Health Economics Commons^™

Sources Of Health Financing And Health Outcomes: A Panel Data Analysis, Tomoki Fujii

Research Collection School Of Economics

We study the differential impacts of public and private sources of health spending on health outcomes using a triple difference approach. We find that private health spending has on average a higher health-promoting effect than public health spending. This result is robust with respect to the choice of outcome measure and covariates in the regression and driven primarily by the countries with ineffective governments. Once we restrict our sample to countries with effective governments, private health spending is no better than public health spending for improving the health outcome.

Does Health Insurance Make People Happier? Evidence From Massachusetts’ Healthcare Reform, Seonghoon Kim, Kanghyock Koh

Research Collection School Of Economics

We study the effects of Massachusetts' healthcare reform on individuals' subjective well-being. Using data from the Behavioral Risk Factor Surveillance System, we find that the reform significantly improved Massachusetts residents' overall life-satisfaction. This result is robust to various sensitivity checks and a falsification test. We also find that the reform improved mental health. An additional analysis on the Tennessee healthcare reform supports our findings' external validity. Using the reform as an instrument for health insurance coverage, we estimate its large impact on overall life-satisfaction. Our results provide novel evidence on the psychological consequences of Massachusetts' healthcare reform.

Regional Prevalence Of Health Worker Absenteeism In Tanzania, Tomoki Fujii

Research Collection School Of Economics

Absenteeism of health workers in developing countries is common and can severely undermine the reliability of health system. Therefore, it is important to understand where the prevalence of absenteeism is high. We develop a simple imputation method that combines a Service Delivery Indicators survey and a Service Provision Assessment survey to estimate the prevalence of absenteeism of health workers at the level of regions in Tanzania. The resulting estimates allow one to identify the regions in which the prevalence of absenteeism is significantly higher or lower than the national average and help policymakers determine the priority areas for intervention.

Essays In The Economics Of Health And Ageing, Yi Jin Tan

Dissertations and Theses Collection (Open Access)

This dissertation consists of four papers in applied microeconomics / the economics of health and ageing that analyse the causal effect of public policies, or of events / issues amenable to policy intervention. Chapter 1 provides an overview of the papers in this dissertation.

Chapter 2 investigates whether a major and growing environmental disamenity – dengue fever – leads to protective behavior that increases residential electricity consumption. Being near a dengue cluster leads to a persistent increase in electricity consumption in 4-room and 5-room/bigger flats (by 1.7% and 1.1% respectively). In addition, electricity consumption rises discontinuously when a dengue cluster’s …

Impact Of Electrification On Children's Nutritional Status In Rural Bangladesh, Tomoki Fujii, Abu S. Shonchoy, Sijia Xu

Research Collection School Of Economics

Access to electricity has the potential to improve the nutritional status of children by a variety of pathways such as increased wealth, reduced fertility through the change in time use, spread of information through technology such as TV, and improved health care services. Yet, the relationship between electrification and children’s nutritional status is rarely explored in the literature. We attempt to fill this lacuna by offering microeconometric evidence from rural Bangladesh, where a rapid expansion of electrification and significant improvement in children’s nutritional status were observed in the past two decades. We find that access to electricity has a positive …

Three Essays On Social Insurance, Jessica Ya Sun

Dissertations and Theses Collection (Open Access)

This dissertation consists of three chapters on the economics of social insurance. Each chapter explores an aspect of the evaluation and design of social insurance in terms of nutrition, healthcare and unemployment.

The first chapter, Kim, Fleisher and Sun (2016) report evidence of long-term adverse health impacts of fetal malnutrition exposure of middle-aged survivors of the 1959-1961 China Famine using data from the China Health and Retirement Longitudinal Study. We find that fetal exposure to malnutrition has large and long lasting impacts on both physical health and cognitive abilities, including the risks of suffering a stroke, physical disabilities in speech, …

Evidence Of Racial And Geographic Disparities In The Use Of Medicare Observation Stays And Subsequent Patient Outcomes Relative To Short-Stay Hospitalizations, Brad Wright, Xuan Zhang, Momotazur Rahman, Mahshid Abir, Padmaja Ayyagari, Keith E. Kocher

Research Collection School Of Economics

To examine racial and geographic disparities in the use of-and outcomes associated with-Medicare observation stays versus short-stay hospitalizations.\nWe used 2007-2010 fee-for-service Medicare claims, including 3,555,994 observation and short-stay hospitalizations for individuals over age 65. We estimated linear probability models with hospital fixed effects to identify within-facility disparities in observation stay use, and estimated in-hospital mortality, and 30- and 90-day post-discharge mortality, return ED visits, and hospital readmissions as a function of placement in observation using linear probability models, propensity-score matching, and interaction terms.\nWe identified racial and geographic disparities in the likelihood of observation stay use within hospitals (blacks 3.9 percentage …

Informing Medicare's Two-Midnight Rule Policy With An Analysis Of Hospital-Based Long Observation Stays, Brad Wright, Xuan Zhang, Momotazur Rahman, Keith Kocher

Research Collection School Of Economics

Outpatient observation stays are increasingly substituting for standard inpatient hospitalizations. In 2013, the Centers for Medicare & Medicaid Services adopted the controversial Two-Midnight Rule policy to curb long observation stays and better define the use of hospital-based observation services versus inpatient hospitalizations. We seek to determine the extent to which Medicare beneficiaries exposed to long observation stays (>48 hours) are clinically similar to those with short observation stays (≤48 hours) because this has relevance to the Two-Midnight Rule.\nUsing 100% Medicare claims data from 2008 to 2010, we identified all patients with long observation stays (>48 hours) who were …