raised by various special needs groups; and then wrestle with some dilemmas in assessing priorities in distributing healthcare... This book is an excellent resource. " Doody's

Download or read book Five Essays on the Economics of Health and Health Care written by Gregory Gill Lubiani and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This doctoral dissertation consists of five essays in applied microeconomics with focus on healthcare economics and health services research. The first three are innovative being the first in the health economics literature to investigate different distinct aspects of modeling the economic contents of U.S. physical therapy production using the generalized flexible translog (GTL) dual cost model and iterative seemingly unrelated regression estimation (ISURE) technique. Using the higher frequency (bi-weekly) panel dataset, pair-wise input factor relationships of three distinct labor types are examined for the fast growing industry, which has up to now lacked current economic investigation due to data paucity. Pair-wise factor relationships (isoquant curvature) were investigated for three competing conceptual measures of the elasticity of substitution (own- and cross-price, Allen-Uzawa, Morishima, and shadow), as well as scale economies at constant output. Second, three Pythagorean means (arithmetic, harmonic and geometric) were investigated for appropriateness as the mean expansion point for the GTL model. Finally, statistical tests were conducted indicating that pediatric and adult clinics operate with distinct underlying technologies. The final two essays incorporate health economics and health services, research in the study of patient care decision, as it relates to Do Not Resuscitate (DNR) orders, and the impact of the decision on health outcomes. The DNR papers, using Probit and propensity score research methodologies, are the first to utilize a large, comprehensive patient discharge dataset to provide insights into the potential implications for healthcare policy, patient awareness and care, most notably for the rapidly aging baby-boomer population.

Download or read book Essays on the Economics of Health Care Markets written by Andrew Olenski and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Our findings establish that insurers can affect health care well outside their direct purview, raising the question of how to match their private objectives with their scope of influence.

Download or read book Essays on the Economics of Information Sharing in Healthcare written by Yeongin Kim and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Since the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act to reform the U.S. healthcare system, health information technology (IT) has attracted much attention from researchers, care practitioners, patients, and policy makers. Among various aspects of IT use in healthcare, information sharing has been considered as a key component in improving U.S. healthcare. In spite of numerous efforts to meaningfully use IT for information sharing, inefficiency issues still remain. This dissertation studies the economics of information sharing in healthcare and provides insights to formulate the right mechanisms to achieve the goal of IT-driven healthcare reform. The first essay examines the contract issues between a policy maker and care providers that can cooperate by implementing health information exchanges (HIEs). Using a gametheoretical model, we show that neither the traditional fee-for-service (FFS) payment model nor the pay-for-performance (P4P) models induce socially optimal outcomes, while an episodebased payment (EBP) model we identified induces the socially desirable effort levels and HIEs adoption. We further show that the value of an HIE is the highest under the FFS model and the lowest under the P4P models. Our findings imply that as payment models evolve over time, there is a real need to reevaluate the value of information sharing though HIE and the government policies that induce providers to adopt an HIE. The second essay studies the role of information sharing in formulation of policy instruments under the new risks of providers’ medical ligation owing to health IT. Specifically, we examine the role of information sharing in formulation of policies on healthcare operations in the presence of physicians’ liability concerns by using a game-theoretic model. We find when litigation is a concern, an underprovisioning policy may become optimal under the litigation risk, depending on the benefit and cost of the health service. We further show that strategically controlling the sharing of risk information restores the optimality of a standard policy (non-underprovisioning). The results of this study imply that the widespread practice of information sharing may induce underutilization of care resources to mitigate the medico-legal risks due to health IT. In the last essay, we study the impact of patient portals on treatment outcomes in the context of kidney allocation for transplant. Using a longitudinal data set of kidney transplant cases, we empirically show that with the implementation of patient portals for information sharing, patients are more likely to use care resources (donated kidneys) that are underutilized without access to a patient portal. However, the impact could be heterogeneous on sub-populations. This indicates that the efforts to bridge the digital divide may benefit some groups of patients at the expense of other groups, leading to further service disparities in the care service.

