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Articles 31 - 53 of 53
Full-Text Articles in Health Economics
Sources Of Health Financing And Health Outcomes: A Panel Data Analysis, Tomoki Fujii
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
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
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.
Impact Of Electrification On Children's Nutritional Status In Rural Bangladesh, Tomoki Fujii, Abu S. Shonchoy, Sijia Xu
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 …
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
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
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 …
The Long-Term Health Effects Of Fetal Malnutrition: Evidence From The 1959-1961 China Great Leap Forward Famine, Seonghoon Kim, Belton Fleisher, Jessica Ya Sun
The Long-Term Health Effects Of Fetal Malnutrition: Evidence From The 1959-1961 China Great Leap Forward Famine, Seonghoon Kim, Belton Fleisher, Jessica Ya Sun
Research Collection School Of Economics
We 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, walking and vision, and measures of mental acuity even half a century after the tragic event. Our findings imply that policies and programs that improve the nutritional status of pregnant women yield benefits on the health of a fetus that …
Sources Of Health Financing And Health Outcomes: A Panel Data Analysis, Tomoki Fujii
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.
Incense Burning During Pregnancy And Birth Weight And Head Circumference Among Term Births: The Taiwan Birth Cohort Study, Le-Yu Chen, Christine Ho
Incense Burning During Pregnancy And Birth Weight And Head Circumference Among Term Births: The Taiwan Birth Cohort Study, Le-Yu Chen, Christine Ho
Research Collection School Of Economics
Incense burning for rituals or religious purposes is an important tradition in many countries. However, incense smoke contains particulate matter and gas products such as carbon monoxide, sulfur and nitrogen dioxide, which are potentially harmful to health. We analyzed the relationship between prenatal incense burning and birth weight and head circumference at birth using the Taiwan Birth Cohort Study. We performed multivariate regression analysis on a sample of 15,773 Taiwanese babies born in 2005 and controlled extensively for factors that may be correlated with incense burning and birth outcomes. Prenatal incense burning environment was associated with lower birth weight and …
Hospital-Skilled Nursing Facility Referral Linkage Reduces Readmission Rates Among Medicare Patients Receiving Major Surgery, Andrew J. Schoenfeld, Xuan Zhang, David C. Grabowski, Vincent Mor, Joel S. Weissman, Momotazur Rahman
Hospital-Skilled Nursing Facility Referral Linkage Reduces Readmission Rates Among Medicare Patients Receiving Major Surgery, Andrew J. Schoenfeld, Xuan Zhang, David C. Grabowski, Vincent Mor, Joel S. Weissman, Momotazur Rahman
Research Collection School Of Economics
BACKGROUND:In the health reform era, rehospitalization after discharge may result in financial penalties to hospitals. The effect of increased hospital-skilled nursing facility (SNF) linkage on readmission reduction after surgery has not been explored.METHODS:To determine whether enhanced hospital-SNF linkage, as measured by the proportion of surgical patients referred from a hospital to a particular SNF, would result in reduced 30-day readmission rates for surgical patients, we used national Medicare data (2011-2012) and evaluated patients who underwent 1 of 5 operative procedures (coronary artery bypass grafting [CABG], hip fracture repair, total hip arthroplasty, colectomy, or lumbar spine surgery). Initial evaluation was performed …
The Impact Of Agglomeration Economies On Hospital Input Prices, Andrew Friedson, Jing Li
The Impact Of Agglomeration Economies On Hospital Input Prices, Andrew Friedson, Jing Li
Research Collection School Of Economics
This paper examines the extent to which agglomeration of the hospital service industry enhances the productivity of producing health care. Specifically, we use a large set of private insurance claims from the FAIR Health database to show that an increasing spatial concentration of hospital services results in a decreased cost of obtaining intermediate medical services. We explicitly test whether the reduced cost at concentrated locations arises from the ability to share intermediate service providers. The identification relies on state variation in medical lab technician licensure requirements, which influence the cost of intermediate services only through the cost of running a …
Bound Estimator Of Hiv Prevalence: Application To Malawi, Tomoki Fujii, Denis H. Y. Leung
Bound Estimator Of Hiv Prevalence: Application To Malawi, Tomoki Fujii, Denis H. Y. Leung
Research Collection School Of Economics
To find lower and upper bounds of HIV prevalence in Malawi under mild and intuitive assumptions to assess the importance of the refusal issue in the estimation of HIV prevalence. Methods: We derive bounds based on the following two key assumptions: (i) Among those who have never taken an HIV test before, those who refuse to take an HIV test (hereafter “refusers”) have at least as much risk to be HIV positive as those who participate in the HIV test, and (ii) among the refusers, those who have a prior testing experience are at least as likely to be HIV …
Long-Term Health Effects Of Malaria Exposure Around Birth: Evidence From Colonial Taiwan, Simon Chang, Belton Fleisher, Seonghoon Kim, Shi-Yung Liu
Long-Term Health Effects Of Malaria Exposure Around Birth: Evidence From Colonial Taiwan, Simon Chang, Belton Fleisher, Seonghoon Kim, Shi-Yung Liu
Research Collection School Of Economics
In the early 20th century, the Japanese colonial government initiated an island-wide malaria eradication campaign in Taiwan, resulting in not only a rapid decline in malaria across time but also elimination of disparity across regions. Exploiting variations in malaria deaths caused by the campaign, we estimate causal effects of malaria exposure around birth on the health of elderly born in the colonial period. To mitigate potential biases caused by measurement errors and omitted confounders, we employ climatic factors to instrument for malaria deaths. Our findings suggest that people who were exposed to a high malaria risk around birth tend to …
The Influence Of State Policy And Proximity To Medical Services On Health Outcomes, Jing Li
The Influence Of State Policy And Proximity To Medical Services On Health Outcomes, Jing Li
Research Collection School Of Economics
This paper examines two factors that help to explain geographic variation in health outcomes. The first factor concerns proximity to medical services. The second factor is state-specific health care policy that may impede access to nearby medical services. Four key findings are obtained. First, the effect of local doctors on reducing mortality rates of various diseases in a county attenuates with distance. Second, at approximately the same distance, in-state doctors contribute more to lowering mortality rates in the primary county than do out-of-state doctors. Third, the lesser impact of nearby out-of-state doctors is further reduced when the primary state adopts …
The Lasting Impact Of Parental Early Life Malnutrition On Their Offspring: Evidence From The China Great Leap Forward Famine, Seonghoon Kim, Quheng Deng, Belton M. Fleisher, Shi Li
The Lasting Impact Of Parental Early Life Malnutrition On Their Offspring: Evidence From The China Great Leap Forward Famine, Seonghoon Kim, Quheng Deng, Belton M. Fleisher, Shi Li
Research Collection School Of Economics
We investigate whether the effects of parents’ in utero malnutrition extend to the second generation (their children). Specifically, we explore whether the second generation’s level of schooling is negatively impacted by their parents’ malnutrition in utero, using the China Famine as a natural experiment. We find that, the impact of mother’s in utero malnutrition due to the Famine reduced second generation male and female entrance into junior secondary school by about 5–7 percentage points. We measure famine severity with provincial excess death rates instrumented by measures of adverse climate conditions, which corrects for possible biases induced by measurement errors and …
Geographic Decomposition Of Inequality In Health And Wealth: Evidence From Cambodia, Tomoki Fujii
Geographic Decomposition Of Inequality In Health And Wealth: Evidence From Cambodia, Tomoki Fujii
Research Collection School Of Economics
Applying the small-area estimation methods to Cambodia data, we decompose the total inequality in wealth (consumption) and health (child undernutrition) indicators into within-location and between-location components. Because the knowledge of the pattern of spatial disparity in poverty and undernutrition is important for the geographic targeting of resources, we conduct a geographic decomposition of the variance of the Foster-Greere-Thorbecke index in addition to the standard decomposition exercise based on the generalized entropy measures. We find that a sizable proportion of wealth inequality is due to between-location inequality, whereas health inequality is mainly due to within-location inequality.
