Health Economics Commons^™

Driving The Southern Nevada Health Economy Forward: Benefits Of A Transformational Unlv Academic Health Center, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD). The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center. Additional academic health …

An Analysis Of The 2014 Medicaid Expansion On New York And California's Maternal Mortality Rate, Reshanna Jagroo

Honors Undergraduate Theses

This thesis seeks to investigate the 2014 Medicaid expansion’s effect on maternal mortality rates for New York and California. The CDC reported in 2019 that maternal mortality rates have been increasing. These findings are concerning for mothers and are a problem for developed nations like the United States with improved healthcare. Furthermore, women of color are disproportionately affected relative to white women. Previous research has indicated that healthcare expansions positively affect decreasing death rates among pregnant women.

In this study, I investigate how increased access to healthcare through the 2014 Medicaid expansion under the Affordable Care Act affects maternal mortality …

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 …

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 …

The Health Care Systems Of The United States And Spain: A Comparison, Tasia Harman

Senior Honors Theses

When it comes to understanding and improving the United States health care system, comparison and analysis with the health care system of another country provides valuable insights. In this thesis, the United States’ health care system was compared to that of Spain, as the health care system of Spain is generally ranked well above the United States in terms of quality, function, and cost. In the comparison, information such as the health of the population, the quality of health care received, accessibility, and health care costs indicate the state of the health care systems and their ability to function well …

Hospital Cost Accounting: Saving Lives And Saving On Costs, Amanda Whitehouse

Honors Projects in Accounting

Within an industry constantly pursuing accuracy, a cost accounting system that addresses the ongoing concerns of saving money and increasing efficiency is a must. Now more than ever, hospitals require reliable information to combat the conflicting relationship between an increase in spending on new instruments and specialized staff, but a decrease in funding. This project explores potential avenues to find a successful cost accounting method using past research, analysis of hospitals’ current environments, and expert opinions from hospital and healthcare personnel. Each hospital is different based on their environment, surrounding population, type of services provided, and personal demands. This study …

Passion With Purpose A Case Study Of St. Jude Children’S Research Hospital, Allyson Favuzza

Honors Projects in Management

St. Jude Children’s Research Hospital is “leading the way the world understands, treats, and defeats childhood cancer and other life threatening diseases” (St. Jude Children’s Research Hospital). Fifty-five years ago when St. Jude opened its doors, the overall childhood cancer survival rate was 20 percent; today, the overall childhood cancer survival rate exceeds 80 percent. Through research and discovery, St. Jude has played a pivotal role in increasing this survival rate. St. Jude, a non-profit organization and hospital in Memphis, Tennessee, operates primarily through donations. St. Jude-American Lebanese Syrian Associated Charities (ALSAC) is the fundraising and awareness organization with the …

The Effect Of Paid Sick Leave Mandates On Access To Paid Leave And Work Absences, Kevin Callison, Michael F. Pesko

Upjohn Institute Working Papers

We evaluate the impact of paid sick leave (PSL) mandates on access to PSL and work absences for private sector workers in the U.S. By exploiting geographic and temporal variation in PSL mandate enactment, we compare changes in outcomes for workers in counties affected by a PSL mandate to changes for those in counties with no mandate. Additionally, we rely on within-county variation in the propensity to gain PSL following a mandate to estimate policy effects for workers most likely to acquire coverage. Results indicate that PSL mandates lead to increased access to PSL benefits, especially for women and those …

Determinants Of Health Expenditures In Oecd Countries, Giang Phi

Honors Projects in Economics

Around the world, governments are coping with spiraling health care spending. This spurs the need for further insight in the determinants of such expenditures. This study investigates the determinants of health care expenditures for a sample of thirty five countries in the Organization for Economic Cooperation and Development (OECD) from 2000 to 2013 in order to understand the impact of different factors on health care spending growth. Besides Gross Domestic Product (GDP), the study accounts for many different driving forces such as demographics, medical progress, health system characteristics, public financing, and other non-medical determinants of health spending such as alcohol …

How Did The Aca Affect Health Insurance Coverage In Kentucky?, Aaron Yelowitz

Institute for the Study of Free Enterprise Working Papers

The major components of the Affordable Care Act (ACA) were implemented in 2014, including the rollout of the Health Insurance Marketplace, Medicaid expansions, and the individual mandate. Kentucky stands out as one of the few southern states to expand Medicaid, and earlier work has demonstrated that Kentucky experienced some of the largest gains in health insurance coverage. The goal of the current study is to further explore the sources that individuals used to gain coverage in Kentucky using a large, publicly available dataset, the American Community Survey (ACS). Several findings emerge. First, overall health insurance coverage increased by 5.7 percentage …

