Essays in Health Economics and Health Policy PDF Download
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Author: Salama S. Freed
Publisher:
ISBN:
Category : Electronic dissertations
Languages : en
Pages : 95
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Author: Salama S. Freed
Publisher:
ISBN:
Category : Electronic dissertations
Languages : en
Pages : 95
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Author: Eun Young Kim
Publisher:
ISBN:
Category : Electronic Dissertations
Languages : en
Pages : 101
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This dissertation is a compilation of three essays. The first essay critiques a recent paper by Wilper et al. (2009) for its inappropriate model calibration in analyzing the association of health insurance and mortality. Using the individual-level data from a nationwide survey with more recent mortality follow-up information, it shows that the privately-insured do not significantly fare better in mortality risk compared to the uninsured. Moreover, hazard ratio estimate for the Medicaid suggests that public provision of insurance increases mortality. The second essay addresses the role of income in explaining the differential public health outcomes across developed countries. Noting that the growing arguments for socioeconomic gradient in health are based mostly on cross-sectional studies, panel analyses of five different public health outcomes are conducted. Results demonstrate that economic development remains critical in explaining health improvements at the aggregate level. The third essay analyzes the association of income and health care spending at the aggregate level. Using a large panel data from 24 industrialized nations for more than three decades, the close relationship between income and health care spending is established. In contrast to earlier cross-sectional studies, the panel analysis suggests that health expenditure growth is not as rapid as income growth in almost all nations.
Author: Colin D. Cannonier
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Category :
Languages : en
Pages :
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Author:
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ISBN:
Category :
Languages : en
Pages : 0
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This dissertation consists of three essays in health economics related issues. In the first chapter, I estimated health insurance expansion's effects on young adults' employment using MEPS. In 2010 young adults were allowed to stay on their parent's health insurance plan until the age of 26 by a policy change under the ACA. I used a difference-in-differences model to estimate labor supply effects of this policy on young adults. 23-25-year-olds are in the treatment group, and 26-30-year-olds are in the control group. Additionally, I estimated heterogeneity of the policy's labor supply effect by socio-economic groups. I found that extensive and intensive labor supply decreased among males. The effect is greater among men in higher socio-economic group. In the second chapter, I analyzed whether internet use has an effect on patients' mental health using BRFSS data. Over the last decade internet use has become universal. It provides various health related tools and information sources which may affect patients' distress levels in several ways, and health related distress can have large impacts on quality of life. I used variation across states' "right of way" policies during the broadband boom period of 2001-2005. Using rights of way rules' easiness as a proxy for broadband penetration rates, I investigated whether patients' mental health levels changed differently in states with more lenient rights of way rules. I found that among men internet use improves patients' mental health. In the third chapter, I studied labor market effects of the early Medicaid expansions under the ACA in 2010 using data from Current Population Survey. The ACA extends public insurance coverage to low income childless adults, yet we know very little about the effect of a public health insurance extension on childless adults' labor supply. The ACA allowed states to extend Medicaid and a number of states opted in early and extended Medicaid in 2010. I utilized this variation among states to evaluate whether the policy had any effect on childless adults' employment. I found that the policy had no effect on labor supply of the overall population. I found evidence that the policy mainly affected near-retirement-aged childless
Author: Henrique Veras De Paiva Fonseca
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Author: Hui Ding
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Category :
Languages : en
Pages :
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This dissertation explores various topics in health economics, specifically the use of different types of health care (i.e., mental health, durable medical equipment, and chronic disease management in primary care settings) and how public insurance policies affect the price and utilization of health care products and services. In Chapter 1, I explore the geographic variation in mental health care use among the Medicare population. Using administrative data from Medicare, I isolates the patient- and place-specific drivers of the geographic variation in mental health care use among elderly adults. Specifically, I use an event-study framework with individual fixed effects to study changes in mental health care utilization for patients who move across areas with differing rates of average utilization. My results show that 60 percent of the geographic variation is attributed to place-specific factors. I then explore components of the "place effect", finding that mental health care provider capacity explains only one tenth of it. Beyond that, local attitudes toward mental health play an important role, as