Download or read book Three Essays in the Economics of Health written by Achintya Ray and published by . This book was released on 2004 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Essays on the Economics of Health Care in the United States written by Patricia Kuan-Pei Foo and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: In this dissertation, I study three related topics regarding the economics of health care in the United States. I begin with a broad look at the recent U.S. health care reform law in Chapter 1. In Chapters 2 and 3, I narrow my focus to study the impact of changing either demand-side incentives (Chapter 2) or supply-side incentives (Chapter 3) on the utilization of medical services. In Chapter 1, Wichsinee Wibulpolprasert and I study changes in firms' asset prices around the passage of the ACA by the House of Representatives to identify the long- run expected impact of the reform for a given firm, including general equilibrium effects (e.g., price changes). The ACA includes a wide-reaching set of reforms to ensure more universal and comprehensive health insurance benefits. The bill has the potential to impact U.S. firms through regulations on employer-sponsored insurance (ESI) and general equilibrium effects. Among 321 publicly traded firms from 19 sec- tors (defined by the 2-digit North American Industry Classification System code), we find that firms experienced heterogeneous effects on their asset prices that are consis- tent with predictions from a partial equilibrium analysis of labor market equilibria. Shareholders of firms with a relatively higher proportion of uninsured employees or employees with ESI prior to the reform experienced a negative impact on their asset prices, while shareholders of firms with a relatively higher proportion of employees who would qualify for the Medicaid expansion or who would qualify for premium subsidies on the health insurance exchanges experienced a positive impact on their asset prices. Our results suggest that the ACA's incidence lies partly on shareholders, but that coverage through public insurance or publicly-supported insurance markets is incident on taxpayers or possibly on the employees of the affected firms. In Chapter 2, Mark Cullen and I study the impact of changing demand-side in- centives on the use of generic drugs during an era of slowing prescription drug ex- penditures. We examine the interaction of two factors that have contributed to this trend change: cost-sharing and generic entry. Specifically, we examine a case in which a large, self-insured company introduced prescription drug plans that increased the difference in the marginal price of brand-name and generic drugs between 2004 and 2006. Using prescription drug claims data, we estimate an elasticity of substitution of -0.03. At the same time, we find that approximately 90% of individuals substitute to generics within two years of first-time generic entry, and that the switching decision is not affected by the change in cost-sharing. We discuss potential policy implications of these two divergent substitution patterns. Finally, in Chapter 3, Robin S. Lee, Kyna Fong and I study the effect of changing the price differential for cesarean versus vaginal deliveries paid by commercial insurers to hospitals and physicians on cesarean rates. Using eight years of claims data con- taining negotiated prices, we exploit within-hospital-physician-group price variation arising from contract renegotiations over time. We find that increasing the physician price differential by $100 yields a 0.55 percentage point (1.9%) increase. Increas- ing the hospital price differential by $1000 for births delivered by hospital-exclusive physician groups yields a 1.1 percentage point (3.7%) increase. Our findings have implications for understanding hospital-physician principal-agent problems and for the future of accountable care organizations.

Download or read book Essays on the Economics of Health Care Provision written by Shan Huang and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Essays on the Economics of Health Care Provision written by Thomas P. Hoe and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

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 Insurance written by Natalia Serna and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rising health care costs motivate the use of demand- and supply-side mechanisms to control the consumption of health services, and generate incentives for insurers to engage in risk selection strategies. Using data from the Colombian health care system, I first measure how demand for different health services responds to cost-sharing using a regression discontinuity design. I then study how cost-sharing impacts negotiated service prices between insurers and hospitals using a model of Nash-in-Nash bargaining. Finally, I quantify the impact of risk selection incentives on hospital network breadth using a model of insurer competition in networks. I find that cost-sharing is effective at reducing health care costs, but that consumption reductions happen across necessary and unnecessary services. Counterfactual simulations show that negotiated hospital prices are U-shaped with respect to the coinsurance rate, and minimized at a coinsurance rate of 30 percent. Findings of the model of insurer competition in networks show that insurers engage in risk selection by providing narrow networks. Improving the risk adjustment formula reduces selection incentives and motivates insurers to expand their networks in every health service. Allowing insurers to compete on premiums and networks, shows that price and non-price characteristics of insurance contracts are substitute mechanisms for risk selection.

