Health Economics Commons^™

The Case For Public Investment In Higher Pay For New York State Home Care Workers: Estimated Costs And Savings, Isaac Jabola-Carolus, Stephanie Luce, Ruth Milkman

Publications and Research

This report explores one potential solution to the mounting home care labor shortage in New York State: substantially raising wages for the state's home care workers. The analysis presents detailed projections, based on the best available data, of the economic effects of such an intervention, estimating the costs and benefits that would result. We find that public funding to raise home care wages would require significant resources, but those costs would be surpassed by the resulting savings, tax revenues, and economic spillover effects. The net economic gain would total at least $3.7 billion. Lifting wages would also help fill nearly …

Framing Inclusion: The Media Treatment Of Irregular Immigrants' Right To Health Care In Spain, Alisa Petroff, Anahí Viladrich, Sònia Parella

Publications and Research

With the passing of Royal Decree-Law 16/2012, Spain’s national health system switched from a model defined by universal and free health care principles, to a private insurance system that excluded large population groups. Based on a qualitative research design, this paper examines the media treatment of undocumented immigrants’ prerogatives to public health care in Spain (2012–2018). The analysis of 234 articles, drawn from three major Spanish newspapers, reveals three frames that underscore the media’s "rhetorics of inclusion," which argue for the extension of free medical services to irregular immigrants a topic traditionally underestimated by the literature. The moralist frame, supported …

The Cost Effectiveness Of Mental Health Treatment In The Lifetime Of Older Adults With Hiv In New York City: A Markov Approach, Juan J. Delacruz, Mark Brennan-Ing, Andreas Kakolyris, Omar Martinez

Publications and Research

Background

There are noticeable gaps in knowledge regarding the cost and effectiveness of integrated medical and behavioral services for older adults with HIV. Their lifespan is close to the population’s level but their quality of life has sharply declined due to depression and substance use. Mental health disorders are widespread among an aging population with HIV. Objective The aim of this study was to build a decision analytic model to evaluate medical interventions with and without mental health treatment using primary data of 139 older adults with HIV and health outcomes from the literature.

Methods

We tracked the progression of …

Essays On The Short-Term Impact Of Minimum Unit Pricing Policy In Scotland, Irena P. Xhurxhi

Dissertations, Theses, and Capstone Projects

This dissertation consists of two chapters, and it evaluates the short-term impact of Scotland’s Minimum Unit Pricing (MUP) policy on a variety of outcome measures. Excessive alcohol consumption has long been considered one of Scotland’s greatest public health challenges, and in an attempt to change this harmful relationship with alcohol, the Scottish Government proposed an alcohol strategy comprising of over 40 measures, a central part of which was the introduction of a statutory minimum price of 50 pence per unit (10ml/8gr) of alcohol known as Minimum Unit Pricing (MUP). This policy aims to reduce alcohol consumption, and in turn, alcohol …

Essays In Applied Microeconomics, Eric Osborne-Christenson

Dissertations, Theses, and Capstone Projects

This dissertation consists of three chapters and covers topics in applied microeconomics broadly defined as health and labor. The precise topics are varied, with their unifying thread being that they are all related to marginalized or at-risk communities. The first chapter estimates the impact of Daylight Saving Time (DST) on deaths of despair (DoD) in the United States. Using Multiple Cause-of-Death Mortality Data from the National Vital Statistics System of the National Center for Health Statistics from 1979-1988, the effect is identified in two ways: a regression discontinuity design (RDD) that exploits discrete time changes in the Spring and Fall; …

The Effects Of Eighth Years Of Compulsory Schooling Enforcement In Turkey, Muhammed Tumay

Dissertations, Theses, and Capstone Projects

This dissertation consists of two chapters that cover Education, Labor and Health Economics.

Chapter 1. Impacts of Compulsory Schooling Reform on Higher Education and Intergenerational Educational Mobility: we estimate the effects of an exogenous increase in mandatory schooling (5 years to 8 years of schooling), as a result of a change in compulsory schooling law, on higher education, potential intergenerational educational mobility, and labor market outcomes among women in Turkey. Our empirical strategy addresses a well-known identification problem where women’s years of schooling are endogenous to individual characteristics. The Law took effect in 1997, whereby girls born before January …

Essays On Paid Sick Leave In The United States, Shaoying Ma

Dissertations, Theses, and Capstone Projects

This dissertation consists of two chapters.

Chapter 1 This study estimates the causal effect of access to paid sick leave on worker mobility, by exploiting variation in the implementation of local paid sick leave mandates over time in the U.S. I use May 2004 - June 2019 Current Population Survey (CPS) basic monthly data, and by taking a Difference-in-Differences approach, I find that the local mandates significantly reduce private sector employees' monthly job turnover. This study is, to the best of my knowledge, the first to present the effect of local paid sick leave mandates in the U.S. on worker …

The Effect Of Naloxone Access Laws On The Type Of Referrals And Admin Treatment Settings Of Drug Treatment Centers For Opioid Abuse, Samanta Kolenovic

Theses and Dissertations

Since 1999, deaths from drug overdose have more than doubled in the U.S. making it one of the leading health problems. This paper examines the impact of passing a naloxone access law on the type of referrals and admin treatment settings of drug treatment centers for opioid abuse.

Effect Of The Affordable Care Act Medicaid Expansion On Labor Participation Of Female Registered Nurses In Outpatient Care, Deborah R. Weissner

Theses and Dissertations

Medicaid expansions were used to examine the effects of a surge in demand for primary care on the labor participation of registered nurses (RN) in outpatient settings relative to hospitals. Using difference-in-differences and two-way fixed effects with the American Community Survey Public Use Microdata Sample single-year 2010 through 2017 files, I find an increase in the probability of an RN working in an outpatient setting among (1) young, unmarried RNs with a maximum household income of 501 percent of the federal poverty level and (2) young unmarried RNs who have at least one child under age 6. These results are …

Medical Resource Use And Costs Of Treating Sickle Cell-Related Vaso-Occlusive Crisis Episodes: A Retrospective Claims Study, Nirmish Shah, Menaka Bhor, Lin Xie, Jincy Paulose, Huseyin Yuce

Publications and Research

Background: The study investigated the economic burden of vaso-occlusive crisis (VOC) among sickle cell disease (SCD) patients, through assessment of overall utilization and costs and costs per VOC episode (regarding the number of VOC episodes and health care setting, respectively).

Methods: Using the Medicaid Analytic Extracts database, the first SCD-related diagnosis claim (index claim) between June 1, 2009–December 31, 2012 was identified among eligible adults. Patients were required to have continuous medical and pharmacy benefits for 6 months pre- and 12 months post-index. Discrete VOC claims identified within a 3-day gap were combined as a single VOC episode. Annual all-cause …

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 …

The Effect Of Hurricane Sandy On Mental Health Outcomes Of New Yorkers, Kacper Perkowski

Theses and Dissertations

This study’s objective is to evaluate the effect of Hurricane Sandy on the long-term mental health of New Yorkers. Health data spanning from 2010-2014 was obtained through the Community Health Survey. Difference-in-differences regressions were employed to evaluate the relationship. The results show Hurricane Sandy had no statistically significant effect on any key mental health variables.

In Utero Nutritional Shocks And Non-Cognitive Skills: Evidence From Ramadan Fasting In Indonesia, Timothy M. Kell-Fien

Theses and Dissertations

This paper estimates the effects of prenatal exposure to maternal Ramadan fasting on the development of non-cognitive skills. To study this relationship, I employ a general structural equation model (GSEM) on a sample of Muslims from the fifth wave of the Indonesian Life and Family Survey (IFLS). The results of this study find that in utero exposure to Ramadan is associated with lower levels of agreeableness and conscientiousness, and higher levels of neuroticism. The impacts I find on agreeableness and conscientiousness are driven by third trimester exposure and the sub-sample of women. The impacts on neuroticism are driven by exposure …

Treatment Patterns And Economic Burden Of Sickle-Cell Disease Patients Prescribed Hydroxyurea: A Retrospective Claims-Based Study, Nirmish Shah, Menaka Bhor, Lin Xie, Rashid Halloway, Steve Arcona, Jincy Paulose, Huseyin Yuce

Publications and Research

Background: This study aimed to evaluate sickle-cell disease (SCD) treatment patterns and economic burden among patients prescribed hydroxyurea (HU) in the US, through claims data.

Methods: SCD patients with pharmacy claims for HU were selected from the Medicaid Analytic Extracts (MAX) from January 1, 2009 - December 31, 2013. The first HU prescription during the identification period was defined as the index date and patients were required to have had continuous medical and pharmacy benefits for ≥6 months baseline and 12 months follow-up periods. Patient demographics, clinical characteristics, treatment patterns, health care utilization, and costs were examined, and variables were …

Effects Of Innovations In Health Care Provision And Financing, Hoda Nouri Khajavi

Dissertations, Theses, and Capstone Projects

This dissertation consists of four chapters that study the impacts of innovations in health care provision and financing. The relentless rise in US health care costs has led the Centers for Medicare and Medicaid Services to launch various pilot programs to create financial incentives for health care providers, suppliers, and local communities to improve the efficiency of the health care system. The fist chapter of this manuscript reviews the main pilot programs implemented and/or funded by the Centers for Medicare and Medicaid Services since the 111th United States Congress passed the Patient Protection and Affordable Care Act, also known as …

The Effect Of Citi Bike Introduction On Injury Rates In New York City, Masakazu Hiruma

Theses and Dissertations

This paper tests the hypothesis that the introduction of Citi Bike influences bicycle injuries by observing the gradual expansion of the bike share system in NYC. Data is analyzed from 2012-2018 New York Police Department (NYPD) Motor Vehicle Collisions and Citi Bike Station Feeds (NYC Open Data).

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 …

The Impact Of Step Parenting On The Health, Behavior And Development Of School-Aged Children, Emmanuel Botwe

Theses and Dissertations

The American family structure has changed rapidly over the years, from the traditional two-biological-parent household to a variety of other family configurations, leading to a substantial number of children growing up in step-families. This paper examines the impact of step-parenting on child health outcomes among school-aged children.

The Effect Of The Dependent Coverage Provision Of The Affordable Care Act On Opioid Use And Abuse, Christian Carrillo

Theses and Dissertations

The non-medical use of prescription opioids has become the fastest growing drug problem in the United States. This paper examines the effect of the ACA's dependent coverage provision on the prevalence of prescription opioid misuse and abuse along with the mechanism driving the results.

Effects Of Physician-Hospital Integration On Malpractice Claims, Elizabet Shvets

Theses and Dissertations

Recent increases in physician-hospital (i.e., vertical) integration has spurred both opposition on the grounds of anti-trust concerns and support on the basis of lowering transaction costs and improving communication. This paper examines the effects of vertical integration on quality of care as measured by malpractice claims.The study employs four data sets from the state of Florida (FL AHCA Financial Data, AHA Survey Data, FL AHCA Discharge Data, and FL Malpractice Claims from the Office of Insurance Regulation) culminating in an unbalanced panel dataset for the years 1998 to 2013. I utilize a linear model with hospital and year fixed effects …

The Impact Of Legalization Of Marijuana On Opioid Overdose Deaths, Radhika N. Bharadwaj

Theses and Dissertations

This masters’ thesis aims to examine the impact of the legalization of marijuana for recreational use on the death toll from opioid misuse in the state of Colorado. This investigation was done using the Synthetic Controls Method via data collected primarily from the CDC and IPUMS databases. The results indicate that the 2012 legalization policy in Colorado appears to reduce the number of deaths due to opioid overdoses.

Essays On The Economics Of Unhealthy Behaviors, Raul Segura-Escano

Dissertations, Theses, and Capstone Projects

This dissertation aims to explore a variety of responses in the form of unhealthy behaviors as a consequence of different sudden events perceived by individuals. The first one is the doubtlessly pure exogenous shock caused by an unexpected terrorist attack, Boston Marathon Bombings. The second one is the turmoil caused by the Great Recession of 2008, which is the most serious economic downturn since the Great Depression during the 1930’s. This dissertation consists of the following two chapters:

Chapter 1: “The Impact of Terrorism on Mental Health and Substance Use: Evidence from the Boston Marathon Bombings” On April 15, 2013, …

Essays On The Market Structure Of The U.S. Health Care System, Ayse S. Diebel

Dissertations, Theses, and Capstone Projects

This dissertation examines the welfare implications of vertical restraints in the U.S. health care market. I focus on two phenomena that influence vertical relationships between hospitals and insurers: vertical integration and vertical bundling. Both of these practices have potential efficiency-inducing and anti-competitive effects from a theoretical standpoint, making welfare implications ambiguous. I analyze their impact on welfare in an empirical setting. This task requires structurally modeling the market by using data on hospitals, insurers, and consumers, and simulating counterfactual worlds free of vertical restraints.

I construct my dataset by combining data from multiple sources. Hospital characteristics come from the American …

Supermarket Retailers’ Perspectives On Healthy Food Retail Strategies: In-Depth Interviews, Olivia Martinez, Noemi Rodriguez, Allison Mercurio, Marie Bragg, Brian Elbel

Publications and Research

Background

Excess calorie consumption and poor diet are major contributors to the obesity epidemic. Food retailers, in particular at supermarkets, are key shapers of the food environment which influences consumers’ diets. This study seeks to understand the decision-making processes of supermarket retailers—including motivators for and barriers to promoting more healthy products—and to catalogue elements of the complex relationships between customers, suppliers, and, supermarket retailers.

Methods

We recruited 20 supermarket retailers from a convenience sample of full service supermarkets and national supermarket chain headquarters serving low- and high-income consumers in urban and non-urban areas of New York. Individuals responsible for making …

The Effects Of The Aca’S Medicaid Expansion And Woodwork Effect On Hospital Finances, Azemina Redzematovic

Theses and Dissertations

With many individuals enrolled in Medicaid through the ACA Medicaid expansion and woodwork effect, this paper estimates the effects on utilization of hospital services and hospital finances. Using a difference-in-differences (DD) instrumental variables model, the results that suggest that increased Medicaid demand does not necessarily equate to increased profits.

Impacts Of Antepartum Health Status And Health Insurance Coverage, Anjelica Gangaram

Theses and Dissertations

This paper examines how a woman's antepartum health and health insurance status affect her likelihood of experiencing postpartum maternal morbidity complications.

Race And Gun Violence In The United States: A Case Study Of Policy Reform In Missouri, Morgan C. Williams Jr

Dissertations, Theses, and Capstone Projects

Gun violence remains an important contributor to racial differences in mortality within the United States. Despite the existence of these significant racial disparities in firearm homicide victimization, the relationship between gun control policy and racial disparities in homicide remains largely unexplored within the empirical crime literature. Previous research suggests that access to secondary firearm markets serves as a salient contributor to local gun violence with the regulation of private firearm sales falling exclusively within state-level jurisdiction. The role of state-level background check requirements for private firearm sales in reducing gun violence remains controversial in both the empirical literature and gun …

Essays On The Economics Of Health And Human Capital, Paloma Lopez De Mesa Moyano

Dissertations, Theses, and Capstone Projects

This dissertation explores dynamics related to the formation of human capital. In the two chapters contained within, my work investigates how human capital is formed and maintained through either individual decisions or historic events. In particular, the first chapter analyzes the long-term health effects of a large-scale bombing campaign on the population of a developing country up to two generations after the event occurred; the second chapter analyzes how attending a public honors college in the U.S. affects the degree completion of students and their college quality choice. In these two different contexts, I approach the common topic of human …

Essays On The Economics Of Driving And Health, Jessica Lynn Peck

Dissertations, Theses, and Capstone Projects

This dissertation comprises three essays on the economics of driving and health. The first examines the effect of the ride-hailing service Uber, its launch in New York City in May 2011, and the resulting drunk-driving outcomes in the counties that received service compared with those that did not. The difference-in-differences estimation of this effect implies a 25 to 35 percent decrease in the alcohol-related collision rate for the affected New York City boroughs, or about 40 collisions per month. With differentiated treatment effects for each affected county, the difference-in-differences effect is higher for Manhattan, middling for the Bronx and Brooklyn, …

The Effect Of Expansions In Medicaid Eligibility On Hospital Financial Performance: Evidence From Medicare Cost Reports, Kevin Wu

Theses and Dissertations

Expansions in Medicaid eligibility and effects on profitability for different hospitals are examined using data from Medicare Cost Reports and difference-in-differences analysis. Critical access and disproportionate share hospitals are associated with the largest profitability gains from these expansions. Results imply that vulnerable hospitals are affected most by changes to Medicaid.