Health Economics Commons^™

Urban-Rural Gaps In The Prevalence Of Hypertension, Obesity And Diabetes In Malaysia, Thangiah Govindamal

Student Works (2020-2029)

Rapid economic growth has driven urbanization in developed and developing economies. However, it also created several problems, such as a deterioration in health conditions worldwide and widening of urban-rural and income inequality. A major consequence of urbanization include the rising prevalence of non-communicable diseases, cardiovascular disease (CVD) and its risk factors, such as hypertension, obesity and diabetes. The rapid nutrient and physical activity transition due to urbanization and the peculiar form of economic transformation has impacted the CVD risk factors. Rising urban-rural differences in health profiles and CVD risk factors in both locations over years in Malaysia prompted this research …

Impacts Of Rift Valley Fever Virus: A One Health Approach To Assess Burden And Inform Prevention And Control Options, Catherine Machalaba

Dissertations and Theses

Background: Rift Valley Fever (RVF) is a climate-sensitive emerging zoonotic disease associated with large-scale livestock production losses and human disease burden in Sub-Saharan Africa and the Middle East. While recognized as a key One Health issue based on its transmission dynamics involving human, animal and environmental determinants, there has been poor coordination between sectors to reduce the risk and impact of RVF. Efforts to counter the disease remain largely reactive, presenting an ongoing threat to local and global health security. The intent of this dissertation was to improve understanding of the burden of RVF across society and to identify entry …

Professional Sporting Events Increase Seasonal Influenza Mortality In Us Cities, Alexander Cardazzi, Brad Humphreys, Jane E. Ruseski, Brian P. Soebbing, Nicholas Watanabe

Economics Faculty Working Papers Series

The COVID-19 pandemic shut down sporting events worldwide. Local policy makers and league officials face important decisions about restarting play, especially in professional leagues that draw large numbers of spectators to games. We analyze the impact of professional sporting events on local seasonal influenza mortality to develop evidence that will help inform sports league reopening policy decisions. Results from a difference-in-differences model applied to data from a sample of US cities that gained new professional sports teams over the period 1962-2016 show that the presence of games in these cities increased local influenza mortality by between 4% and 24%, depending …

298— Rural Economic Growth And Disease Intervention In Ghana; The Edward Pettinella '73 Endowed Ambassadorship In Business, Lucas Sutton

GREAT Day Posters

Schistosomiasis is a leading parasitic infection that debilitates many individuals in sub Saharan Africa. Because this parasitic infection involves a snail as an intermediate host, we use a native prawn species as a natural predator to decrease the population of this snail community. This study focuses on Tomefa, a primarily fishing peri-urban community located oi the outskirts of Accra, the capital city of Ghana. A survey was also given to the local community measuring economic characteristics. In the laboratory, Macrobrachium spp prawn exhibit preference of Bulinus snails over Biomphalaria snails while non-parasitic snails were consumed in higher proportion to parasitized …

Did Social-Distancing Measures In Kentucky Help To Flatten The Covid-19 Curve?, Charles J. Courtemanche, Joseph Garuccio, Anh Le, Joshua C. Pinkston, Aaron Yelowitz

Institute for the Study of Free Enterprise Working Papers

In the absence of a vaccine or more effective treatment options, containing the spread of novel coronavirus disease 2019 (COVID-19) must rely on non-pharmaceutical interventions. All U.S. states adopted social-distancing measures in March and April of 2020, though they varied in both timing and scope. Kentucky began by closing public schools and restaurant dining rooms on March 16th before progressing to closing other non-essential businesses and eventually issuing a “Healthy at Home” order with restrictions similar to the shelter-in-place (SIPO) orders adopted by other states. We aim to quantify the impact of these measures on COVID-19 case growth in the …

Congenital Chagas Disease In The United States: The Effect Of Commercially Priced Benznidazole On Costs And Benefits Of Maternal Screening, Victoria Perez-Zetune, Stephanie R. Bialek, Susan P. Montgomery, Eileen Stillwaggon

