Download or read book Essays on the Economics of Investments in Health written by and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Essays on Health Economics written by Eamon Joseph Molloy and published by . This book was released on 2012 with total page 181 pages. Available in PDF, EPUB and Kindle. Book excerpt: The essays of this dissertation study the effect of alcohol advertising on individual drinking, alcohol firm advertising decisions, and the relationship between education and mortality. The first essay focuses on the possible effects of alcohol advertising on youth drinking. Researchers still disagree about how advertising affects alcohol consumption. This disagreement largely arises because alcohol firms target marketing at people who already drink. Drinkers prefer particular media; firms recognize this and target alcohol advertising at these media. Endogenous targeting of alcohol advertisements presents a challenge for empirically identifying a causal effect of advertising on drinking. In this chapter, I overcome these challenges by leveraging a plausibly exogenous source of variation in advertising exposure, and by utilizing novel data with detailed individual measures of media viewing and alcohol consumption. I adopt three approaches to control for endogeneity bias due to targeting. First, I use average audience characteristics of the media an individual views to capture targeting. Second, I use media fixed effects to directly control for media choice. Third, I exploit variation in advertising exposure due to a 2003 change in an industry-wide rule that governs where firms may advertise. I use the rule change as an instrument for exposure to alcohol advertising. Though the unconditional correlation between advertising and drinking is strong, this relationship is not robust to more rigorous controls for targeting and to the use of an instrumental variables estimator. The results suggest that any effect of alcohol advertising on youth drinking is modest. The second essay studies the effects of the end of the liquor broadcast advertising ban on firm behavior. I study which firms and brands first took advantage of this new medium I study which spirits brands take advantage of the newly available medium of television. I compare the consumer characteristics and market competition of brands that transition to television advertising to those that do not, using two different definitions of television advertising adoption. I model brand-level, yearly television advertising spending and estimate hazard models of the transition to the use of television advertising. I find evidence that competitive pressure correlates with a brand's adoption of the "new" medium. Firms that are dominant in their market are much more likely to adopt television advertising when their competitors possess a larger share of the market. However, I find little evidence that the demographic characteristics (age, gender, race, income, education, magazine reading, and television viewing) and alcohol consumption of a brand's consumers are related to the adoption of television advertising. The results suggest that television advertising in the spirits market may play larger role dividing market shares than growing market size. The third essay revisits the question of whether people live longer if they get more education or if people who get more education have unobservable traits and habits that cause them to live longer. Like previous studies, we use compulsory schooling laws as instruments for education, However, we use better instruments and Panel Study of Income Dynamics data that include each respondent's date and cause of death. We find our compulsory schooling instruments are stronger predictors of education than those used in previous studies. However, relying on within-state variation greatly reduces the predictive power of our instruments, which only weakly predict educational attainment. We model three different measures of mortality: probit models of mortality over 5- and 10-year age spans and continuous-time survival models of the number of months a person lives past forty years of age. We confirm a strong statistical association between education and mortality in all three model types. However, due to the weakness of our instruments, our results are imprecise and provide little useful insight into whether education reduces mortality. We show the relationship between schooling and mortality is strongest for post-secondary education, though there exists little evidence in the literature concerning whether this link is causal.

Download or read book Three Essays on Health Economics written by Seungchul Lee and published by . This book was released on 2010 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Essays in Health Economics written by Anna Elizabeth Hill and published by . This book was released on 2015 with total page 210 pages. Available in PDF, EPUB and Kindle. Book excerpt: My first essay examines the relationship between medical innovation and moral hazard. I examine the behavioral response to one recent medical innovation: the Human Papillomavirus (HPV) vaccine. I use both medical claims and survey data to observe a comprehensive set of variables indicating risky behavior. I use instrumental variables and regression discontinuity designs to account for selection into vaccination and to determine the causal effect of receiving the vaccine on behavior and I find evidence of heterogeneous treatment effects. Results indicate that receiving the vaccine leads to moral hazard in low income adolescents; however the vaccine leads to a reduction in risky behavior in the overall population. My second essay is joint work with John Cawley. We use the American Time Use Survey to examine socioeconomic differences in waiting times. Socioeconomic characteristics are correlated with waiting time for medical care. Low income and publicly insured individuals wait longer than higher income groups and those with private coverage. It could be that lower income respondents are getting care without an appointment or that they experience a lower opportunity cost of time than high income respondents and are therefore showing up earlier to appointments. My third essay is also joint work with John Cawley, we examine the relationship between macroeconomic conditions and health. The majority of previous work on the relationship between economic conditions and health focuses on three categories of outcomes: mortality, health and wellbeing measures and health behaviors. We contribute to the large body of empirical work on the relationship between iii macroeconomic conditions and health by examining a range of behaviors via the American Time Use Survey that provide evidence about both the local labor market effect on the opportunity cost of time-intensive health investments. These health-related behaviors provide evidence about the mechanisms driving the relationship between the macroeconomy and health outcomes. We find that time spent in transit is reduced when the local unemployment rate increases and time spent sleeping increases. We also find mixed evidence on diet and exercise-related activities as well as risky behaviors. iv.