Geographic Decomposition Of Inequality In Health And Wealth: Evidence From Cambodia, Tomoki Fujii
Geographic Decomposition Of Inequality In Health And Wealth: Evidence From Cambodia, Tomoki Fujii
Research Collection School Of Economics
The small-area estimation developed by Elbers, Lanjouw and Lanjouw (2002, 2003), in which a census and a survey are combined to produce the estimates of welfare measures for small geographic areas, has become a standard tool for poverty analysis in developing countries. The small-area estimates are typically plotted on a map, which are commonly called a poverty map. Poverty maps proved useful for policy analysis and formulation, and have become increasingly popular among policy-makers and researchers. In Cambodia, poverty maps have been used by various international organizations, ministries and non-governmental organizations for analyzing the poverty situations for their operation areas, …
The Consequences Of A Public Health Insurance Option: Evidence From Medicare Part D Prescription Drug Markets, Daniel P. Miller, Jungwon Yeo
The Consequences Of A Public Health Insurance Option: Evidence From Medicare Part D Prescription Drug Markets, Daniel P. Miller, Jungwon Yeo
Research Collection School Of Economics
This paper examines a public option competing alongside private insurers in Medicare Part D. We estimate a random coefficient demand system and oligopoly supply-side model with endogenous premium subsidies and risk adjustment payments. If the public option does not affect health risk sorting, counterfactual results show modest competitive benefits. However, increased subsidy payments eliminate welfare gains regardless of the public option's cost position. If the public option adversely selects -- facilitating insurers' ability to cream-skim favorable risk -- the risk adjustment mechanism creates a downward pricing distortion, amplifying competitive benefits. Despite greater selection, total surplus may increase, but the division …
Estimating Dynamic Discrete Choice Models Of Product Differentiation: An Application To Medicare Part D With Switching Costs, Daniel P. Miller, Jungwon Yeo
Estimating Dynamic Discrete Choice Models Of Product Differentiation: An Application To Medicare Part D With Switching Costs, Daniel P. Miller, Jungwon Yeo
Research Collection School Of Economics
This paper proposes an algorithm to estimate dynamic discrete choice models using aggregate market share data. The algorithm achieves a computational advantage by decomposing the complicated mapping between market shares and utility flows into two simpler ones. The first maps observed market shares to mean choice specific values, and the second then maps to mean utility flows. In the application, we estimate switching costs in the Medicare Part D market. Our results indicate a large switching cost of around $1,700, which implies an average welfare loss of $480 as enrollees choose to remain in sub-optimal plans to avoid switching costs.
Micro-Level Estimation Of Child Undernutrition Indicators In Cambodia, Tomoki Fujii
Micro-Level Estimation Of Child Undernutrition Indicators In Cambodia, Tomoki Fujii
Research Collection School Of Economics
One major limitation to addressing child undernutrition is a lack of the information required to target resources. This article extends the small-area estimation technique of Elbers, Lanjouw, and Lanjouw (2002, 2003) to jointly estimate multiple equations while allowing for individual-specific random errors across equations (in addition to cluster- and household-specific random errors). Estimates of the prevalence of stunting and underweight for children under age 5 in Cambodia from 17 Demographic and Health Survey strata are disaggregated into 1,594 communes by combining the Demographic and Health Survey data. The estimates are consistent with the surveyonly estimates at the aggregate and primary …
Geographic Decomposition Of Inequality In Health And Wealth: Evidence From Cambodia, Tomoki Fujii
Geographic Decomposition Of Inequality In Health And Wealth: Evidence From Cambodia, Tomoki Fujii
Research Collection School Of Economics
The small-area estimation developed by Elbers, Lanjouw and Lanjouw (2002, 2003), in which a census and a survey are combined to produce the estimates of welfare measures for small geographic areas, has become a standard tool for poverty analysis in developing countries. The small-area estimates are typically plotted on a map, which are commonly called a poverty map. Poverty maps proved useful for policy analysis and formulation, and have become increasingly popular among policy-makers and researchers. In Cambodia, poverty maps have been used by various international organizations, ministries and non-governmental organizations for analyzing the poverty situations for their operation areas, …
Micro-Level Estimation Of Child Malnutrition Indicators And Its Application In Cambodia, Tomoki Fujii
Micro-Level Estimation Of Child Malnutrition Indicators And Its Application In Cambodia, Tomoki Fujii
Research Collection School Of Economics
One of the major limitations in addressing child malnutrition is lack of information that could be used to target resources. By combining demographic and health survey (DHS) and population census data, the author disaggregates the estimates of the prevalence of child malnutrition in Cambodia from currently available 17 DHS strata into 1,594 communes. The methodology is built on the small-area estimation technique developed by Elbers, Lanjouw, and Lanjouw. The author extends it to jointly estimate multiple indicators and to allow for a richer structure of error terms. Average standard errors for the commune-level estimates in this study were about 4 …
Comment: A Selective Overview Of Nonparametric Methods In Financial Econometrics, Peter C. B. Phillips, Jun Yu
Comment: A Selective Overview Of Nonparametric Methods In Financial Econometrics, Peter C. B. Phillips, Jun Yu
Research Collection School Of Economics
These comments concentrate on two issues arising from Fan’s overview. The first concerns the importance of finite sample estimation bias relative to the specification and discretization biases that are emphasized in Fan’s discussion. Past research and simulations given here both reveal that finite sample effects can be more important than the other two effects when judged from either statistical or economic viewpoints. Second, we draw attention to a very different nonparametric technique that is based on computing an empirical version of the quadratic variation process. This technique is not mentioned by Fan but has many advantages and has accordingly attracted …