Download or read book Essays on Labor Economics and Health Care written by David White Silver and published by . This book was released on 2016 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation studies marginal returns to healthcare in a large but under-explored segment of the healthcare sector -- the emergency department (ED). My empirical strategy exploits quasi-random assignment of physicians to coworker teams to generate instruments for case-level inputs based on workplace peer effects. I use time-stamped case-level data on millions of ED visits across New York State from 2005-2013 to infer time-varying coworker groups. In Chapter 1, I find that a physician's peers are influential in determining her pace of work and the intensity with which she treats each patient. I find robust evidence that physicians in fast-paced team environments ration care on other dimensions (tests and spending). I argue that these peer influences largely represent differential levels of peer pressure that a physician faces when working in different team configurations. Peer effects are estimated to be large in this setting, as they have a variance one quarter to one third as large as physician effects within a hospital. In the second chapter, I use peer-induced variation in a physician's intensity of care to estimate impacts on patient outcomes, namely 30-day mortality. Reducing the amount of time and testing that a physician spends on cases leads to increases in mortality among at-risk patients and cases with particularly vague symptoms. Among fast, low-spending physicians, marginal returns to time are high, whereas among slower physicians marginal returns are 0. At first glance, this is strong evidence of diminishing returns to treatment. However, the cross-physician relationship between intensity of care and patient outcomes is flat, suggesting that physicians operate on very different production functions, even within hospitals, and even within a single department of the hospital. Reallocation of time and testing away from slow physicians to fast physicians could produce efficiency gains. I discuss implications for increasingly popular physician-targeted incentives to cut back on wasteful care.

Download or read book Essays on Health and Healthcare Economics written by Sarah Marie Abraham and published by . This book was released on 2018 with total page 156 pages. Available in PDF, EPUB and Kindle. Book excerpt: This thesis consists of three chapters on the economics of health and healthcare. The first and third chapters explore geographic variation in health outcomes within the United States. The second chapter focuses on empirical methods for obtaining causal estimates of treatment effects with an application to healthcare settings. In the first chapter I study geographic variation in health care utilization under two different insurance systems: traditional Medicare and employer-provided private insurance. For each system, I use patient migration as a source of identification combined with empirical Bayes methods to construct optimal linear forecasts for the causal effects of place on utilization. These place effects measure the causal differences in treatment intensity across areas. I find similar levels of variation in the causal place effects for the publicly and privately insured patients, with a correlation of .39 across the two systems. These findings emphasize that insurance systems are affecting the forces that drive the causal component of geographic variation in utilization. In the second chapter, Liyang Sun and I explore event studies, a model for estimating treatment effects using variation in the timing of treatment. Researchers often run fixed effects regressions for event studies that implicitly assume treatment effects are constant across cohorts first treated at different times. In this paper we show that these regressions produce causally uninterpretable estimands when treatment effects vary across cohorts. We propose alternative estimators that identify convex averages of the cohort-specific treatment effects, hence allowing for causal interpretation even under heterogeneous treatment effects. We illustrate the shortcomings of fixed effects estimators in comparison to our proposed estimators through an empirical application on the economic consequences of hospitalization. In the third chapter, Raj Chetty, Michael Stepner, Shelby Lin, Benjamin Scuderi, Nicholas Turner, Augustin Begeron, David Cutler and I use newly available administrative data to quantify the relationship between income and mortality in the United States. Although it is well known that there are significant differences in health and longevity between income groups, debate remains about the magnitudes and determinants of these differences. We use new data from 1.4 billion anonymous earnings and mortality records to construct more precise estimates of the relationship between income and life expectancy at the national level than was feasible in prior work. We then construct new local area (county and metro area) estimates of life expectancy by income group and identify factors that are associated with higher levels of life expectancy for low-income individuals. Our study yields four sets of results. First, higher income was associated with greater longevity throughout the income distribution. The gap in life expectancy between the richest 1% and poorest 1% of individuals was 14.6 years for men and 10.1 years for women. Second, inequality in life expectancy increased over time. Between 2001 and 2014, life expectancy increased by 2.34 years for men and 2.91 years for women in the top 5% of the income distribution, but increased by only 0.32 years for men and 0.04 years for women in the bottom 5%. Third, life expectancy varied substantially across local areas. For individuals in the bottom income quartile, life expectancy differed by approximately 4.5 years between areas with the highest and lowest longevity. Changes in life expectancy between 2001 and 2014 ranged from gains of more than 4 years to losses of more than 2 years across areas. Fourth, geographic differences in life expectancy for individuals in the lowest income quartile were significantly correlated with health behaviors such as smoking, but were not significantly correlated with access to medical care, physical environmental factors, income inequality, or labor market conditions. Life expectancy for low income individuals was positively correlated with the local area fraction of immigrants, fraction of college graduates, and local government expenditures. Additional information on this project is available at https: //healthinequality. org/.

Download or read book Three essays in applied health economics written by Christian Philipp Schmid and published by . This book was released on 2014 with total page 146 pages. Available in PDF, EPUB and Kindle. Book excerpt: