Health Economics Commons^™

Economic Costs And Benefits Of A Community-Based Lymphedema Management Program For Lymphatic Filariasis In Odisha State, India, Eileen Stillwaggon, Larry Sawers, Jonathan Rout, David Addiss, Leanne Fox

Economics Faculty Publications

Lymphatic filariasis afflicts 68 million people in 73 countries, including 17 million persons living with chronic lymphedema. The Global Program to Eliminate Lymphatic Filariasis aims to stop new infections and to provide care for persons already affected, but morbidity management programs have been initiated in only 24 endemic countries. We examine the economic costs and benefits of alleviating chronic lymphedema and its effects through a simple limb-care program. For Khurda District, Odisha State, India, we estimated lifetime medical costs and earnings losses due to chronic lymphedema and acute dermatolymphangioadenitis (ADLA) with and without a community-based limb-care program. The program would …

Three Essays On Informal Payments In The Health Care Sector In Russia, Alexandra Polovinka

Dissertations

Health care is one of the most corrupt sectors in Russia. In 2015 twenty percent of patients paid a bribe for the health care services once or twice, and thirteen percent more than twice (Russian Public Opinion Research Center, 2015). Using data on adults from over 5,000 households in Russia, this three-essay study analyzes out-of-pocket formal (official) and informal (unofficial, bribes) payments for the health care.

In the first essay, I study whether there is a difference in the amount of unofficial pay-ments across five types of health care services (ambulance, inpatient, outpatient, dental, and medical checkups) and two types …

The Influence Of Projection Bias On Outcomes Of Healthcare Financial Incentive Programs, Jordyn M. Bader

Department of Agricultural Economics: Dissertations, Theses, and Student Research

This thesis contributes to the behavioral health literature and literature regarding healthcare financial incentive programs by discussing the influences of the behavioral economic concept of projection bias on programs designed to recruit healthcare providers to rural or under served areas. First, I propose an adaptation to the model of projection bias by introducing a term that captures variability in individuals’ propensity to exhibit projection bias based on the amount of effort expended in predicting future preferences. Next, I conduct a probit model regression to observe what incentive program design features and participant characteristics are likely to influence the probability of …

The Financial Dialogue In The Development Of Medical Treatment Plans, Christopher D. Busack, Ms3, Bethany Fox, Ms3

The Medicine Forum

As patients face increasingly high out-of-pocket costs and difficulties navigating the healthcare system, failing to discuss available treatment options in financial terms can lead to grave consequences for patients. Medical bills are responsible for the majority of bankruptcies in the United States. Given the severe financial implications of medical bills, it is imperative that patients become more involved in discussions of their treatment plans and become aware of the costs of their decisions up front. Counseling about costs ensures that physicians avoid placing a debilitating financial burden on patients and maintain adherence to the ethical principle of non-maleficence. Various studies …

Biaya Dan Outcome Hemodialisis Di Rumah Sakit Kelas B Dan C, Firda Tania, Hasbullah Thabrany

Jurnal Ekonomi Kesehatan Indonesia

Chronic Kidney Disease (CKD) is a condition that is increasing in incidence in Indonesia, consuming a lot of National Health Insurance (JKN) public funds. In the JKN program, hemodialysis (HD) for treating CKD is guaranteed but requires a balance between costs and outcomes. Since 2014, BPJS has covered almost all HD costs in Indonesia with different Casemix Base Group (CBG) rates according to hospital class.

Application Of Decision Analytic Model In Health Economic Evaluation: Smoking Cessation Cases, Septiara Putri

Jurnal Ekonomi Kesehatan Indonesia

Health economic evaluation that encompasses decision analytic model is a beneficial approach for assisting decision maker to choose the best health intervention for patients. Decision analytic model has been increasingly applied in health economic evaluation. This mathematical approach is mostly used for conducting cost-effectiveness of healthcare interventions. Decision tree and Markov model has been widely applied in the past 20 years. Decision tree is the simplest form of decision model that drawn by the series of branches and clear pathways. Meanwhile, Markov model is one of the powerful approaches that employ stochastic process in health economic evaluation. This paper describes …

Terapi Sistemik Defisit Jkn: Bahan Refleksi Bagi Semua Pihak, Budi Hidayat

Jurnal Ekonomi Kesehatan Indonesia

The deficit deserves to be considered a chronic JKN disease. Indications of the deficit are revealed from the claims ratio figures. In 2014 and 2015, the claims ratio was consistently above 100%. This figure results from dividing claim costs (or participant health costs) by contribution income. Thus, the claims ratio describes the absorption of contribution funds for health costs only. However, contribution income must also be allocated for operational expenses and reserves. The JKN deficit will continue to grow if systemic therapy is nil. For 2016, the author's estimation results by referring to the assumed contribution amounts by Presidential Regulation …

People’S Support On Sin Tax To Finance Uhc In Indonesia, 2016, Hasbullah Thabrany, Zahrina Laborahima

Jurnal Ekonomi Kesehatan Indonesia

Indonesia has the highest prevalence of smokers with 67% of adult males were smokers. Smoking prevalence among all adults increased sharply from 27% in 1995 to 36.3% in 2013. High consumption of cigarettes has been correlated with low price and excise of cigarettes. Experiences from other countries showed that one of the most effective way to reduce cigarette consumption is by increasing cigarette price and excise. Burden of tobacco related diseases has increased. The health burden will increase claims of JKN or Universal Health Coverage which currently has claim ratio of 115% and the quality of care remain low. The …

A Comparative Budget Requirements For Tb Program Based On Minimum Standard Of Services (Spm) And Budget Realization: An Exit Strategy Before Termination Of Gf Atm, Ery Setiawan, Purwa K. Sucahya, Hasbullah Thabrany

Jurnal Ekonomi Kesehatan Indonesia

It has become a common issue that the Global Fund (GF) as one of the largest international donors to AIDS, Tuberculosis, and Malaria Program will immediately stop the funding. Data shows that in 2009 GF ATM support reached 88,8% while APBN funding just cover 11,2% of the total budget needed. However, APBN budget for ATM programs was significantly increased in 2012 which covered almost 30% of the total budget. Eventhough the increasing trend of ATM budget seemed at the central government level, how ever the local governments will hold the key to the sustainability of the post- termination GF ATM …

Evaluasi Pengadaan Obat Publik Pada Jkn Berdasarkan Data E-Catalogue Tahun 2014-2015, Ary Dwiaji, Prih Sarnianto, Hasbullah Thabrany

Jurnal Ekonomi Kesehatan Indonesia

Since National Health Insurance (JKN) has been implemented, drug procurement in public health care facilities use e-Purchasing via e-Catalogue. Based on the RKO and HPS, drafting e-Catalogue have gone through a tender process and price negotiations. The process chain will effect the type (molecules) and the amount of drug through the e-Catalogue as well as the number and volume of demand by public health care facilities (e-Order).

Ageing And Long-Term Care Planning Perceptions Of Hispanics In The Usa: Evidence From A Case Study In New London, Connecticut, María Amparo Cruz-Saco, Mónika López-Anuarbe

Economics Faculty Publications

This paper explores the ageing attitudes and long-term care planning behavior of adult Hispanics in New London, Connecticut, a town with 30 thousand inhabitants that is rapidly ageing. We conducted six focus groups and had 37 participants share their ageing perceptions and long-term care needs. Our main findings suggest that informal care arrangements are vulnerable and unsustainable especially since women have historically and disproportionately provided most family eldercare even at their own personal and financial expense. Though male participants expected their female relatives to care for them when they age and need personal assistance, female participants did not necessarily expect …

The Economics Of Lotto, Ian Walker, Robert E. Pryce, Rhys Wheeler, Nick Powdathvee

International Conference on Gambling & Risk Taking

No abstract provided.

Essays On The Well-Being Of An Aging Population, Alice Zulkarnain

Dissertations, Theses, and Capstone Projects

This dissertation consists of three essays that examine health and labor issues among the middle aged and elderly.

