Health Economics Commons^™

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 …

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.

Retroactive Eligibility Waivers: Innovative Or Ineffective?, Mohamed Kacem Benyamine

Theses and Dissertations

Medicaid’s retroactive eligibility provision covers medical expenses for beneficiaries up to 90 days before the application date. Retroactive eligibility insulates uninsured, low-income households from expensive healthcare emergencies. New Hampshire, Arkansas, and Iowa recently obtained waivers to end retroactive coverage. Using a difference-in-differences design and data from the Behavioral Risk Factor Surveillance System, I evaluate whether changes in retroactive coverage affect enrollment rates and self-reported health. Removing retroactive eligibility has no statistically significant effects on insurance enrollment or self-reported health. However, it does increase rates of access to a doctor by 1.0% overall and by 1.6% for women. Removing retroactive eligibility …

The Effect Of Medical Aid In Dying On Health Outcomes And Risky Behavior Of The Elderly, Jacky Wu

Theses and Dissertations

This study examines the effects of Medical Aid in Dying (MAiD) legalization on health outcomes and behavior among elderly U.S. adults using BRFSS data from 2005-2022. Using staggered difference-in-differences, this paper finds that MAiD increases exercise, lowers BMI, and reduces blood pressure medication use.

Intergenerational Transmission Of Health: Evidence From Indonesia, Fatima Khan

Theses and Dissertations

This study estimates the causal transmission of health from mothers to their children. Intergenerational associations in health and other human capital outcomes are well established, but those associations may not be causal due to common unobserved factors between a mother and her child. This study employs two-stage least squares, using weather variation as an instrument, to causally identify the relationship between maternal health and child health outcomes in five dimensions: height-for-age, self-reported health, blood pressure, lung capacity, and hemoglobin levels. The data are from the Indonesian Family Life Survey (1993--2014), a longitudinal survey that provides a 21-year look into the …

Behavioral Responses To The Medicare Part D Coverage Gap And Its Closure, Selene Urbatsch

Theses and Dissertations

The author examines how exposure to the Medicare Part D coverage gap affects future prescription drug use and whether the closure of the gap under the Affordable Care Act (ACA) altered beneficiary behavior. Using 2007–2019 MEPS data, the analysis compares Part D enrollees to similarly aged, privately insured individuals, producing first-differences and difference-in-differences estimates. Before the ACA, exposure to the gap was associated with 4.9 fewer prescription fills relative to comparable non-Part D individuals. After the ACA, the effect fell to a reduction of 2.2 generic fills, with no significant decline in branded use. Sudden out-of-pocket cost increases prompted sharp …

Differential Effects Of Health Insurance Coverage On Health For Sexual Minorities, Ruby W. Morr

Theses and Dissertations

Much existing research has found a substantial gap in health between sexual minorities and non-minorities. This is usually attributed to discrimination or access to care. I seek to find the role that insurance plays, including minorities' choices of insurance coverage. If a gap does exist, insurance may have a stronger impact on sexual minorities. Also, if minorities are less likely to have insurance coverage, they may be susceptible to worse health. I confirm results from the literature that sexual minorities do have worse health. While health insurance accounts for some of the gap, it is only a small portion, though …

The Effects Of Pre-Abortion Restrictions On Women's Well-Being, Reesa Sooklall

Theses and Dissertations

Eleven states require women seeking abortions to undergo mandated ultrasounds prior to the procedure while twenty-four states require women to wait either 24, 48 or 72 hours between receiving state mandated counseling and the procedure. I examine the effects of abortion restrictions on health behaviors and health care of women. I apply staggered difference-in-differences to the Behavioral Risk Factor Surveillance System data to estimate the causal effects of the two-trip mandatory waiting period (MWP) law and mandatory ultrasounds (MUS) law on women’s mental health, use of alcohol and tobacco, and whether women are obtaining routine mammograms and pap smears. The …

Budget Capping Health Care: Its Impact On Health, Susan Chen

Theses and Dissertations

The goal of a budget cap on healthcare is to constrain total healthcare expenditure without compromising quality. This paper examines the impacts of budget capping on health and behavioral health outcomes, exploiting the completed Maryland All-Payer Model and the ongoing, extensional Maryland Total Cost of Care model, both of which capped healthcare budgets in Maryland. I use data from 2011-2021 surveys of the Behavioral Risk Factor Surveillance system and generalized difference-in-difference regression models to find that budget capping improves health and behavioral health outcomes with a greater favorable effect during the Maryland Total Cost of Care model.

