Dynamic hospital competition under rationing by waiting times
Publication date: Available online 19 June 2019Source: Journal of Health EconomicsAuthor(s): Luís Sá, Luigi Siciliani, Odd Rune StraumeAbstractWe develop a dynamic model of hospital competition where (i) waiting times increase if demand exceeds supply; (ii) patients choose a hospital based in part on waiting times; and (iii) hospitals incur waiting time penalties. We show that, whereas policies based on penalties will lead to lower waiting times, policies that promote patient choice will instead lead to higher waiting times. These results are robust to different game-theoretic solution concepts, designs of th...
Source: Journal of Health Economics - June 19, 2019 Category: Health Management Source Type: research

Just what the nurse practitioner ordered: Independent prescriptive authority and population mental health
Publication date: July 2019Source: Journal of Health Economics, Volume 66Author(s): Diane Alexander, Molly SchnellAbstractWe examine whether relaxing occupational licensing to allow nurse practitioners (NPs)—registered nurses with advanced degrees—to prescribe medication without physician oversight improves population mental health. Exploiting time-series variation in independent prescriptive authority for NPs from 1990 to 2014, we find that broadening prescriptive authority leads to improvements in self-reported mental health and decreases in mental health–related mortality. These improvements are concen...
Source: Journal of Health Economics - June 19, 2019 Category: Health Management Source Type: research

How effective are pictorial warnings on tobacco products? New evidence on smoking behaviour using Australian panel data.
Publication date: Available online 15 June 2019Source: Journal of Health EconomicsAuthor(s): Daniel KuehnleAbstractStudies examining the introduction of pictorial warnings on cigarette packages provide inconclusive evidence due to small samples and methodological issues. We use individual-level panel data from Australia to examine the association between pictorial warnings and smoking behaviour – prevalence, quitting, initiating and relapsing. The pictorial warnings were accompanied by a reference to a smoking cessation helpline and supportive television commercials. Applying an event study framework, we show that th...
Source: Journal of Health Economics - June 16, 2019 Category: Health Management Source Type: research

Does Children's Education Matter for Parents’ Health and Cognition? Evidence from China
Publication date: Available online 14 June 2019Source: Journal of Health EconomicsAuthor(s): Mingming MaAbstractIntergenerational transmission of human capital from parents to offspring is widely documented. However, whether there are upward spillovers from children to parents remains understudied. This paper uses data from the China Health and Retirement Longitudinal Study to estimate the causal impact of educational attainment of children on various health and cognition outcomes of older parents. Identification is achieved by using the exposure of children to the compulsory education law in China and its interaction with...
Source: Journal of Health Economics - June 15, 2019 Category: Health Management Source Type: research

Parallel imports, price controls, and innovation
Publication date: July 2019Source: Journal of Health Economics, Volume 66Author(s): Markus Reisinger, Lluís Saurí, Hans ZengerAbstractThe impact of parallel trade on innovation in R&D-intensive industries, such as pharmaceuticals, is a hotly debated question in antitrust and IP policy. The well-known argument that parallel trade dampens innovation by undermining firms’ ability to price discriminate has been challenged by recent literature. The argument is that with endogenous price controls, parallel trade increases innovation by reducing governments’ incentives to set particularly low price c...
Source: Journal of Health Economics - June 13, 2019 Category: Health Management Source Type: research

Do Report Cards Predict Future Quality? The Case of Skilled Nursing Facilities
Publication date: Available online 24 May 2019Source: Journal of Health EconomicsAuthor(s): Momotazur RahmanAbstractReport cards on provider performance are intended to improve consumer decision-making and address information gaps in the market for quality. However, inadequate risk adjustment of report-card measures often biases comparisons across providers. We test whether going to a skilled nursing facility (SNF) with a higher star rating leads to better quality outcomes for a patient. We exploit variation over time in the distance from a patient’s residential ZIP code to SNFs with different ratings to estimate the...
Source: Journal of Health Economics - June 1, 2019 Category: Health Management Source Type: research

Data Transformations to Improve the Performance of Health Plan Payment Methods
We present a general economic model that incorporates the previously overlooked two-way relationship between health plan payment and insurer actions. We then demonstrate our systematic approach for data transformations in two Medicare applications: underprovision of care for individuals with chronic illnesses and health care disparities by geographic income levels. Empirically comparing our method to two other common approaches shows that the “side effects” of these approaches vary by context, and that data transformation is an effective tool for addressing misallocations in individual health insurance markets....
Source: Journal of Health Economics - May 26, 2019 Category: Health Management Source Type: research

Do Report Cards Predict Future Quality?The Case of Skilled Nursing Facilities
Publication date: Available online 24 May 2019Source: Journal of Health EconomicsAuthor(s): Momotazur RahmanAbstractReport cards on provider performance are intended to improve consumer decision-making and address information gaps in the market for quality. However, inadequate risk adjustment of report-card measures often biases comparisons across providers. We test whether going to a skilled nursing facility (SNF) with a higher star rating leads to better quality outcomes for a patient. We exploit variation over time in the distance from a patient’s residential ZIP code to SNFs with different ratings to estimate the...
Source: Journal of Health Economics - May 26, 2019 Category: Health Management Source Type: research

Impacts of shifting responsibility for high-cost individuals on Health Insurance Exchange plan premiums and cost-sharing provisions
Publication date: Available online 23 May 2019Source: Journal of Health EconomicsAuthor(s): Miaomiao ZouAbstractInsurance companies can respond to increases in expected per-capita healthcare expenditures by adjusting premiums, cost-sharing requirements, and/or plan generosity. We use a Difference-in-Difference model with Plan-level Fixed Effects to estimate the impacts of increases in expected expenditures generated by closure of state-operated High Risk Pools (HRPs). For Silver plans, we find that issuers responded to HRP closures by increasing both premiums and deductibles, and by increasing the ratios of premiums to ded...
Source: Journal of Health Economics - May 24, 2019 Category: Health Management Source Type: research

Birth Weight and Vulnerability to a Macroeconomic Crisis
Publication date: Available online 23 May 2019Source: Journal of Health EconomicsAuthor(s): Prashant Bharadwaj, Jan Bietenbeck, Petter Lundborg, Dan-Olof RoothAbstractThis paper shows that early-life health is an important determinant of labor market vulnerability during macroeconomic downturns. Using data on twins during Sweden's crisis of the early 1990s, we show that individuals with higher birth weight are differentially less likely to receive unemployment insurance benefits after the crisis as compared to before it, and that this effect is concentrated among workers in the private sector. While differences in early-li...
Source: Journal of Health Economics - May 24, 2019 Category: Health Management Source Type: research

Competition and physician behaviour: Does the competitive environment affect the propensity to issue sickness certificates?
Publication date: Available online 21 May 2019Source: Journal of Health EconomicsAuthor(s): Kurt R. Brekke, Tor Helge Holmås, Karin Monstad, Odd Rune StraumeAbstractCompetition among physicians is widespread, but compelling empirical evidence on its impact on service provision is limited, mainly due to endogeneity issues. In this paper we exploit that many GPs, in addition to own practice, work in local emergency centres, where the matching of patients to GPs is random. The same GP is observed both with competition (own practice) and without (emergency centre). Using high-dimensional fixed-effect models, we find that...
Source: Journal of Health Economics - May 22, 2019 Category: Health Management Source Type: research

The Effect of Paid Family Leave on Infant and Parental Health in the United States
Publication date: Available online 16 May 2019Source: Journal of Health EconomicsAuthor(s): Lindsey Rose BullingerAbstractCalifornia’s paid family leave (PFL) policy improved mothers’ labor market outcomes, however, the health impacts of this program are less studied. I compare child and parental health of likely eligible households to a series of control groups before and after California’s PFL program was implemented. I find improvements in parent-reported overall child health and suggestive improvements in maternal mental health status. Findings also suggest a reduction in asthma and a greater likeliho...
Source: Journal of Health Economics - May 16, 2019 Category: Health Management Source Type: research

E-Cigarette Minimum Legal Sale Age Laws and Traditional Cigarette Use among Rural Pregnant Teenagers
Publication date: Available online 13 May 2019Source: Journal of Health EconomicsAuthor(s): Michael F. Pesko, Janet M. CurrieAbstractTeenagers under 18 could legally purchase e-cigarettes until states passed minimum legal sale age laws. These laws may have curtailed teenagers' use of e-cigarettes for smoking cessation. We investigate the effect of e-cigarette minimum legal sale age laws on prenatal cigarette smoking and birth outcomes for underage rural teenagers using data on all births from 2010 to 2016 from 32 states. We find that the laws increased prenatal smoking in by 0.6 percentage points (pp) overall. These effect...
Source: Journal of Health Economics - May 14, 2019 Category: Health Management Source Type: research

Teen driver licensure provisions, licensing, and vehicular fatalities
In this study, separate GDL provisions and no pass, no drive laws are studied to understand reduction mechanisms. The evaluation is based on a state-by-year panel and uses difference-in-difference and triple-difference specifications to identify causal impacts on rates of licensing, vehicular fatalities, and fatalities per licensee.The empirical results find that the minimum intermediate licensing age of 16.5 or older provision reduces licensing of 16- to 17-year-old teens by 20.1%, and no other licensure provision consistently impacts licensing. In addition, vehicular fatalities decrease from the minimum intermediate lice...
Source: Journal of Health Economics - May 12, 2019 Category: Health Management Source Type: research

The willingness to pay for health improvement under comorbidity ambiguity
This study examines the conditions under which the willingness to pay for health improvement is larger with comorbidity ambiguity than without it. This study also examines the effect of changes in ambiguity and ambiguity aversion on the willingness to pay. (Source: Journal of Health Economics)
Source: Journal of Health Economics - May 10, 2019 Category: Health Management Source Type: research

The effect of retirement on elderly cognitive functioning
This article estimates the short-term effect of retirement on cognitive performance of elderly Australians by exploiting the exogenous variation in retirement decisions induced by changes in social security eligibility rules. The empirical results show that on average retirement has a negative but modest effect on cognition, and the rate of cognitive decline with age is greater for men than women. The results for women display no significant effects on working memory and speed of information processing. The article further adds to the literature by providing evidence on the possible mechanisms through which retirement coul...
Source: Journal of Health Economics - May 10, 2019 Category: Health Management Source Type: research

Minimum unit prices for alcohol
Publication date: July 2019Source: Journal of Health Economics, Volume 66Author(s): Paul CalcottAbstractMinimum unit prices (MUPs) have been proposed on the grounds that they can reduce alcohol consumption of the heaviest drinkers, without significantly burdening moderate drinkers. This paper examines the case for MUPs in an optimal tax framework. Such a policy can improve welfare when two conditions are both satisfied. First, beverage quality and quantity should be substitutes. Second, there should be more distortion to consumption of cheaper alcohol than to more expensive varieties. The consequences of a MUP for the opti...
Source: Journal of Health Economics - May 10, 2019 Category: Health Management Source Type: research

Sunset time and the economic effects of social jetlag: evidence from US time zone borders
This study uses a spatial regression discontinuity design to estimate the economic cost of the misalignment between social and biological rhythms arising at the border of a time-zone in the presence of relatively rigid social schedules (e.g., work and school schedules). Exploiting the discontinuity in the timing of natural light at a time-zone boundary, we find that an extra hour of natural light in the evening reduces sleep duration by an average of 19 minutes and increases the likelihood of reporting insufficient sleep. Using data drawn from the Centers for Disease Control and Prevention and the US Census, we find that t...
Source: Journal of Health Economics - April 28, 2019 Category: Health Management Source Type: research

Health-Related Life Cycle Risks and Public Insurance
Publication date: Available online 25 April 2019Source: Journal of Health EconomicsAuthor(s): Daniel KemptnerAbstractBased on a dynamic life cycle model, this study analyzes health-related risks of consumption and old-age poverty. The model allows for health effects on employment risks, on productivity, on longevity, the correlation between health risks, productivity and preferences, and the financial incentives of the German public insurance schemes. The estimation uses data on male employees and an extended Expectation-Maximization algorithm. Simulations suggest that health shocks induce average losses in annual consumpt...
Source: Journal of Health Economics - April 25, 2019 Category: Health Management Source Type: research

Childhood Health Shocks, Comparative Advantage, and Long-Term Outcomes: Evidence from the Last Danish Polio Epidemic
Publication date: Available online 23 April 2019Source: Journal of Health EconomicsAuthor(s): Miriam Gensowski, Torben Heien Nielsen, Nete Munk Nielsen, Maya Rossin-Slater, Miriam WüstAbstractThis paper examines the long-term effects of childhood disability on individuals’ educational and occupational choices, late-career labor market participation, and mortality. We merge medical records on children hospitalized with poliomyelitis during the 1952 Danish epidemic to census and administrative data, and exploit quasi-random variation in paralysis incidence in this population. While childhood disability increases t...
Source: Journal of Health Economics - April 25, 2019 Category: Health Management Source Type: research

Uterus at a Price: Disability Insurance and Hysterectomy
Publication date: Available online 23 April 2019Source: Journal of Health EconomicsAuthor(s): Elliott Fan, Hsienming Lien, Ching-to Albert MaAbstractTaiwanese Labor, Government Employee, and Farmer Insurance programs provide 5 to 6 months of salary to enrollees who undergo hysterectomies or oophorectomies before their 45th birthday. These programs create incentives for more and earlier treatments, referred to as inducement and timing effects. Using National Health Insurance data between 1997 and 2011, we estimate these effects on surgery hazards by difference-in-difference and bunching-smoothing polynomial methods. For Gov...
Source: Journal of Health Economics - April 23, 2019 Category: Health Management Source Type: research

Sunset Time and the Economic Effects of Social Jetlag Evidence from US Time Zone Borders
This study uses a spatial regression discontinuity design to estimate the economic cost of the misalignment between social and biological rhythms arising at the border of a time-zone in the presence of relatively rigid social schedules (e.g., work and school schedules). Exploiting the discontinuity in the timing of natural light at a time-zone boundary, we find that an extra hour of natural light in the evening reduces sleep duration by an average of 19 minutes and increases the likelihood of reporting insufficient sleep. Using data drawn from the Centers for Disease Control and Prevention and the US Census, we find that t...
Source: Journal of Health Economics - April 14, 2019 Category: Health Management Source Type: research

[Job] Locked and [Un]loaded: The effect of the Affordable Care Act dependency mandate on reenlistment in the U.S. Army
Publication date: May 2019Source: Journal of Health Economics, Volume 65Author(s): Michael S. Kofoed, Wyatt J. FrasierAbstractOne concern with employer-based health insurance is job lock or the inability for employees to leave their current employment for better opportunities for fear of losing benefits. We use the implementation of the Affordable Care Act's dependency mandate as a natural experiment. Data from the United States Army overcome some limitations in previous studies including the ability to examine workers with fixed contract expiration dates, uniform pay, and health coverage. We find that the ACA decreased re...
Source: Journal of Health Economics - April 13, 2019 Category: Health Management Source Type: research

Graded Return-to-Work as a Stepping Stone to Full Work Resumption
Publication date: Available online 6 April 2019Source: Journal of Health EconomicsAuthor(s): Lieke Kools, Pierre KoningAbstractWhile there is increasing evidence that graded return-to-work is an effective tool for the rehabilitation of sick-listed workers, little is known on the optimal timing and level of grading in return-to-work trajectories. We use administrative data from a Dutch private workplace reintegration provider to fill this gap. In order to correct for the selection bias inherent to the evaluation of activation strategies, we exploit the discretionary room of the case managers in setting up treatment plans. W...
Source: Journal of Health Economics - April 8, 2019 Category: Health Management Source Type: research

Stubbing out hypothetical bias: improving tobacco market predictions by combining stated and revealed preference data
Publication date: Available online 2 April 2019Source: Journal of Health EconomicsAuthor(s): John Buckell, Stephane HessAbstractIn health, stated preference data from discrete choice experiments (DCEs) are commonly used to estimate discrete choice models that are then used for forecasting behavioral change, often with the goal of informing policy decisions. Data from DCEs are potentially subject to hypothetical bias. In turn, forecasts may be biased, yielding substandard evidence for policymakers. Bias can enter both through the elasticities as well as through the model constants. Simple correction approaches exist (using ...
Source: Journal of Health Economics - April 3, 2019 Category: Health Management Source Type: research

Sick of retirement?
Publication date: Available online 1 April 2019Source: Journal of Health EconomicsAuthor(s): Nick Fabrin NielsenAbstractThis paper examines the causal effect of retirement on health and healthcare utilization using two identification strategies on Danish full population data. First, I use a reform of the statutory retirement age in an IV design. Second, I use a large discontinuity in retirement take-up at the earliest age of retirement (60) in a regression discontinuity design. The results show that early retirement leads to decreases in GP visits and hospitalizations of 8-10% in the short run. The reduction in GP visits i...
Source: Journal of Health Economics - April 2, 2019 Category: Health Management Source Type: research

[Job] Locked and [Un]loaded The Effect of the Affordable Care Act Dependency Mandate on Reenlistment in the U.S. Army
Publication date: Available online 30 March 2019Source: Journal of Health EconomicsAuthor(s): Michael S. Kofoed, Wyatt J. FrasierAbstractOne concern with employer-based health insurance is job lock or the inability for employees to leave their current employment for better opportunities for fear of losing benefits. We use the implementation of the Affordable Care Act's dependency mandate as a natural experiment. Data from the United States Army overcome some limitations in previous studies including the ability to examine workers with fixed contract expiration dates, uniform pay, and health coverage. We find that the ACA d...
Source: Journal of Health Economics - April 1, 2019 Category: Health Management Source Type: research

Reference Pricing: The Case of Screening Colonoscopies
Publication date: Available online 29 March 2019Source: Journal of Health EconomicsAuthor(s): Marion Aouad, Timothy T. Brown, Christopher M. WhaleyAbstractWe study the introduction of reference pricing to the California Public Employees’ Retirement System. Reference pricing changes the relative price of using a hospital versus an ambulatory surgery center (ASC) for patients receiving a colonoscopy, leading to as good as random variation in patients’ use of ASCs. We find a 10 percentage point increase in the share of patients using an ASC, leading to a $2300 to $1700 reduction in prices paid for patients who swi...
Source: Journal of Health Economics - March 31, 2019 Category: Health Management Source Type: research

Weight, Reference Points, and the Onset of Eating Disorders
Publication date: Available online 30 March 2019Source: Journal of Health EconomicsAuthor(s): Tiziano Arduini, Daniela Iorio, Eleonora PatacchiniAbstractWe investigate whether the development of eating disorders, in the form of purging, is influenced by peers’ body size through interpersonal comparisons. Using detailed information on recent cohorts of U.S. teenagers, we document a sizeable and significant negative effect of high school peers’ body mass index (BMI) on purging behavior during the adolescence for females, but not for males. Interpersonal comparisons operate through the formation of a distorted sel...
Source: Journal of Health Economics - March 31, 2019 Category: Health Management Source Type: research

Editorial Board
Publication date: March 2019Source: Journal of Health Economics, Volume 64Author(s): (Source: Journal of Health Economics)
Source: Journal of Health Economics - March 27, 2019 Category: Health Management Source Type: research

Inter-brand Competition in the Convenience Store Industry, Store Density and Healthcare Utilization
Publication date: Available online 25 March 2019Source: Journal of Health EconomicsAuthor(s): Hung-Hao Chang, Chad D. MeyerhoeferAbstractWe investigate the impact of access to convenience stores and competition between convenience store chains on the use of medical care in Taiwan. Using insurance claims from 0.85 million individuals and administrative data on store sales, we find that greater store density and more inter-brand competition reduced expenditures on outpatient medical services and prescription drugs. In support of these findings, we demonstrate that convenience store competition was associated with greater con...
Source: Journal of Health Economics - March 27, 2019 Category: Health Management Source Type: research

Physician altruism and moral hazard: (no) evidence from Finnish national prescriptions data
Publication date: Available online 19 March 2019Source: Journal of Health EconomicsAuthor(s): Giovanni Crea, Matteo M. Galizzi, Ismo Linnosmaa, Marisa MiraldoAbstractWe test the physicians’ altruism and moral hazard hypotheses using a national panel register containing all 2003-2010 statins prescriptions in Finland. We estimate the likelihood that physicians prescribe generic versus branded versions of statins as a function of the shares of the difference between what patients have to pay out of their pocket and what is covered by the insurance, controlling for patient, physician, and drug characteristics. We find th...
Source: Journal of Health Economics - March 21, 2019 Category: Health Management Source Type: research

Cash on delivery: Results of a randomized experiment to promote maternal health care in Kenya
Publication date: May 2019Source: Journal of Health Economics, Volume 65Author(s): Karen A. Grépin, James Habyarimana, William JackAbstractWe conducted a randomized controlled experiment to test whether vouchers, cash transfers, and SMS messages were effective in boosting facility delivery rates among poor, pregnant women in rural Kenya. We find a strong effect of the full vouchers and the conditional cash transfers: 48% of women with access to both interventions delivered in a health facility, while only 36% of those with neither did. Amongst women who did not receive a cash transfer, we find that a small copayment...
Source: Journal of Health Economics - March 15, 2019 Category: Health Management Source Type: research

Knowing is not half the battle: Impacts of information from the National Health Screening Program in Korea
Publication date: May 2019Source: Journal of Health Economics, Volume 65Author(s): Hyuncheol Bryant Kim, Suejin A. Lee, Wilfredo LimAbstractHealth screening provides information on disease risk and diagnosis, but whether this promotes health is unclear. We estimate the impacts of information provided by Korea's National Health Screening Program by applying a regression discontinuity design around different biomarker thresholds of diabetes, obesity, and hyperlipidemia risk using administrative data that includes medical claims, biomarkers, and behavioral surveys over four years after screening. Generally, we find limited re...
Source: Journal of Health Economics - March 14, 2019 Category: Health Management Source Type: research

Economic assessment of nutritional recommendations: a comment
Publication date: Available online 12 March 2019Source: Journal of Health EconomicsAuthor(s): Guy MeunierAbstractThis is a Comment on the paper by Irz et al. (2015) in this Journal, on nutritional recommendations. Irz et al. (2015) propose to compute the cost of a nutritional constraint as the consumer loss of surplus, derived from their observed choices. Introducing behavioral biases into an extended version of their model, I show that their proposed methodology implicitly assumes that consumer dietary choices do not involve any health considerations. The cost per Quality-Adjusted Life Year that they compute should be cor...
Source: Journal of Health Economics - March 13, 2019 Category: Health Management Source Type: research

Knowing is Not Half the Battle: Impacts of Information from the NationalHealth Screening Program in Korea
Publication date: Available online 1 March 2019Source: Journal of Health EconomicsAuthor(s): Hyuncheol Bryant Kim, Suejin A. Lee, Wilfredo LimAbstractHealth screening provides information on disease risk and diagnosis, but whether this promotes health is unclear. We estimate the impacts of information provided by Korea's National Health Screening Program by applying a regression discontinuity design around different biomarker thresholds of diabetes, obesity, and hyperlipidemia risk using administrative data that includes medical claims, biomarkers, and behavioral surveys over four years after screening. Generally, we find ...
Source: Journal of Health Economics - March 4, 2019 Category: Health Management Source Type: research

Reproductive Health Care in Catholic-Owned Hospitals
Publication date: Available online 3 March 2019Source: Journal of Health EconomicsAuthor(s): Elaine L. Hill, David J.G. Slusky, Donna K. GintherAbstractMergers that affiliate a hospital with a Catholic owner, network, or system reduce the set of possible reproductive medical procedures since Catholic hospitals have strict prohibitions on contraception. Using changes in ownership of hospitals, we find that Catholic hospitals reduce the per bed rates of tubal ligations by 31%, whereas there is no significant change in related permitted procedures such as Caesarian sections. However, across a variety of measures, we find mini...
Source: Journal of Health Economics - March 4, 2019 Category: Health Management Source Type: research