shown by asymmetric responses for people who move from low-to-high and high-to-low care utilization areas, especially among those who were never diagnosed with any mental illness before moving. Lastly, I find a strong negative correlation between area-level mental health care utilization and suicide rates, and evidence that moving to high utilization areas is associated with a lower risk of self-harm-related Emergency Department visits. These findings suggest that promoting mental health care could benefit the elderly population, and that there is substantial scope for achieving this goal with interventions targeting place-specific factors. In Chapter 2, along with co-authors Mark Duggan and Amanda Starc, I study Medicare's competitive bidding program (CBP) for durable medical equipment (DME). We use Medicare claims data to examine the effect on prices and utilization, focusing on continuous positive airway pressure (CPAP) devices for sleep apnea. We find that spending falls by 47.2% percent after a highly imperfect bidding mechanism is introduced. This is almost entirely driven by a 44.8% price reduction, though quantities also fall by 4.3\%. To disentangle supply and demand, we leverage differential cost sharing across Medicare recipients. We measure a demand elasticity of -0.272 and find that quantity reductions are concentrated among less clinically appropriate groups. In Chapter 3, along with co-authors Yiwei Chen, Min Yu, Jieming Zhong, Ruying Hu, Xiangyu Chen, Chunmei Wang, Kaixu Xie and Karen Eggleston, I investigate the effect of chronic disease management provided in primary health care (PHC) setting in rural China. Health systems globally face increasing morbidity and mortality from chronic diseases, yet many - especially in low- and middle-income countries - lack strong chronic disease management and PHC system. We provide evidence on China's efforts to promote PHC management using unique five-year panel data in a rural county, including health care utilization from medical claims and health outcomes from biomarkers. Utilizing plausibly exogenous variation in management intensity generated by administrative and geographic boundaries, we compare hypertension/diabetes patients in villages within two kilometers distance but managed by different townships. Results show that, compared to patients in townships with median management intensity, patients in high-intensity townships have 4.8% more PHC visits, 5.2% fewer specialist visits, 11.7% fewer inpatient admissions, and 3.6% lower medical spending. They also tend to have better medication adherence and better control of blood pressure. The resource savings from avoided inpatient admissions substantially outweigh the costs of the program.
Author: Ryuta Kato
Publisher:
ISBN:
Category :
Languages : en
Pages : 214
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Author: Olga V. Milliken
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 284
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Author:
Publisher:
ISBN: 9781321033229
Category :
Languages : en
Pages : 167
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This dissertation presents three essays in health economics. The first essay sheds light on the relationship between health insurance and access to care. The second essay considers the relationship between health and labor markets. The third essay explores one facet of health inequality.
Author: Anna Choi
Publisher:
ISBN:
Category :
Languages : en
Pages : 234
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This dissertation contains three essays in the field of health economics and health policy. The first essay studies the effects of legalizing medical use of marijuana on marijuana use and other risky health behaviors. I examine the restricted-use data from the National Survey of Drug Use and Health (NSDUH), which is a repeated cross sectional data set with state identifiers from 2004 to 2012. During this period, 9 states and Washington D.C. allowed patients with medical conditions to use marijuana. I estimate difference-in-differences (DID) models to examine the impacts of these policy changes on risky health behaviors. Allowing medical use of marijuana does not lead to higher marijuana use among the overall population and the youth. However, I find that medical marijuana laws (MMLs) are positively and significantly associated with marijuana use among males and heavy pain reliever users. The second essay is a joint work with John Cawley and tests a novel hypothesis: that these health disparities across education are to some extent due to differences in reporting error across education. We use data from the pooled National Health and Nutrition Examination Survey (NHANES) Continuous for 1999-2012, which include both self-reports and objective verification for an extensive set of health behaviors and conditions, including smoking, obesity, high blood pressure, high cholesterol and diabetes. We find that better educated individuals report their health behaviors more accurately. This is true for a wide range of behaviors and conditions, even socially stigmatized ones like smoking and obesity. We show that the differential reporting error across education leads to underestimates of the true health disparities across education that average 19.3%. The third essay is a joint work with Rachel Dunifon and studies how state regulations related to the quality of child care centers-such as teachers' education and degree requirements, staff to child ratios, maximum group size, and unannounced inspection compliance requirement-are predictive of children's health, developmental and cognitive outcomes. State level policies that are related to improving the productivity of child care center teachers by having a higher staff to child ratios and advanced schooling requirement are predictive of child's weight related outcomes and cognitive outcomes.