Chapter 1. A Delayed Retirement Policy and Male Labor Supply: Evidence from the Entire Dutch Population

This chapter examines the labor supply effects of a national delayed retirement policy introduced in the Netherlands in 2009. The policy offers a reduction in taxes on labor income for each year after the age of 62 in which a person worked. I estimate the average effect of the policy on male labor supply as well as its responsiveness to the size of the incentive. Comparing …

The Effect Of Health Information Technology On Hospital Quality Of Care, Ruirui Sun

Dissertations, Theses, and Capstone Projects

Health Information Technology (Health IT) is designed to store patients’ records safely and clearly, to reduce input errors and missing records, and to make communications more efficiently. Concerned with the relatively lower adoption rate among the US hospitals compared to most developed countries, the Bush Administration set up the Office of National Coordinator for Health Information Technology in 2006 to mandate the Health IT implementation with $25.9 billion subsidies to eligible hospitals starting 2009. Underlying the huge subsidy is the belief that Health IT can reduce hospital cost by improving efficiency and quality, and can help reduce total health expenditure. …

Essays On The Economics Of Health And Risky Behavior, Markus Gehrsitz

Dissertations, Theses, and Capstone Projects

As Forrest Gump has ever eloquently pointed out: stupid is as stupid does. It turns out that most people engage in behavior that could reasonably be considered stupid, or at least risky. People overeat, chain-smoke cigarettes, drink excessively, consume harmful drugs, and drive too fast; if worst comes to worst they do some of these things simultaneously. This work evaluates three policy measures that are designed to promote health and less risky behavior: I evaluate the effects of penalties for speeding transgressions on future driving behavior, the effects of low emission zones on infant health and air pollution, and the …

Essays In Health Economics, Aigbokhai Unuigbe

Dissertations, Theses, and Capstone Projects

This dissertation is motivated by changes in health and labor policies of the United States that have occurred over the last two decades. It examines how these policies as well as public programs affect behavior and outcomes. These programs and policies have the potential to impact behavior directly at the individual level and could also have indirect effects at the household level. In addition, the effects on healthcare use and health status are also examined. This dissertation consists of three chapters.

The first chapter looks at the effect of changes in Medicaid policy on legal immigrant parents in the United …

Essays On Portfolio Choice And Risk Management, Yi-Chin Hsin

Dissertations

Globalization increases the access to financial markets and provides expanding opportunities for investors to diversify internationally. As suggested by the Modern Portfolio Theory (Markowiz, 1952), rational investors should use one of the following two strategies to achieve portfolio diversification: (1) Investing in asset classes thought to have low correlations or (2) increasing the sizes of their portfolios in multiple markets. In the early 1970s, diversification was referred to as the “free lunch” in investment. However, French and Poterba (1991) show that investors still tend to hold a disproportionate part of domestic equities in their portfolios. This phenomenon is called “the …

Effects Of The Affordable Care Act On Part-Time Employment: Early Evidence, Marcus Dillender, Carolyn J. Heinrich, Susan N. Houseman (Corresponding Author)

Upjohn Institute Working Papers

The Affordable Care Act (ACA) requires employers with at least 50 full-time-equivalent employees to offer “affordable” health insurance to employees working 30 or more hours per week. If employers do not comply with the mandate, they may face substantial financial penalties. Employers can potentially circumvent the mandate by reducing weekly hours below the 30-hour threshold or by using other nonstandard employment arrangements (direct-hire temporaries, agency temporaries, small contractors, and independent contractors). We examine the effects of the ACA on short-hours, part-time employment. Using monthly CPS data, we estimate that the ACA resulted in an increase in low-hours, involuntary part-time employment …

Air Pollution And Fetal Loss In The Global Tropics, Shuqiao Cheng

Master's Theses

Abstract: Recent work has shown that in-utero air pollution has negative effects on both contemporaneous birth outcomes and long-term human capital outcomes. However, only a few studies explore the effects of in-utero exposure to air pollution on fetal loss, and none of the studies has been done in developing countries. In this study, we examine the impact of naturally caused CO and PM 2.5 on reproductive outcomes in 40 developing countries from 1997 to 2009. We present childbirths and birth gender as measures for potential fetal losses. The richest model identified using variation in pollution between pregnancies with controlling for …

Air Pollution, Temperature And Cognitive Performance In The Short Run: Evidence From Women’S Ability To Recall Dates, Ke Yang