The unobserved pattern of material hardship and health among older Americans
Publication date: Available online 28 February 2019Source: Journal of Health EconomicsAuthor(s): Paolo Li DonniAbstractThis paper investigates the relationship between self-reported health and material hardship among older Americans. Differently from income-based measures, material hardship provides a more specific description of the concrete adversities faced by the elderly. We have used the last six waves of the Health and Retirement Study to explore the relative contributions of state dependence, unobserved heterogeneity and time-specific shocks on reporting poor health, experiencing food insecurity and medication cutba...
Source: Journal of Health Economics - February 28, 2019 Category: Health Management Source Type: research

Editorial Board
Publication date: January 2019Source: Journal of Health Economics, Volume 63Author(s): (Source: Journal of Health Economics)
Source: Journal of Health Economics - February 20, 2019 Category: Health Management Source Type: research

Motivated health risk denial and preventative health care investments
Publication date: Available online 19 February 2019Source: Journal of Health EconomicsAuthor(s): Peter SchwardmannAbstractPeople deny health risks, invest too little in disease prevention, and are highly sensitive to the price of preventative health care, especially in developing countries. Moreover, private sector R&D spending on developing-country diseases is almost non-existent. To explain these empirical observations, I propose a model of motivated belief formation, in which an agent's decision to engage in health risk denial balances the psychological benefits of reduced anxiety with the physical cost of underprev...
Source: Journal of Health Economics - February 20, 2019 Category: Health Management Source Type: research

Cash on delivery:Results of a randomized experiment to promote maternal health care in Kenya
Publication date: Available online 18 February 2019Source: Journal of Health EconomicsAuthor(s): Karen A. Grépin, James Habyarimana, William JackAbstractWe conducted a randomized controlled experiment to test whether vouchers, cash transfers, and SMS messages were effective in boosting facility delivery rates among poor, pregnant women in rural Kenya. We find a strong effect of the full vouchers and the conditional cash transfers: 48% of women with access to both interventions delivered in a health facility, while only 36% of those with neither did. Amongst women who did not receive a cash transfer, we find that a s...
Source: Journal of Health Economics - February 19, 2019 Category: Health Management Source Type: research

Contemporaneous and Long-term Effects of Children’s Public Health Insurance Expansions on Supplemental Security Income Participation
This study explores the interplay between two important public programs for vulnerable children: Medicaid and the Supplemental Security Income (SSI) program. Children’s public health insurance eligibility increased dramatically during the late 1990s with the launch of the Children’s Health Insurance Program along with concurrent Medicaid expansions. We use a measure of simulated eligibility as an exogenous source of variation in Medicaid generosity to identify the effects of the eligibility expansions on SSI outcomes. Though increases in eligibility for public health insurance did not affect contemporaneous you...
Source: Journal of Health Economics - February 13, 2019 Category: Health Management Source Type: research

One Lab, Two Firms, Many Possibilities: on R&D outsourcing in the biopharmaceutical industry
Publication date: Available online 13 February 2019Source: Journal of Health EconomicsAuthor(s): Etienne Billette de Villemeur, Bruno VersaevelAbstractWe draw from documented characteristics of the biopharmaceutical industry to construct a model where two firms can choose to outsource R&D to an external unit, and/or engage in internal R&D, before competing in a final market. We investigate the distribution of profits among market participants, and the incentives to coordinate outsourcing activities or to integrate R&D and production. Consistent with the empirical evidence, we find that the sign and magnitude of...
Source: Journal of Health Economics - February 13, 2019 Category: Health Management Source Type: research

Healing the Poor: The Influence of Patient Socioeconomic Status on Physician Supply Responses
Publication date: Available online 10 February 2019Source: Journal of Health EconomicsAuthor(s): Alice Chen, Darius LakdawallaAbstractA longstanding literature explores how altruism affects the way physicians respond to incentives and provide care. We analyze how patient socioeconomic status mediates these responses. We show theoretically that patient socioeconomic status systematically influences the way physicians respond to reimbursement changes, and we identify the channels through which these effects operate. We use two Medicare reimbursement changes to investigate these insights empirically. We confirm that a given p...
Source: Journal of Health Economics - February 11, 2019 Category: Health Management Source Type: research

Seeing and Hearing: The Impacts of New York City’s Universal Pre-Kindergarten Program on the Health of Low-Income Children
Publication date: Available online 10 February 2019Source: Journal of Health EconomicsAuthor(s): Kai Hong, Kacie Dragan, Sherry GliedAbstractWe examine the effect of New York City’s universal pre-kindergarten program (UPK) on the health and utilization of children enrolled in Medicaid using a difference-in-regression-discontinuities design. We find that UPK increases the probability that a child is diagnosed with asthma or with vision problems, receives treatment for hearing or vision problems, or receives an immunization or screening during the pre-kindergarten year. These effects are not offset by lower rates in th...
Source: Journal of Health Economics - February 11, 2019 Category: Health Management Source Type: research

The Effect of Predictive Analytics-Driven Interventions on Healthcare Utilization
Publication date: Available online 10 February 2019Source: Journal of Health EconomicsAuthor(s): Guy David, Aaron Smith-McLallen, Benjamin UkertAbstractThis paper studies a commercial insurer-driven intervention to improve resource allocation. The insurer developed a claims-based algorithm to derive a member-level healthcare utilization risk score. Members with the highest scores were contacted by a care management team tasked with closing gaps in care. The number of members outreached was dictated by resource availability and not by severity, creating a set of arbitrary cutoff points, separating treated and untreated memb...
Source: Journal of Health Economics - February 11, 2019 Category: Health Management Source Type: research

Low-risk isn’t no-risk: Perinatal treatments and the health of low-income newborns
Publication date: Available online 2 February 2019Source: Journal of Health EconomicsAuthor(s): N. Meltem Daysal, Mircea Trandafir, Reyn van EwijkAbstractWe investigate the effects of perinatal medical treatments on low-income newborns who are classified as low-risk. A policy rule in The Netherlands states that low-risk deliveries before week 37 should be supervised by physicians and later deliveries only by midwives with no physician present. This creates large discontinuities in the probability of receiving medical interventions only physicians are allowed to perform. Using a regression discontinuity design, we find that...
Source: Journal of Health Economics - February 3, 2019 Category: Health Management Source Type: research

Drivers of the Fatal Drug Epidemic
This study examines the contributions of the medium-run evolution of local economies and of changes in the “drug environment’ in explaining county-level changes in drug and related mortality rates from 1999-2015. A primary finding is that drug mortality rates did increase more in counties experiencing relative economic decline than in those with more robust growth, but that the relationship is weak and mostly accounted for by confounding factors. In the preferred estimates, less than one-tenth of the rise in drug and opioid-involved fatality rates is explained and the contribution is even smaller, quite possibl...
Source: Journal of Health Economics - January 15, 2019 Category: Health Management Source Type: research

Does external medical review reduce disability insurance inflow?
Publication date: Available online 14 January 2019Source: Journal of Health EconomicsAuthor(s): Helge LiebertAbstractThis paper investigates the effects of introducing external medical review for disability insurance (DI) in a system relying on treating physician testimony for eligibility determination. Using a unique policy change and administrative data from Switzerland, I show that medical review reduces DI incidence by 23%. Incidence reductions are closely tied to difficult-to-diagnose conditions, suggesting inaccurate assessments by treating physicians. Due to a partial benefit system, reductions in full benefit award...
Source: Journal of Health Economics - January 15, 2019 Category: Health Management Source Type: research

Measuring Multivariate Risk Preferences in the Health Domain
Publication date: Available online 27 December 2018Source: Journal of Health EconomicsAuthor(s): Arthur E. Attema, Olivier l’Haridon, Gijs van de KuilenAbstractWe investigate univariate and multivariate risk preferences for health (longevity) and wealth. We measure attitudes toward correlation and attitudes toward higher order dependence structures such as cross-prudence and cross-temperance, making use of the risk apportionment technique proposed by Eeckhoudt et al. (2007). For multivariate gains, we find correlation aversion and cross-prudence in longevity and wealth. For losses, we observe correlation seeking and ...
Source: Journal of Health Economics - December 28, 2018 Category: Health Management Source Type: research