Health Economics Commons^™

Can Institutional Deliveries Reduce Newborn Mortality? Evidence From Rwanda, Edward Okeke, A.V. Chari

Edward Okeke

Current global health policies emphasize institutional deliveries as a pathway to achieving reductions in newborn mortality in developing countries. There is however remarkably little evidence regarding a causal relationship between institutional deliveries and newborn mortality. In this paper we take advantage of a shock to institutional deliveries provided by the randomized rollout of a government performance-based financing program in Rwanda, to provide the first estimates of this causal effect. We construct an instrumental variables estimator that combines interrupted time-series and difference-in-differences approaches. We do not find any statistically significant effect of an institutional birth on either 7- or 30-day mortality …

Brain Drain: Do Economic Conditions “Push” Doctors Out Of Developing Countries?, Edward Okeke

Edward Okeke

Health worker migration is an issue of first order concern in global health policy circles and continues to be the subject of much policy debate. In this paper, we contribute to the discussion by studying the impact of economic conditions on the migration of physicians from developing countries. To our knowledge, this is one of the first papers to do so. A major contribution of this paper is the introduction of a new panel dataset on migration to the US and the UK from 31 sub-Saharan Africa countries. The data spans the period 1975-2004. Using this data, we estimate the …

Aids Treatment And Mental Health: Evidence From Uganda, Edward Okeke, Glenn Wagner

Edward Okeke

Increased access to antiretroviral therapy (ART) in developing countries over the last decade is believed to have contributed to reductions in HIV transmission and improvements in life expectancy. While numerous studies document the effects of ART on physical health and functioning, comparatively less attention has been paid to the effects of ART on mental health outcomes. In this paper we study the impact of ART on depression in a cohort of patients in Uganda entering HIV care. We find that twelve months after beginning ART, the prevalence of major and minor depression in the treatment group had fallen by approximately …

Price Elasticity Of Expenditure Across Health Care Services, Fabian Duarte

Fabian Duarte

Policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures. Estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies. Using unique individual-level data compiled from administrative records from the Chilean private health insurance market, I estimate the price elasticity of expenditures across a variety of health care services. I find elasticities that range between zero for the most acute service (appendectomy) and −2.08 for the most elective (psychologist visit). Moreover, the results show that at least one third of …

The Likely Impact Of Mandated Paid Sick And Family-Care Leave On The Economy And Economic Development Prospects Of The State Of Ohio, Edward W. Hill, Spence Christopher, Daila Shimek, Ziona Austrian

Ziona Austrian

This report analyzes the potential impact of a proposed paid sick and family care leave legislation on the economy of the state of Ohio, the economic development prospects of the state and on the management of production processes that depend on highly integrate teams. The report also reviews the literature on the effect of mandated paid sick and family care leave on the industrial relations system—workplace performance and worker retention. Our analysis concludes that there would have been a net cost associated with the paid sick leave and family-care initiative proposed in Ohio with a lower bound estimate of $63.84 …

Inadequate Feeding Of Infant And Young Children In India: Lack Of Nutritional Information Or Food Affordability?, Nisha Malhotra

Nisha Malhotra

Why does child malnutrition persist in India? Amongst the fastest growing economies over the last two decades, India has struggled to make progress in the health of its children. In this article the author argues that the reason malnutrition persists is not limited to poverty or inadequate access to food; but that a lack of nutritional knowledge amongst families plays a very important role.

Scientific Abstract Objective: Despite a rapidly growing economy and rising income levels in India, improvements in child malnutrition have lagged. Data from the most recent National Family Health Survey reveal that the infant and young child …

Marginal Effects In Multivariate Probit And Kindred Discrete And Count Outcome Models, John Mullahy

John Mullahy

Estimation of marginal or partial effects of covariates x on various conditional parameters or functionals is often the main target of applied microeconometric analysis. In the specific context of probit models, estimation of partial effects involving outcome probabilities will often be of interest. Such estimation is straightforward in univariate models, and Greene, 1996, 1998, has extended these results to cover the case of quadrant probability marginal effects in bivariate probit models. The first purpose of this paper is to extend these results to encompass the general multivariate probit (MVP) context for arbitrary orthant probabilities. It is suggested that such partial …

Mother Earth "Speaks": Change Yourself, Change The World, Use The Archetypal Energy "Harmony" As A Guide, Carroy U. Ferguson

Carroy U "Cuf" Ferguson, Ph.D.

In relation to the Cosmos, we all, as human beings, live on this tiny planet we call Earth, a planet that supports and sustains life, as we know it. There are many different kinds of people, plants, and animals functioning in harmony with soil, air, and water--all linked to one another in a complex web of life to form one Earth community. Unfortunately, we often take this miracle and ecosystem of life for granted. When, however, we take the ecosystem of life too much for granted, Mother Earth "speaks," reflecting imbalances and dis-harmonies. When Mother Earth "speaks," her message is …

Workers On The Margin: Who Drops Health Coverage When Prices Rise?, Edward Okeke, Richard Hirth, Kyle Grazier

Edward Okeke

We revisit the question of price elasticity of employer-sponsored insurance (ESI) take-up by directly examining changes in the take-up of ESI at a large firm in response to exogenous changes in employee premium contributions. We find that, on average, a 10% increase in the employee’s out-of-pocket premium increases the probability of dropping coverage by approximately 1%. More importantly, we find heterogeneous impacts: married workers are much more price-sensitive than single employees, and lower-paid workers are disproportionately more likely to drop coverage than higher-paid workers. Elasticity estimates for employees below the 25th percentile of salary distribution in our sample are nearly …

Too Cold For A Jog? Weather, Exercise, And Socioeconomic Status, Daniel Eisenberg, Edward Okeke

Edward Okeke

This study examines how exercise responds to plausibly exogenous "price shocks," in the form of weather conditions. Most notably, we find that within cold temperature ranges, a decrease in past-month temperature causes a significant decrease in past-month exercise, and this effect is generally larger for lower education and income groups. In large part this differential by socioeconomic group appears to be due to smaller increases in indoor activity during cold weather. These results suggest that interventions and policies aiming to increase exercise participation, particularly among lower socioeconomic populations, could do so in part by increasing the availability and attractiveness of …

Empowering The Public Health Service, Louis Graham

Louis F Graham