Download or read book Essays on Early Investments in Child Health written by Miriam Wüst and published by . This book was released on 2012 with total page 201 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Essays in Health Economics and Applied Econometrics written by Alden Cheng and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare expenditures account for roughly 20 percent of the US economy, and this number is likely to remain high in the near future as baby boomers age into Medicare. Yet, in spite of high healthcare spending, quality of care varies widely across providers. Reasons for these discrepancies have yet to be explored fully, and given the increasing proliferation of rich healthcare datasets and econometrics tools, this presents an exciting avenue for research. In the first chapter of this thesis, I consider one potential explanation for why competition has not driven low-quality nursing homes out of the market or induced them to increase investments in quality: information frictions. I start by showing that there is huge variation in nursing home quality in California: value-added estimates (validated using a distance-based IV strategy) indicate that one standard deviation higher quality is associated with 2 percent lower risk-adjusted 90-day mortality rate. Yet, despite the high stakes for consumers, structural demand estimates reveal that demand for quality is very low, with patterns of heterogeneity suggesting that information frictions are the most likely explanation. Finally, in counterfactual simulations, I find that eliminating information frictions may reduce nursing home deaths by at least 8 to 28 percent, and potentially even more if supply side responses are taken into account. In the second chapter, I study the estimation of regression discontinuity and regression kink designs with multiple running variables (respectively, MRD and MRK), single-dimensional versions of which have been used for program evaluation in a wide range of settings. In MRD and MRK designs, individuals are assigned different treatments based on whether their values on several observed running variables exceed known thresholds, which aligns with eligibility criteria for numerous healthcare programs (for example, Medicaid eligibility depends on both an income and an asset threshold). However, there is relatively little econometric work studying MRD and essentially none studying MRK, so applied work often analyze each running variable separately using single-dimensional methods. Here, I propose an MRD and MRK estimator that improves upon this applied practice in two ways: first by increasing precision, and second by allowing the researcher to estimate heterogeneous treatment effects. I establish theoretical results for this estimator, and demonstrate its performance in simulations as well as two empirical applications. In the final chapter, I study consumer behavior in the cigarette market. I find that consumers are less responsive to sales taxes compared to excise taxes, in line with a theory of tax salience (since only excise taxes are included in posted prices), but that consumers also appear to learn over time. These results highlight that when consumers are imperfectly informed, notionally equivalent policies may have very different effects as a consequence of small differences in the way they are implemented.

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 on Human Health and Economics of Diseases written by Boris Houenou and published by . This book was released on 2019 with total page 167 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation is an essay on investments in human health, disease control and impacts of disease shocks on economy. In the first chapter, we revisit the causal relationship between parental income and children's diseases symptoms, examining the attenuating role of child nutrition and household sanitation. We employ panel data from the population morbidity surveillance and socio-economic survey in Asembo, Kenya. We specify linear and nonlinear models, correct for sample selection and endogeneity of parental income with children' diseases symptoms and perform a mediation analysis. Lower-income children have a higher number of reported symptoms, and child nutrition and household sanitation attenuate the causal relationship between parental income and children's health in a context where communicable diseases make a substantial share of diseases burden. The second chapter proposes a Bayesian approach to systematically estimate the economic impacts of diseases shocks. The approach is illustrated with the US meat industry shocked by Bovine Spongiform Encephalopathy (BSE), Rift Valley Fever (RVF), and Highly Pathogenic Avian Influenza (HPAI). Farm supply shock harms the most the industry. BSE has the most significant adverse aggregate effects on the beef sector and the industry. Farmers are the most affected for BSE and RVF while for HPAI wholesalers incur the most substantial impact. Consumers are mostly worst off under the scenario analysis, but the distribution differs per affected commodities. Their welfare change under the sensitivity analysis depends on the affected sector. We find that a non-informative prior is a proxy to a medium outbreak while categorizing shocks based on their distributional moments provides detailed outcomes and improves estimation of impacts. The third chapter endogenizes Ebola Virus Disease (EVD) incidence on economy allowing a two-way interaction between the economy and the disease dynamics to study health investment, disease control and learning associated with it. We show that the change in the steady state of economic variables is non-linear and can be non-monotonic. Disease control, and health capital investment increase with a decreasing discount rate as does the output share of disease, although non-monotonically. While the disease-free steady state is parameter-free, a parameter-dependent steady state emerges from the endemic problem.