Skilled Workers’ Mobility And Attrition: The Case Of Florida Emergency Medicine Physicians, Vassina Hassane Meite

Theses and Dissertations

Emergency medicine (EM) physicians constitute the front line of healthcare providers. They work swiftly to address critical situations, diagnose illnesses, and stabilize patients. Amidst a growing need and shortage of EM physicians, this longitudinal descriptive study captures EM physicians’ preferences for practice locations by studying Florida EM physicians’ relocation patterns between 2006 and 2020. Esti- mates from a Cox Proportional-Hazards model and fixed effects logistic regressions suggest that wage amenities are not a strong determinant of relocation over time. Physician attrition and relocation are instead more saliently affected by high work volumes within the EM physician’s primary work location.

Effects Of The Raising The Minimum Legal Purchasing Age For Tobacco On Cigarette, Cocaine And Inhalant Consumption, Ahmed Adil

Theses and Dissertations

Over the past few years, several states have passed laws that increase the minimum legal purchasing age (MLPA) for tobacco from 18 to 21 years. This study examines the impact of statewide MLPA laws on youth tobacco consumption. Using data from the 2009-2019 Youth Risky Behavior Surveys (YRBS) and a difference-in-differences approach, I find that the enactment of MLPA laws is associated with a decrease in tobacco usage among adolescents. I also find that MLPA laws have important spillover effects to other youth risky behaviors. MLPA law adoption is associated with a reduction in cocaine use and inhalant abuse.

Family Structure Variables As Proxies For Socialization And Their Effect On Cognitive Decline: An Empirical Analysis, Peter Amato

Theses and Dissertations

The risk of several common diseases causing dramatic cognitive decline (Alzheimer’s, dementia, anterograde memory loss) and short-term memory impairment are all common, even inevitable ailments as one continues to age. There is a body of literature that suggests stronger social networks reduce the chance of cognitive decline through mentally stimulating activities or socializing. This study examines the rates of cognitive decline in people with larger families by using ordinary least squares (OLS) regression and a cox hazard proportion hazards model to examine the protective effects of different family structures on the rates of cognitive decline using the American Community Supplement …

A Latent Class Approach To The Utilization Effects Of The Aca, Dennis Jones

Theses and Dissertations

The dependent coverage provision of the Affordable Care Act raised eligibility for young adults to remain eligible their parents’ health care up to the age of 26. This study uses a combination of latent class analysis and difference-in-difference regression to examine the effect the intervention had on health care utilization.

The Effect Of The Fresh Program On Fruit And Vegetable Consumption In Nyc, Haido Andrianos

Theses and Dissertations

This study examines whether the NYCEDC's FRESH Program has had an effect on the fruit and vegetable consumption of NYC residents. Using data collected by the NYC DOHMH, a difference-in-difference regression with fixed effects was run. Stratifications for race and sex were also performed.

The Effects Of Hospital-Acquired Condition (Hac) Reduction Program On Hospital Services And Finances, Yuting Chen

Theses and Dissertations

Effective 10/01/2014, the HAC Reduction Program was implemented by CMS. Using 2015-2017 hospital-level data, this paper measures the effects of this Program on hospital days, discharges, revenues, costs, and service performance. I find penalized hospitals barely improved healthcare performance; meanwhile they increased patients numbers by 12.0% to cover penalties received.

Cost-Effectiveness Of Interventions Targeting Hard-To-Reach Populations Living With Hiv In Eastern And Southern Africa, Deo Mujwara

Theses and Dissertations

In Eastern and Southern Africa, hard-to-reach populations (e.g., long distance truck drivers and female sex workers), defined as populations that are difficult to interact or engage with due to their unique behaviors and characteristics, are disproportionately affected by the HIV epidemic and are at high-risk of acquiring and transmitting HIV. Further, these populations have substantially low uptake of HIV testing services, and those that have been diagnosed with HIV and on antiretroviral therapy experience high loss-to-follow-up from treatment programs.

Hard-to-reach populations face unique barriers in accessing and utilizing routine HIV care such as provider stigmatization towards sex workers and highly …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

Health Outcomes And Utilization Associated With Renal Diseases In Patients With Cancer In The United States, Mitisha Dedhia

Theses and Dissertations

Background: Adverse events and impairments associated with cancer and its treatments causes worse outcomes. Increased incidence of renal diseases among cancer patients is of particular concern. Objective: To determine the risk factors for renal disease in cancer patients and compare healthcare costs, utilization and health-related quality of life (HRQoL) of cancer patients with a renal disease and cancer patients without renal diseases. Methods: Medical Expenditure Panel Survey files from 2009 – 2018 for cancer patients was used for this study. Multiple logistic regression, generalized linear model, Poisson regression and multiple linear regression for analyses after adjusting for demographic, socioeconomic and …

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 …

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 …

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.