Economics Faculty Publications

Chagas disease, caused by Trypanosoma cruzi, is transmitted by insect vectors, and through transfusions, transplants, insect feces in food, and mother to child during gestation. An estimated 30% of infected persons will develop lifelong, potentially fatal cardiac or digestive complications. Treatment of infants with benznidazole is highly efficacious in eliminating infection. This work evaluates the costs of maternal screening and infant testing and treatment for Chagas disease in the United States, including the cost of commercially available benznidazole. We compare costs of testing and treatment for mothers and infants with the lifetime societal costs without testing and consequent morbidity and …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Kinerja Rumah Sakit Swasta Dengan Pembayaran Ina Cbgs Di Era Jaminan Kesehatan Nasional: Casemix, Casemix Index, Hospital Base Rate, Atik Nurwahyuni, Ery Setiawan

Jurnal Ekonomi Kesehatan Indonesia

Private hospitals must monitor their performance using indicators commonly used in DRG payment systems: casemix, casemix index and hospital base rate. This study aims to analyze the performance of private hospitals including casemix, casemix index and hospital base rate. This cross sectional study was conducted with a sample of 7 hospitals selected purposively representing private hospital type B, C, and D in 6 provinces. Casemix and CMI RS are strongly influenced by the hospital capacity, which the hospitals class B have higher casemix and CMI than class C and D hospitals. There is a phenomenon, CMI in class C hospitals …

Analysis Of Risk For Class Shifting And Determinants Of Bpjs Kesehatan Membership Using Generalized Ordered Logit-Unconstrained Partial Proportional Odds Model, Siskarossa Ika Oktora, Ika Yuni Wulansari, Geri Yesa Ermawan

Jurnal Ekonomi Kesehatan Indonesia

The main source of funding of BPJS Kesehatan comes from the different premium class in which the participant registered. The medical benefits among classes are equivalent, except inpatient facilities. But when the improvement health degree is not linear with the incurred costs, problem would arise. This study aims to analyze class shifting and determinants of BPJS Kesehatan membership. Around 1.53 percent of participants access higher classes, while 5.62 percent access lower classes. Class III participants with inpatient status severity level 2 and 3, reaching 41% and 43%, respectively. In addition, 60% of non-PBI participants are Class II premium participants; most …

Kajian Literatur Sistematis: Skema Pengendalian Biaya Dalam Asuransi Kesehatan Nasional Di Beberapa Negara, Eka Pujiyanti, Ery Setiawan, Euis Ratna Sari, Indah Pratiwi Suwandi

Jurnal Ekonomi Kesehatan Indonesia

Cost-containment is one of several strategies to ensure the financial sustainability of the National Health Insurance scheme. Several cost-containment models were commonly globally, such as cost-sharing, capping, and others. This review aims to determine the costs and impacts of implemented policy schemes as cost-containment instruments in various countries. We performed a systematic review from several primary databases (Proquest, Pubmed, and Cochrane Library) with the primary intervention are the cost-sharing methods. The results of our review focused on the cost containment scheme from the government perspective, in which the context of social insurance can be a modification of payment systems, cost-sharing, …

Kemampuan Dan Kemauan Pasien Umum Rawat Inap Dalam Membayar Pelayanan Kesehatan Rawat Inap Di Rumah Sakit Umum Kaliwates Kabupaten Jember, Yanuar Anafia, Eri Witcahyo

Jurnal Ekonomi Kesehatan Indonesia

testRational rates were determined by calculating unit costs into account characteristics of product as information related ability and willingness to pay. Ability and willingness were calculated for quality control and cost at the hospital. Community satisfaction index in Kaliwates General hospital released number of customer satisfaction that hasn’t met the standard was rate of inpatient services. Results of preliminary study on general inpatients were 70% having an estimated rate of less than rate set by the hospital, 20% said rates were less affordable and 10% couldn’t estimate rates, then this study was calculate ability and willingness to pay for inpatient …

Analisis Biaya Satuan (Unit Cost) Dengan Metode Activity Based Costing (Abc) Di Poliklinik Jantung Rsu Dr. H. Koesnadi Bondowoso, Sumiati Sumiati, Eri Witcahyo, Andrei Ramani

Jurnal Ekonomi Kesehatan Indonesia

Determination of rate calculated based on unit cost, based on Bondowoso Regent Regulation Number 62 of 2017, RSU dr. H. Koesnadi Bondowoso unit cost calculates using the Double Distribution method. Double Distribution (DD) method is not appropriate to be applied because it does not reflect activity, method based on activity, precise and accurate so that it can provide the right information is Activity Based Costing (ABC) method. RSU Dr. H. Koesnadi Bondowoso has not made unit cost calculation using Activity Based Costing (ABC) method, especially for outpatient installation. The purpose of this research is unit cost analysis with Activity Based …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

The Effects Of Opioids On Kentucky's Workforce, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

From the executive summary:

Opioid abuse represents a significant and growing public health issue for both the nation and Kentucky. In 2016, opioids contributed to more than 62,000 deaths nationally and 1,406 deaths in Kentucky. National studies have placed the societal costs of opioid abuse at $55.7 billion in 2007 and $78.5 billion in 2013 (Birbaum et al. (2011) and Florence et al. (2016)). These costs included increased health care expenditures, higher criminal justice costs, and lost earnings due to reduced employment and premature deaths. The While House Council of Economic Advisors (2017) estimated the societal costs of opioid abuse …

The Cost-Effectiveness Of Neonatal Versus Prenatal Screening For Congenital Toxoplasmosis, Christine Binquet, Catherine Lejeune, Valérie Seror, François Peyron, Anne-Claire Bertaux, Olivier Scemama, Catherine Quantin, Sophie Béjean, Eileen Stillwaggon, Martine Wallon

Economics Faculty Publications

Congenital Toxoplasmosis (CT) can have severe consequences. France, Austria, and Slovenia have prenatal screening programs whereas some other countries are considering universal screening to reduce congenital transmission and severity of infection in children. The efficiency of such programs is debated increasingly as seroprevalence among pregnant women and incidence of congenital toxoplasmosis show a steady decrease. In addition, uncertainty remains regarding the effectiveness of pre- and postnatal treatments.

Out-Of-Pocket Expenditure For Home And Facility Based Delivery Among Rural Women In Zambia: A Mixed-Methods, Cross-Sectional Study, Jeanette L. Kaiser, Kathleen L. Mcglasson, Peter C. Rockers, Rachel M. Fong, Thandiwe Ngoma, Davidson H. Hamer, Taryn Vian, Godfrey Biemba, Jody R. Lori, Nancy A. Scott

Nursing and Health Professions Faculty Research and Publications

Purpose: Out-of-pocket expenses associated with facility-based delivery are a well-known barrier to health care access. However, there is extremely limited contemporary information on delivery-related household out-of-pocket expenditure in sub-Saharan Africa. We assess the financial burden of delivery for the most remote Zambian women and compare differences between delivery locations (primary health center, hospital, or home).

Methods: We conducted household surveys and in-depth interviews among randomly selected remote Zambian women who delivered a baby within the last 13 months. Women reported expenditures for their most-recent delivery for delivery supplies, transportation, and baby clothes, among others. Expenditures were converted to …

Perhitungan Biaya Satuan Pada Tindakan Intensive Unit Care Di Rumah Sakit X Di Jember Melalui Metode Activity Based Costing (Abc), Eri Witcahyo

Jurnal Ekonomi Kesehatan Indonesia

Hospital X in Jember is one of the government hospitals with C type status. In National Health Insurance (JKN) era, the payment scheme in hospital by using the INA CBG’s tariff package. Hospital could have profit or even loss, therefore health services effiency was needed. The objective of study was to identify service product and calculate of service product unit cost at Intensive Care Unit (ICU) in Hospital X in Jember. The type of this research was observational descriptive with cross sectional approach. The unit of analysis was ICU at Hospital X in Jember. The unit cost calculation method is …

Ekuitas Layanan Rawat Inap Rumah Sakit Di Indonesia, Devi Senja Ariani, Pujiyanto Pujiyanto

Jurnal Ekonomi Kesehatan Indonesia

In order to encourage the achievement of UHC in Indonesia, the government organized National Health Insurance (JKN) program. One of the objectives of the JKN program is the improvement of access and equity utilization of health services. This study aims to analyze Equity of Inpatient Utilization in Health Service in second and third year of JKN program implementation in 2015 and 2016. This study uses secondary data of SUSENAS in 2015 and 2016 with analysis using concentration curve and concentration index. The results showed that the Utilization of inpatient services in hospitals in the JKN group of participants increased in …

Determinan Sosial Ekonomi Konsumsi Minuman Berpemanis Di Indonesia: Analisis Data Susenas 2017, Widi Astutty Casimira Daeli, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

Sugar-Sweetened Beverages (SSBs) are added liquids with various of sugar. Consumption of SSBs contributes to Non-Communicable Diseases (NCDs) such as weight gain, increasing the risk of type 2 diabetes mellitus and cardiovascular diseases. NCDs can be prevent ed as early as possible by reducing the consumption of calories in sugar. WHO recommends adults and children to reduce sugar intake to less than 10% of total energy intake and continue to less than 5% of total energy intake. This study aims to determine the socio-eco nomic factors consumption of SSBs. We employed secondary data from the 2017 National Socio-Economic Survey (Susenas) …

Penghitungan Biaya Satuan Pada Instalasi Rawat Jalan Di Rumah Sakit X Jambi Menggunakan Metode Step Down, Susilo Wulan, Ade Herman Surya Direja, Dian Reflisiani

Jurnal Ekonomi Kesehatan Indonesia

Hospital has a responsibility to provide quality and affordable health care to the community. Therefore, determining tariffs by calcu lating the actual cost is very important, especially for internal stakeholders in undergoing cost analysis, performance evaluation and decision making, including tariff negotiation with external stakeholders. This research objective is to calculate unit costs and compar atively analyzing costs between units in an outpatient installation using the step-down method. This research used a partial economic evaluation which only portrays the description of cost object without comparing the output from the analyzed unit. The stages of data analysis include identifying the resource …

Determinan Cakupan Imunisasi Dasar Lengkap Pada Penerima Program Keluarga Harapan, Wulansari Wulansari, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Poverty is a multidimensional social problem and related to the problems of health, education and other social welfare. National Basic Immunization Coverage (IDL) reached 57.9%, with 32.9% was incomplete and 9.2% were not immunized, while national coverage indicators were at least 90%. This study aims to determine the determinants that affects basic complete immunization coverage for babies receiving the Family Hope Program (PKH). The study design used was cross sectional. The research was located in 34 provinces. The total population is 9,205 respondents using secondary data from the National Socio-Economic Survey (Susenas) in 2017. The research shows that the achievement …

Impacts Of Contraception On Women’S Decision-Making Agency In Indonesia, Michaela J. Fogarty

Undergraduate Economic Review

Increasing access to contraception has the potential to empower women and improve the economic standing of families across the globe. Many researchers have explored the impacts of contraception on families and the determinants of women’s level of empowerment, but little scholarship exists on their direct relationship. This paper explores the impacts of contraceptive use on women’s empowerment, measured by a sum of women’s household decision-making agency. Panel data from three rounds of the Indonesian Family Life Survey is used to run multiple regressions with household fixed effects. Results suggest that women who use contraception have input on two additional types …

An Evaluation Of The Impact Of Leading Pedestrian Interval Signals In Nyc, Jeremy J. Sze

Theses and Dissertations

I evaluated the impact of the phased introduction of Leading Pedestrian Interval Signals (LPIs) on collision and injury outcomes at 12,987 signalized traffic intersections in New York City over the course of 25 quarters from 2012 to 2018. An intersection is treated when a LPIs is installed to give pedestrians lead time to cross the street before vehicles are allowed to move. Outcomes from NYPD’s Motor Vehicle Collisions data were matched to signalized intersections. I hypothesize that LPIs would reduce collisions and reduce injuries for pedestrians at intersections. A difference in difference fixed effects panel regression was used to identify …

A Framework For Learning During An Honors Internship: Embold Health Inc., Haley Haldeman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Embold Health Inc. is a health care analytics start-up company that identifies top performing providers using large data sets and clinically nuanced measurement. A comprehensive assessment of quality, appropriateness, and cost is what Embold Health delivers. Embold allows payers more control in choosing providers within their region. Being able to identify top provider behaviors through rigorous data driven measurement is significant both clinically and commercially; it provides the opportunity to increase value of care, decrease waste, and drive down cost.

Over the past year as an intern, I’ve had a first-hand look into the complexity that surrounds data driven health …

Differences In Tsimane Children’S Growth Outcomes And Associated Determinants As Estimated By Who Standards Vs. Within-Population References, Melanie Martin, Aaron Blackwell, Hillard Kaplan, Michael Gurven

Economics Faculty Articles and Research

Anthropometric measures are commonly converted to age stratified z-scores to examine variation in growth outcomes in mixed-age and sex samples. For many study populations, z-scores will differ if calculated from World Health Organization (WHO) growth standards or within-population references. The specific growth reference used may influence statistical estimates of growth outcomes and their determinants, with implications for biological inference. We examined factors associated with growth outcomes in a sample of 152 Tsimane children aged 0–36 months. The Tsimane are a subsistence-scale population in the Bolivian Amazon with high rates of infectious disease and growth faltering. To examine the influence of …

Quality Over Quantity: A Comparative Analysis Of The Quality Measures And Performance Between Switzerland And The United States, Lexi Farina

Independent Study Project (ISP) Collection

Even in the best health systems, poor quality of care continues to cause harm to patients and prevent them from receiving the best treatment possible. Thus, it is important to record and report quality of care measures because they can help inform policy changes and improve performance. In this paper, a comparative analysis between the United States and Switzerland is conducted to understand the process for defining and assessing quality indicators in each country as well as compare their quality of care performance results. The methods for this study include a literature review of relevant background information relating to quality …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Maintaining Stability In A Changing Climate: A Comparative Analysis Of Public Health Systems And Migration Policies In The U.S. And Canada, Laura Cutlip

Climate and Society

This paper examines the relation between climate change, migration, and public health to better understand how the United States health system is positioned to deal with likely challenges to human health posed by environmental changes. The author reviews probable impacts of climate change on population displacement and disease before considering how the current structure of the health system of the United States will render it unable to adapt to these changes and challenges. The Canadian health care system and refugee policies are then reviewed to provide a counterpoint to this analysis. These findings are then considered in tandem as the …

The Association Between Neonatal Death And Facility Birth In Regions Of India, Diane Coffey

Journal Articles

BACKGROUND Reducing neonatal mortality in India is critical to achieving the 2030 Sustainable Development Goal of a global neonatal mortality rate (NNM) of no more than 12 per 1,000. Policy efforts to reduce India's NNM, including a large-scale conditional cash transfer program, have focused on promoting birth in health facilities, rather than at home. Between 2005 and 2015, the percentage of facility births doubled, from 40% to 80%. OBJECTIVE We assess evidence for the hypothesis that facility births reduce NNM by using new data from the National Family Health Survey, 2015-2016. METHODS We analyze the association between neonatal death and …

Water And Life. A Cross-Sectional Study On Determinants Of Beverage Consumption And Water Access In One Tribal Community, Christina White

All Master's Theses

Increasingly, poor diet has been shown to be one of the most crucial factors associated with cause of death, even more critical than smoking. Research in the past two decades has consistently linked increased consumption of sugar-sweetened beverages (SSB) to the obesity epidemic contributing to a public health crisis all over the United States. Native Americans, among other minority groups, suffer obesity disproportionately from the rest of the US population, yet they continually fail to be included in research on the subject. Traditional research methods, sparse care coverage on reservations, consolidation of unique tribes into one classification, and failure to …