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 Three Essays in Empirical Health Economics written by Lucile Romanello and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation aims at better understanding the determinants of individual health status. It focuses both on determinants of health investments and external factors impacting directly the health status. Chapter 2 focuses on determinants of the demand for prevention among elderly. During last years, the Retirement Insurance has increased prevention supply, in particular for housing adaptation but the take-up for the program still remains very low. We implement a large field experiment with several incentives in order to determine the nature of demand-side barriers for prevention. We provide evidence that providing information is the main fruitful policy avenue. Chapter 3 evaluates the impact of an information campaign on health demand in Mali. The campaign did not take place in all Malian health districts at the same time and was therefore realized in three waves. We exploit these temporal exogenous variations in order to evaluate the impact of the campaign on health demand. We find that providing information has a strong impact on assisted childbirth and prenatal care rates. Chapter 4 points out that the working environment could lead to large consequences on the health status, in particular on the psychological dimension. We overcome methodological problems linked to endogeneity issues by exploiting the exogenous change of the European legislation that aimed at increasing competition in the energy market. We use unique panel data on workers and provide evidence that organizational changes caused a deterioration of the workers' health outcomes.

Download or read book Essays in Health Economics and Public Finance written by Boris Viktorovich Vabson and published by . This book was released on 2015 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation focuses on topics in health economics and public finance. I deal with questions that have importance for health policy, and that are simultaneously of general economic interest; in particular, I consider the efficiency impact of privatization, the effects of competition in health care markets, and the effects of incomplete contracting and imperfect competition on rates of pass-through to consumers and governments. In Chapter One, I examine the extent to which contracting out by governments yields efficiency improvements, by looking to Medicaid contracting in New York State. To identify the efficiency impact of private, relative to public Medicaid, I exploit involuntary switching between the two; primarily, I leverage age-based rules forcing individuals to switch from private to public Medicaid at 65. I also leverage unique administrative data, which longitudinally tracks individual utilization across the public and private Medicaid settings. I find evidence that private Medicaid yields efficiency improvements, but find no evidence that these improvements are passed on to either governments or patients. Instead, I find that pass-through is substantially limited by incomplete contracting, with plans shifting costs to medical services that remain under government provision. In Chapter Two, I examine the effects of cost-sharing among a previously understudied population-those dually enrolled in Medicaid and Medicare. I leverage an exogenous court ruling that resulted in loss of Medicaid coverage in Tennessee, among 25,000 individuals who had previously been dually-enrolled. This disenrollment resulted in an increase in average cost-sharing rates, from around 0% to around 20%. I find that this cost-sharing increase resulted in a utilization reduction of about 30%, implying an arc-elasticity in spending of about -.2. In Chapter Three, with Mark Duggan and Amanda Starc, we examine how contracts are affected by their generosity, by looking to the Medicare Advantage program. In doing so, we exploit a substantial policy-induced increase in MA reimbursement in metropolitan areas with a population of 250,000 or more relative to MSAs below this threshold. Our findings also reveal that about one-eighth of the additional reimbursement is passed through to consumers in the form of better coverage.

Download or read book Uncertain Times written by Peter J. Hammer and published by Duke University Press. This book was released on 2003-12-08 with total page 373 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume revisits the Nobel Prize-winning economist Kenneth Arrow’s classic 1963 essay “Uncertainty and the Welfare Economics of Medical Care” in light of the many changes in American health care since its publication. Arrow’s groundbreaking piece, reprinted in full here, argued that while medicine was subject to the same models of competition and profit maximization as other industries, concepts of trust and morals also played key roles in understanding medicine as an economic institution and in balancing the asymmetrical relationship between medical providers and their patients. His conclusions about the medical profession’s failures to “insure against uncertainties” helped initiate the reevaluation of insurance as a public and private good. Coming from diverse backgrounds—economics, law, political science, and the health care industry itself—the contributors use Arrow’s article to address a range of present-day health-policy questions. They examine everything from health insurance and technological innovation to the roles of charity, nonprofit institutions, and self-regulation in addressing medical needs. The collection concludes with a new essay by Arrow, in which he reflects on the health care markets of the new millennium. At a time when medical costs continue to rise, the ranks of the uninsured grow, and uncertainty reigns even among those with health insurance, this volume looks back at a seminal work of scholarship to provide critical guidance for the years ahead. Contributors Linda H. Aiken Kenneth J. Arrow Gloria J. Bazzoli M. Gregg Bloche Lawrence Casalino Michael Chernew Richard A. Cooper Victor R. Fuchs Annetine C. Gelijns Sherry A. Glied Deborah Haas-Wilson Mark A. Hall Peter J. Hammer Clark C. Havighurst Peter D. Jacobson Richard Kronick Michael L. Millenson Jack Needleman Richard R. Nelson Mark V. Pauly Mark A. Peterson Uwe E. Reinhardt James C. Robinson William M. Sage J. B. Silvers Frank A. Sloan Joshua Graff Zivin

Download or read book Three Essays in Development Economics written by Lire Ersado and published by . This book was released on 2001 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Essays on Human Capital Investments written by and published by . This book was released on 2014 with total page 144 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 in Health Economics written by Leigh Ann Leung and published by . This book was released on 2012 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: The second essay examines the effect of mortgage debt on health. Homeownership in the U.S. is promoted through the use of financing. These policies improve the liquidity of the housing market and make homeownership more affordable. But it also encourages greater consumption of mortgage debt. Using mortgage loan to value (LTV) as a proxy for financial stress, I show that homeowners with high LTVs are more likely to be in poor health.

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: