Essays in the Economics of Health and Medical Care PDF Download
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Author: Victor R. Fuchs
Publisher: New York : National Bureau of Economic Research distributed by Columbia University Press
ISBN:
Category : Medical
Languages : en
Pages : 272
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Book Description
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.
Author: Victor R. Fuchs
Publisher: New York : National Bureau of Economic Research distributed by Columbia University Press
ISBN:
Category : Medical
Languages : en
Pages : 272
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Book Description
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.
Author: Brett William Wendling
Publisher:
ISBN:
Category :
Languages : en
Pages : 406
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Book Description
As medical care becomes an increasingly large share of Gross Domestic Product, understanding the mechanisms for how and why medical care spending is rising becomes increasingly important. Such an evaluation should consider the productivity relationship between medical care and health. An evaluation of medical productivity involves the measurement of medical care input prices, disease treatment output prices, and the productive relationship between medical care inputs and disease treatment health outcomes. Medical care price measurement is complicated by the heterogeneity of services, the role of insurance in negotiating prices, rapid technological advancements in medical care and limited availability of transaction price data. Health outcome prices are difficult to construct because of the difficulty in measuring health outcomes, the heterogeneity of health outcomes, and the messy relationship between consumption goods and health. Finally, in addition to accurate input and output price measurement, a productivity assessment requires a measurable causal relationship between medical care services and health outcomes. To date, all of these requirements have been insurmountable hurdles to assessing the productivity of medical care for the entire United States economy. This dissertation uses the Medical care Expenditure Panel Survey to address the necessary requirements for evaluating the productivity of medical care. The second chapter constructs regional medical care price indices using transaction prices that control for service type heterogeneity. The data employed in the analysis associates the observed medical care spending with the diseases the spending is used to treat. This association is exploited in the third chapter, which constructs medical care treatment prices for twelve of the major health conditions in the United States. The fourth chapter compares the productivity of medical care services used to produce disease treatment health outcomes across insurance types.
Author: Bradley Thomas Howells
Publisher:
ISBN:
Category :
Languages : en
Pages : 218
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Book Description
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.
Author: M. Perlman
Publisher: Springer
ISBN: 1349636606
Category : Art
Languages : en
Pages : 560
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Book Description
Record of Discussion6 Economics of Need: The Experience of the British Health Service; 7 Private Patients in N.H.S. Hospitals: Waiting Lists and Subsidies; 8 Consumer Protection, Incentives and Externalities in the Drug Market; Summary Record of Discussion; 9 Price and Income Elasticities for Medical Care Services; 10 Supplier-Induced Demand: Some Empirical Evidence and Implications; 11 Some Economic Aspects of Mortality in Developed Countries; Summary Record of Discussion; PART THREE: THE IMPACT OF DEMAND FOR HEALTH SERVICES; 12 Health, Hours and Wages
Author: Clarence Rufus Rorem
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 224
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Book Description
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.
Author: Sarah Marie Abraham
Publisher:
ISBN:
Category :
Languages : en
Pages : 156
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Book Description
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/.
Author: Gregory Gill Lubiani
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
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.
Author: Lanis Hicks
Publisher: Jones & Bartlett Learning
ISBN: 1284219283
Category : Medical
Languages : en
Pages : 389
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Book Description
Economics of Health and Medical Care is an introduction to population-based health economics as well as the traditional, market-oriented approach to health care economics. The book examines economics through the lens of descriptive, explanatory, and evaluative economics. The Seventh Edition is an extensive revision that reflects the vast changes that have been occurring in the health care industry and in the economy, most notably in the areas for payment systems and quality improvement. Additionally, the text offers expanded discussion of the impact of the Affordable Care Act on the demand for healthcare services and health insurance, particularly regarding Medicare and Medicaid programs. Evolving issues in healthcare as well as discussion of the implication for efficiency in the production and consumption of healthcare services are covered throughout the text.
Author: Lori L. Timmins
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
Author: Robin McKnight
Publisher:
ISBN:
Category :
Languages : en
Pages : 116
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Book Description
This thesis brings together three essays on issues in the economics of health insurance. The first study considers the effects of average per-patient caps on Medicare reimbursement for home health care, which took effect in October 1997. I use regional variation in the restrictiveness of per-patient caps to identify the short-run effects of this reimbursement change on home health agency behavior, beneficiary health care utilization, and health status. The empirical evidence suggests that agencies responded to the caps by shifting the composition of their caseload towards healthier beneficiaries. In addition, I find that decreases in home care utilization were associated with an increase in outpatient care, and had little adverse impact on the health status of beneficiaries. In the second paper, I examine the impact of Medicare balance billing restrictions on physician behavior and on beneficiary spending. My findings include a significant decline in out-of-pocket expenditures for medical care by elderly households, but no impact on the quantity of care received or in the duration of office visits. The third paper (written with Jonathan Gruber) explores the causes of the dramatic rise in employee contributions to employer-provided health insurance over the past 20 years. We find that there was a large impact of falling tax rates, rising eligibility for insurance through the Medicaid system and through spouses, and deteriorating economic conditions (in the late 1980s and early 1990s). We also find more modest impacts of increased managed care penetration and rising health care costs. Overall, this set of factors can explain about one-quarter of the rise in employee contributions over the 1982-1996 period.