Master's Theses

Abstract: Cognitive performance is important to productivity across many fields and potentially correlated to air pollution and extreme temperatures. We study the effects of daily ambient air pollution and monthly temperature on women’s ability of recalling dates across 42 developing countries from 1997 to 2009. We use an estimated natural air pollution data, and calculate the AQI to get an aggregate effect of air pollution. We find that one standard deviation increase in the AQI leads to a statistical decrease in women’s probability to recall dates such as birthdays, marriage date or children’s birthdays by 0.44 percentage point. Furthermore, there …

Does Infant Formula Availability Reduce Breastfeeding?, Ingvild Madsen Lampe

Master's Theses

Abstract: Several key studies highlight the importance of breastfeeding and there is a broad consensus that it plays a crucial role for a child's health and cognitive development. This is especially true for the poor in developing countries, where vulnerable infants' access to proper nutrition is vital. We investigate the effect of introducing infant formula into a market on changes in breastfeeding patterns. Using the Demographic Health Surveys and annual reports from the baby food industry between 1981 and 2002 in 11 tropical countries, we find evidence that import of infant formula significantly reduces breastfeeding duration. The effects are stronger …

Behavioral Determinants Of Biofortified Food Acceptance: The Case Of Orange-Fleshed Sweet Potato In Ghana, Chinonso E. Etumnu

Master's Theses

Biofortified foods are being introduced in sub-Saharan Africa as an important strategy to help address micronutrient malnutrition. However, there has been little research on factors that could play decisive roles in their successful introduction. This paper investigates the determinants of consumer acceptance of biofortified orange-fleshed sweet potato (OFSP) using data from a choice experiment conducted in Ghana. I find that OFSP is preferred to traditional white-fleshed and yellow-fleshed sweet potatoes as indicated by consumers' marginal willingness to pay for the three varieties. I also find that respondents' socio-economic characteristics do not have a significant effect on consumer acceptance of OFSP. …

The Effect Of Gambling Expansion On Health, Marina Li

Theses and Dissertations

This study examines the effect of gambling expansion on health and health behaviors. This paper hypothesized gambling expansion decreases individual’s health and increases negative health behaviors. The study is done by observing the health and health behavior of individuals and results generally supports hypothesis.

Evaluating The Causal Effect Of Insurance Access On Labor Market Outcomes Among Young Adults, Eden Volkov

Theses and Dissertations

The ACA youth coverage mandate took effect in 2010. Under this provision, individuals through age 26 can remain on their parent's health insurance plan. This provision increased insurance coverage. This has led to 22-29 year olds being more likely to be self-employed, to not work, and to work part time.

Variation In Restaurant Sanitary Scores In New York City, Kyle Gregory

Theses and Dissertations

The purpose of this study was to determine whether restaurants that are homogenous in nature would exhibit substantially different hygiene scores based on the underlying consumer learning behaviors present in the neighborhoods in which the restaurants are located.

Exploring The Effects Of Calorie Labeling Laws, Carmen Vargas

Theses and Dissertations

This study explores the effects of Calorie labeling laws implemented in some counties in the United States on several health related variables. The findings show a small significant decreasing effect of the law on Limited activity and Poor health of 0.083 and 0.047 at 95% significant level respectively.

Public Health Spending And Its Contributions To The Total Spend On Health, Glen P. Mays

Health Management and Policy Presentations

This presentation provides an overview of recent research on governmental public health expenditures and their interaction with medical spending, carried out through the Robert Wood Johnson Foundation supported initiatives on Public Health Services and Systems Research (PHSSR) and the new Systems for Action research program. This work illustrates the value of tracking resource use across multiple sectors that influence health and well-being in American communities. As such, this work can inform the ongoing dialogue about methodologies for summarizing total health spending for the U.S. and for state and local areas.

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 …

Measuring Progress To Comprehensive Public Health Systems, National Preparedness, And A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

This update describes recent progress on two national health measurement initiatives: The National Health Security Preparedness Index and the National Longitudinal Survey of Public Health Systems. These longitudinal data sources offer valuable perspectives on how health security practices and public health delivery systems are changing across the U.S.

The Effect Of Health Insurance On Out Of Pocket Expenditure, Andrew M. Bean

Theses and Dissertations

The dependent care provision of the Affordable Care Act went into effect September 2010. This change in insurance policy can be used as a natural experiment to examine the effect of health insurance on healthcare expenditures using a control function two-part model to address endogeneity.