Health Economics Commons^™

Cost Analysis Of Integrated Genderaffirming And Sexual Health Services For Transgender Women In Thailand: Evidence From The Tangerine Clinic, Braprut Sawatwipachai, Kunncadah Anuwong, Nittaya Phanuphak, Rena Janamnuaysook, Kritima Samitpol, Sujin Nitadpakorn

The Thai Journal of Pharmaceutical Sciences

Background: Transgender women experience a disproportionate burden of human immunodeficiency virus (HIV) globally and in Thailand. Integrating gender-affirming care into sexual health services may improve uptake of HIV and sexually transmitted infections (STIs) testing, treatment, and prevention. Cost data are essential to inform program planning and policy decisions regarding inclusion of such services within Thailand’s Universal Health Coverage (UHC) system.
Objectives: To estimate the full and unit costs of trans-led, integrated gender-affirming and sexual health services along the HIV care cascade.
Methods: Costs of Tangerine Clinic services in 2021 were assessed from the provider perspective, using standard and activity-based costing …

Clinical Outcomes Of Adjunctive Use Of Oxygen-Releasing Formula In Non-Surgical Treatment Of Periodontal Abscess Associated With Type 2 Diabetes Mellitus, Anil Kumar Kanakamedala, Laxmi Kavya Gangireddy, Gautami S Penmetsa, Sruthima Gottumukkala, Mohan Kumar Pasupuleti, Konathala Santhosh Venkata Ramesh

Journal of Dentistry Indonesia

Background: This study aimed to evaluate the effectiveness of oxygen-releasing formula (ORF) as an adjunct in the non-surgical management of periodontal abscess in patients with type 2 diabetes mellitus.

Methods: This split-mouth clinical trial was conducted on 14 patients with periodontal abscess with type 2 diabetes mellitus (T2DM), who were divided into a control group, nonsurgical periodontal therapy (NSPT) alone, and a test group (NSPT+ORF). Parameters such as Landry's healing index (HI) were evaluated at 1 week, 2 weeks, and 1 month. Probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing presence or absence (BOP) …

Adverse Drug Reaction Reporting In Dental Practice And The Importance Of Pharmacovigilance In Dental Education, Radhakrishna Lagishetty, Lakshmi Ramya T, Kvr Barath Raju, Mohan Kumar Pasupuleti

Journal of Dentistry Indonesia

Background: Adverse drug reactions (ADRs) are a critical component of patient safety; however, ADR monitoring remains underutilized in dentistry. This study aimed to assess knowledge, attitudes, and practices regarding ADR reporting among undergraduate and postgraduate students and practicing dentists.

Methods: A cross-sectional observational study was conducted using a structured, validated 19-item questionnaire covering socio-demographics, knowledge (6 items), attitude (4 items), and practice (5 items), which was distributed both in person and online. A total of 258 complete responses were analyzed out of 300 individuals contacted (response rate: 86%). Descriptive statistics and Chi-square tests were applied, with p < 0.05 considered statistically significant.

Results …

Investigation Of Patients' Use Of Non-Pharmacological Substances In Dental Pain Management, Neslihan Yılmaz Çırakoğlu, Özgenur Kaya

Journal of Dentistry Indonesia

Background: Dental pain is a complex condition influenced by biological, biochemical, environmental, and psychological factors. Before seeking professional care, many patients attempt to relieve dental pain using self-administered, non-medical agents. This study aimed to investigate patients’ use of non-pharmacological substances in dental pain management and to identify factors influencing these practices.

Methods: The questionnaire consisted of four sections addressing demographic characteristics, oral hygiene habits, pain characteristics, and pain-relief agents. Categorical variables were analyzed using Pearson’s chi-square test. Categorical data are presented as frequencies and percentages, while continuous data are expressed as mean ± standard deviation and median values. …

Orthodontic Camouflage Treatment Of A Severe Class Iii Skeletal Pattern With Anterior Open Bite: A Case Report, Dikeledi Maureen Letsholo, Mandla Dominic Nyakale, Mosimane Peter Silas Sethusa

Journal of Dentistry Indonesia

Background: Class III malocclusion combined with anterior open bite (AOB) is one of the most challenging occlusal problems to treat. The objective of this article was to report a case of an adult female patient diagnosed with Class III malocclusion combined with an anterior open bite and a hyperdivergent facial pattern.

Case Report: Camouflage orthodontic treatment with the extraction of maxillary and mandibular first premolars was used to treat the patient. Anterior teeth were retracted maximally against the Nance holding arch and fixed lingual arch appliances, and box elastics were used to close AOB. At the end of …

Assessing Healthcare Access Among Overweight And Obese Individuals In Türkiye Using Latent Variable Modeling, Banu Beyaz Sipahi

Makara Journal of Health Research

Background: Overweight and obesity are critical determinants of healthcare access, yet evidence on how the COVID-19 pandemic reshaped these dynamics in Türkiye remains limited. This study investigates whether the early post-pandemic recovery period altered healthcare access patterns for individuals with excess weight.

Methods: Using nationally representative microdata from the 2014, 2016, 2019, and 2022 Turkish Health Surveys, we constructed a latent Healthcare Access Index based on six indicators of unmet care needs. Probit models were estimated to assess associations between BMI categories and healthcare access, controlling for socioeconomic and demographic factors. The 2022 wave serves as the early …

Preventive Interventions Targeting Social Determinants Of Health: Implications For Healthcare Utilization And Cost, Audrey Wrinkle

NEXUS: The Liberty Journal of Interdisciplinary Studies

Preventive interventions targeting social determinants of health could reduce avoidable healthcare utilization and positively impact long-term cost outcomes within healthcare systems. Evidence indicates that financial and social barriers to preventive care lead to delayed treatment and increased use of high-cost healthcare services in the long term. Preventive interventions focusing on upstream social factors, like home-based care and digital health programs, could improve patient outcomes and reduce avoidable service utilization. Also, incorporating social needs data into policy creation could promote better allocation of healthcare resources. This research highlights the role of prevention-focused strategies in promoting cost-effective, sustainable healthcare delivery.

Bridging Fiscal Sustainability And Health Equity: A Policy Analysis Of California’S Healthcare Coverage Safeguards, Guadalupe Castaneda Martinez

Master's Projects and Capstones

Without structural policy intervention, approximately 4.6 million Californians remain at risk of being uninsured by 2030, worsening racial and ethnic health disparities and hospital uncompensated care burdens. This policy analysis advocates for a hybrid universal coverage model combining sliding-scale subsidies (California Senate Bill 78) with full-scope Medi-Cal expansion for all income-eligible residents regardless of legal status (California Assembly Bill 133). The framework relies on existing funding mechanisms, including the Managed Care Organization tax and the Health Care Affordability Reserve Fund. Comparative analysis indicates that market-only subsidies leave severe equity gaps, whereas immediate single-payer transitions pose substantial fiscal and administrative risks. …

Cost-Effectiveness Evaluation Of Artificial Intelligence-Assisted Chest Radiograph Interpretation For Tuberculosis Screening In Rural Health Units In The Philippines, Harold Henrison C. Chiu, Bryan Christopher C. Lao, Gloanne C. Adolor

Graduate School of Business Publications

Background: Tuberculosis remains a major public health burden in the Philippines, where diagnostic delays are amplified by limited radiology capacity in rural health units (RHUs) and geographically isolated and disadvantaged areas (GIDAs). Computer-aided diagnosis (CAD) using artificial intelligence (AI)-assisted chest radiograph interpretation may shorten the screening pathway and reduce reliance on scarce specialist readers. However, its economic value for RHUbased tuberculosis screening has not been fully evaluated.
Methods: We developed a decision-tree cost-effectiveness model in Microsoft Excel 365 to compare AI-assisted chest radiograph interpretation with conventional manual radiologist or teleradiology interpretation among a theoretical annual cohort of 1,000 presumptive tuberculosis …

The Effect Of Vaccine Mandates On Disease Spread: Evidence From College Covid-19 Mandates, Riley K. Acton, Wenjia Cao, Emily E. Cook, Scott A. Imberman, Michael F. Lovenheim

Research Collection School Of Economics

Nearly 700 4-year U.S. colleges mandated students receive COVID-19 vaccinations in fall 2021. Using data on college policies and county health, we estimate how mandates affect surrounding communities. Event studies from August to November 2021 show that mandates covering all colleges in a county reduced COVID-19 deaths by 5.6 per 100,000 persons, a 4.6% reduction in the U.S. total during this period. Mandates reduced COVID cases by 504 and ICU admissions by 16.2 per 100,000, though we see no statistically significant impact on hospitalizations. Impacts are larger in counties with larger college populations and low estimated ex-ante student vaccination rates.

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Cooling Deserts For Renters: Heat Equity Inside The Nyc Housing System, Tahreem Ashraf

Dissertations, Theses, and Capstone Projects

This study introduces the Cooling Desert Index (CDI), a composite spatial measure designed to identify census tracts in New York City where extreme heat vulnerability and structural barriers to adaptive cooling converge. Drawing on five publicly available datasets and a seven phase statistical pipeline, the CDI scores all 2,231 NYC census tracts on a continuous 0 to 100 scale by integrating heat exposure, severe rent burden, household income, racial composition, language access, disability status, and housing crowding. The analysis identifies 557 cooling deserts, defined as tracts where environmental heat risk is high and financial constraints make effective cooling structurally inaccessible, …

Essays On Health And Immigration Policy, Selen Ozdogan

Dissertations, Theses, and Capstone Projects

This dissertation consists of two essays in applied microeconomics, each examining how individuals and institutions respond to policy changes. Both essays leverage natural experiments and recent advances in difference-in-differences estimation to identify causal effects. Both also speak to a common theme in public policy: the gap between intended and actual consequences of government intervention, and the role that policy design plays in shaping those consequences.

The first essay examines the impact of state-level e-cigarette excise taxes on nicotine and tobacco exposure among adults aged 18 and older. A central contribution is its use of individual-level panel biomarker data from urine …

The Effect Of State Abortion Restrictions On Female Labor Force Participation And School Enrollment, Elena T. Albano

Graduate Masters Theses

This paper examines the causal effect of state-level abortion restrictions on young women’s labor force participation and school enrollment following the Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization. Using a difference-in-differences design that exploits the cross-state variation in post-Dobbs abortion policies, I estimate that abortion bans led to a decline in combined school and labor force participation among young women by at least 1 percentage point. This effect is qualitatively robust to a triple difference specification that uses men as a within-state control group, confirming that the results do not reflect broader economic shocks specific to …

Linking Fishery Productivity To Child Health In The Coastal Tropics, Francisco Flores-Mejia

Master's Theses

Fish are a primary source of calories, macronutrients, and income for coastal communities around the world, but overfishing and environmental changes have dramatically reduced productivity in the majority of small-scale fisheries. The social costs of these losses are believed to be large, particularly in poorer communities, but most estimates of fishery productivity effects on households are contextual and difficult to generalize. We combine a remote sensing measure of pelagic fishery productivity with geolocated child health and growth data from 34 countries in the coastal tropics. We estimate that the difference between sustainedly good versus bad fishing conditions corresponds up to …

Spatial Analysis Of Maize Yields And Household Dietary Diversity In Sub-Saharan Africa: Causal Evidence From A Machine Learning Instrument, Addi Joof

Master's Theses

MAIZE YIELDS AND HOUSEHOLD DIETARY DIVERSITY IN SUB-SAHARAN AFRICA: EVIDENCE ON THE CAUSAL EFFECT FROM A MACHINE LEARNING INSTRUMENT

Addi Joof, University of San Francisco, May 2026

This paper provides estimates of the effect of maize yield on household dietary diversity across seven Sub-Saharan African countries, using data from 36,474 maize-growing households in the Living Standards Measurement Study Integrated Surveys on Agriculture (LSMS-ISA) panels for the period 2008--2021. OLS estimates which include district and country-by-wave fixed effects yield a positive and significant coefficient of 0.070 (SE = 0.006, p < 0.001), implying that a 10 percent increase in maize yield raises the Household Dietary Diversity Score (HDDS) by approximately 0.007 food groups. Because self-reported yields are subject to classical measurement error and unobserved household characteristics confound the OLS estimate, we construct an instrumental variable using a Random Forest model trained on satellite-derived agro-environmental features including the Enhanced Vegetation Index, Normalized Difference Vegetation Index, Growing Degree Days, precipitation, and soil moisture obtained from Google Earth Engine at the GPS-coordinate-by-year level. Our preferred 2SLS specification, which adds region fixed effects to absorb persistent sub-national geographic variation, returns a positive point estimate of 0.217 (SE = 0.206; 95% CI: -0.19 to +0.63, p = 0.294) larger than OLS and consistent with downward attenuation bias, but imprecisely estimated and statistically indistinguishable from zero at conventional levels. We interpret the OLS estimate of 0.070 as a credible lower bound on the true effect, with the IV evidence pointing to a moderately larger but uncertain magnitude. Heterogeneity analysis reveals a declining gradient across consumption quintiles the effect is strongest among the poorest households (Q1: 0.055, p < 0.01) and diminishes with wealth (Q5: 0.015, not significant) while showing no gradient across market-integration levels. These patterns are consistent with own-consumption, rather than market income from surplus sales, as the primary pathway from yield to dietary diversity. OLS estimates are positive and significant in five of six estimable countries. The findings suggest that maize yield improvements can serve as a nutrition co-investment, particularly for subsistence-oriented smallholders, though the available data do not permit a sharp causal quantification of the effect size.

Keywords: dietary diversity, maize yields, instrumental variables, Sub-Saharan Africa, LSMS-ISA, satellite …

Solid Waste Management In Greater Khartoum City, Sudan, Roba Mahmoud

Student Theses 2015-Present

This study investigates the rising solid waste management (SWM) dilemma in Greater Khartoum City (GKC), a critical environmental and public health issue caused by fast urbanization and inadequate infrastructure, with historical linkages to Sudan's colonial and postcolonial growth. Chapter 1 describes the current problem using quantitative and qualitative data, demonstrating that GKC produces approximately 3,340 tons of waste each day, with 56% organic matter, 8% plastics, and 16% paper. Collection efficiency remains severely poor, at 31.5%. Informal recyclers known as Nakasha or Barkata collect approximately 7% of total waste, supporting roughly 3,900 people, whereas filthy open dumps and unsorted medical …

The Effects Of Private Equity Ownership Of Acute Care Hospitals On Patient Experience, Abigail M. Huffman

Theses and Dissertations

In 10 years, private-equity firms' share of hospitals has grown from 2-3% to 8%.  Using data from two sources: the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient surveys and the Private Equity Stakeholder Project (PESP), I demonstrate a causal effect of private-equity ownership on patient satisfaction using difference-in-difference methods.

Effects Of Punitive Immigration Enforcement On The Health Of Latinos With Lower Educational Attainment, Andrea Sofia Mendoza

Theses and Dissertations

This paper analyzes the effects of the Secure Communities (SC) immigration enforcement program on self reported health and healthcare-seeking behaviors of citizen and non-citizen Latinos with lower educational attainment. SC allowed local jails to use FBI and DHS data to determine whether arrested individuals were eligible for deportation. SC was rolled out across counties from late 2008 through 2013. Using data from the Behavioral Risk Factors Surveillance Survey (BRFSS) and implementation records from Alsan and Yang (2024), staggered difference-in- difference regression estimates show that SC implementation increased the likelihood of a reported heart attack and heart disease across the sample. …

The Effect Of Prenatal Substance Use Policies On Women's Well-Being, Zukruf Alam

Theses and Dissertations

This paper examines the effects of punitive and priority treatment policies relating to the use of illicit substances during pregnancy on women's health and health-related behavior. Punitive interventions criminalize substance use during pregnancy, which can even lead to termination of parental rights. In contrast, priority treatment policies support pregnant women and grant them priority access to substance use disorder treatment programs. I use staggered difference-in-differences methods and data from the Behavioral Risk Factor Surveillance System data from 2004 to 2018 to estimate the impact of prenatal substance use policies on women's mental health, physical health, self-reported poor health, and cigarette …

Private Equity, State Enforcement, And Arbitration Outcomes Under The No Surprises Act: Evidence From Air Ambulance Disputes, Peter Readman

Theses and Dissertations

The No Surprises Act (NSA) removed patients from responsibility for out-of-network surprise medical bills. In its place, the NSA established an independent dispute resolution (IDR) process through which providers and insurers submit competing payment offers to an arbitrator, who selects one offer in full. Using the universe of federal air ambulance IDR disputes from Q1 2023 through Q2 2025 (57,368 dispute line items), I examine whether provider ownership structure and enforcement jurisdiction jointly predict arbitration outcomes. The two outcomes, whether the provider offer prevails, and how large that prevailing offer is relative to the benchmark payment rate, the Qualifying Payment …

Air Pollution And Self-Reported Health Outcomes In The United States, Alina Dervisevic

Theses and Dissertations

This study examines the relationship between short-term PM2.5 exposure and self-reported health outcomes among U.S. adults using BRFSS data from 2000 to 2012 linked to county-level pollution and weather data. Results show that PM2.5 exposure is associated with worse mental health and gender specific behavioral responses.

In Silico Model Of Musa Acuminata Stem As An Anticancer On Oral Squamous Cell Carcinoma Against Egfr, Nevrila Dewi Rachmayani, Amy Nindia Carabelly, I Wayan Arya Krishnawan Firdaus, Maharani Laillyza Apriasari, Juliyatin Putri Utami

Journal of Dentistry Indonesia

Background: Oral squamous cell carcinoma (OSCC) is characterized by overexpression of the epidermal growth factor receptor (EGFR). Citral, eucalyptol, and caffeic acid phenethyl ester (CAPE), which are derived from Musa acuminata, have shown anticancer activity. This study evaluated the potential of citral, eucalyptol, and CAPE from Musa acuminata as anticancer agents for OSCC by targeting EGFR using an in silico approach.

Methods: Potential biological activity was predicted using Prediction of Activity Spectra for Substances (PASS) Online. Molecular docking was conducted with AutoDock Vina, and BIOVIA Discovery Studio was used to analyze binding affinity, interaction types, and bond …

Micro-Ct Evaluation Of Root Canal Transportation And Centering Ability In Mesial Canals Of Mandibular First Molars, Selen Ince Yusufoglu, Esma Saricam, Mert Ocak, Ferhat Geneci, Burak Bilecenoğlu

Journal of Dentistry Indonesia

Background: This study aimed to evaluate canal transportation, centering ability, structure model index (SMI), surface area, and root canal volume changes in the mesial canals of mandibular first molars using micro-CT.

Methods: Twenty-four mandibular first molars with two separate mesial canals and moderate curvature were included. Teeth were scanned using micro-CT before instrumentation and randomly divided into three groups (N = 8). Root canals were prepared using OneShape, OneCurve, and Rotate file systems, followed by post-instrumentation micro-CT scanning (10µm/pixel resolution). Changes in canal volume, surface area, transportation, centering ability, and SMI were analyzed at the apical, middle, and …

Competition As A Solution To High Prices And Low Capacity In U.S. Healthcare: A Synthetic Control Analysis Of Certificate Of Need Repeal As A Lever For Hospital Market Reform, Eve Velasquez, Wyatt Greco

School of Public Policy Capstones

The U.S. healthcare system faces dual challenges: rising hospital prices and declining capacity. Between 2000 and 2024, average hospital expenses per adjusted inpatient day increased from approximately $1,000 to over $3,000, while hospital beds per capita declined from 3.11 to 2.45. This capstone evaluates three policy alternatives to address affordability and accessibility: restrictions on most-favored nation clauses in insurance-provider contracts, elimination of federal tax exemptions on employer-sponsored health insurance, and repeal of certificate of need (CON) laws. Through a comprehensive literature review and a synthetic control analysis of Indiana's 2019 nursing home CON reinstatement, we assess the empirical effects on …

Hospital Concentration And Aca Premiums, Lucas Piselli

Bryant REDay (Research and Engagement Day)

This research examines the relationship between hospital market concentration and health insurance premiums in the Affordable Care Act (ACA) Marketplaces. As hospitals across the United States have increasingly merged or closed, provider markets have become more concentrated, raising questions about whether consolidation improves efficiency or instead increases healthcare costs through greater market power. Using Marketplace premium data, hospital discharge information, and demographic controls from 2014–2017, the study analyzes how hospital concentration, measured by the Herfindahl–Hirschman Index (HHI), affects insurance pricing. The findings show that highly concentrated hospital markets are associated with significantly higher Marketplace premiums, even after controlling for insurer …

Costs, Demographics, And Causative Agents In Patients Hospitalized For Drug Induced Liver Injury: Trends In A Large Academic Healthcare System, Megan Kozar, Yunisse Gonzalez, Dina Halegoua-De Marzio

Department of Medicine Faculty Papers

PURPOSE: Drug-induced liver injury (DILI) is an uncommon but potentially life-threatening condition. To date, the burden of DILI on a single, large healthcare system has not been investigated, preventing adequate resource allocation. This study aims to quantify DILI-related healthcare utilization within the Jefferson Health System (JHS) and identify case-related factors associated with high resource requirements; such information is crucial to focus efforts toward resource reduction.

PATIENTS AND METHODS: This study characterizes trends of 48 DILI cases within JHS, including demographics, payer status, causative agent, and DILI pattern. These variables were correlated with length of stay (LOS) and cost relating to …

Drowning Prevention In The West: Who Did It Better?, Arran Hedley

University Honors Theses

This paper aims to communicate the differences on how the US, UK and Australia have approached drowning prevention in each of their nations. This paper addresses drowning statistics within each nation, national, state and local policies, access to public facilities, and the preventative strategies, swim lessons and Lifeguarding. These are the criteria each nation is being graded upon, because each criteria is a factor that can help mitigate drowning deaths.

For literature around this subject, there are many papers on each individual nation's approach to drowning but in researching there does not appear to be a comparison of the nations' …

Cost-Effectiveness Of Blood-Based Fibrosis Screening In High-Risk Metabolic Liver Diseases With Emerging Therapies, Wanyi Chen, Stephanie T. Chang, Ramsey C. Cheung, Donald B. Chalfin, Kinpritma Sangha, Szu-Yu Zoe Kao, Artem T. Boltyenkov

College of Population Health Faculty Papers

BACKGROUND AND AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) remains a global public health threat. With emerging effective pharmacologic therapies, early identification of significant fibrosis in primary care is critical. We evaluated the cost-effectiveness of blood-based noninvasive tests incorporating real-world diagnostic performance in the contemporary MASLD treatment era.

METHODS: We developed a decision-analytic model for MASLD natural history and treatment to compare 6 noninvasive test strategies using Fibrosis-4 (FIB-4) and/or enhanced liver fibrosis (ELF) tests at varying cutoffs. Patients identified with significant fibrosis were referred for hepatology staging (biopsy and/or imaging-based), and eligible individuals were considered for Resmetirom ($47,400/y; mean …

Expanding Public Health Insurance To Parents: Effect On Parents' And Children’S Well-Being, Michelle Marcus, Xuan Zhang

Research Collection School Of Economics

Expanding public health insurance to parents may not only improve parental outcomes but also have spillover effects on their children. This paper leverages the natural experiment of the Affordable Care Act (ACA) to estimate the causal effects of expanding public health insurance to low-income parents on their well-being and that of their children. Using a difference-in-differences model and data from the 2010–2017 National Health Interview Surveys, we observe significant improvements in health care access, increased health care utilization, reduced financial burdens, and slight improvements in health status among low-income parents. For children in Medicaid expansion states, we find reductions in …