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 …

What Is The True Cost To Stay In The Hospital?, Samantha Alicandro

Honors Projects in Mathematics

Currently, the unfortunate reality that receiving diverse health procedures can be extremely expensive is widely acknowledged and woefully accepted. However, have you inquired or been curious about the specific factors that influence the cost per day expensed by a hospital? Through examination, investigation, and evaluation operating SAS Enterprise Guide, SAS Enterprise Miner and Tableau I have attempted to arrive at a conclusion for this very question. Utilizing a 1.5 million row data set provided by Rhode Island, for the years 2003-2013, I analyzed the assorted elements conceivably bearing impact on the cost per day at a hospital. Regressions, decision trees, …

The Economics Of Health, Donald J. Meyer Editor

Upjohn Press

Donald J. Meyer leads a group of notable health economists who explore critical issues—and their economic impacts—facing the nation's healthcare system today. These include lifestyle choices and their health impacts, decisions on medical care and self-care, the fee-for-service payment model, disability and workers’ compensation insurance claims, long-term care, and how various aspects of the Patient Protection and Affordable Care Act (ACA) impact the nation’s healthcare system. Contributors include M. Kate Bundorf, Marcus Dillender, John H. Goddeeris, Donald J. Meyer, Edward C. Norton, and Charles E. Phelps.

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 …

Trends In Health Care Delivery Systems: Implications For Cancer Prevention And Control, Glen P. Mays

Health Management and Policy Presentations

The Affordable Care Act and larger economic forces are leading both health care providers and public health agencies to renegotiate their roles and responsibilities within the U.S. health system. This session reviews major changes occurring in both health care and public health delivery systems, with a focus on the implications for cancer prevention and control. The information infrastructure created by cancer registries and other health information systems are increasingly important for enabling greater coordination, alignment and accountability within the nation's changing delivery systems.

Geographic Variation Of Health Care Spending On Heart Failure In Metropolitan Areas, Kevin Mcmillan

Department of Geography: Dissertations, Theses, and Student Research

The costs of healthcare have long been a concern in the United States. It is well known that these costs vary geographically, but attempts to explain this variation have been met with limited and varied success. This is partly attributable to the fact that data available have restricted analyses to assessing the issue to using Medicare cost per beneficiary. In June, 2013, the Center for Medicare and Medicaid Services (CMS) released new Medicare data that detailed the charges and payments made to hospitals throughout the United States in 2011. In this thesis, this new dataset was used to examine costs …

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 …

Explaining Political Activeness And Attitudes Toward Unionization Among Nurses In The United States., Crystal L. Lesmeister

Political Science Theses and Capstones

There is no question; nurses play a key role in healthcare. Nurses provide direct care, coordinate health promotion activities, educate, and provide support and advocacy to patients. Today, there are over two million registered nurses in the United States. My research aims to determine the variables that influence some nurses to be more politically active and more engaged in unionization than their counterparts. I analyze The National Sample Survey of Registered Nurses 2004 looking at a variety of potential explanations for union participation. Findings show a strong regional variation in the percentage of unionization, however, some of the conventional explanations …

The Effect Of Employer Health Insurance Offering On The Growth And Survival Of Small Business, Adela Luque, C. J. Krizan, Alice Zawacki

Upjohn Institute Technical Reports

No abstract provided.

Who Will Care For The Women?, Candace Howes

Economics Faculty Publications

Over 20 million people today, including children, working-age disabled, and elderly persons, require some sort of assistance to live safely. Largely because women live longer than men, well into the ages when the probability of needing care increases, 70 percent of elderly people who need long-term care are women. Furthermore, most long-term care is provided by women, mainly as unpaid care in the home, or as low-paid care in institutions and community settings (Stone & Weiner 2001). The United States faces a severe long-term care crisis because of the nation's inability to plan for the changing demographic balance. The crisis …

Michigan Socioeconomic Conditions And Trends: West Michigan Compared To East Michigan, Brad R. Watts

Reports

No abstract provided.

The Effects Of Malpractice Tort Reform On Defensive Medicine, Heather M. O'Neill, Katherine D. Hennesy

Business and Economics Faculty Publications

Medical malpractice crises occur across states to differing degrees, thus the proposed changes in state tort reforms differ accordingly. The primary overt goals of tort reform aim to address: rising medical malpractice insurance rates, increased frequency and severity of awards, and the increased incidence of doctors shuttering offices or fleeing states due to untoward malpractice environments. A secondary goal of tort reform is to reduce health care costs attributed to malpractice costs. Clearly, as malpractice tort reforms are debated in state capitols and reforms take place, the effects of the reforms on the goals above can be examined. However, there …

The Effects Of Malpractice Tort Reform On Defensive Medicine, Katherine D. Hennesy, Heather M. O'Neill

Business and Economics Faculty Publications

Positive defensive medicine occurs when physicians order additional tests or procedures primarily to avoid malpractice liability. This paper shows the degree of defensive medicine occurring across states is related to the malpractice environment in the states. As the environment changes due to malpractice tort reform, defensive medicine practices also change. This paper shows the existence of positive defensive medicine and how it adds to total health care expenditures for head trauma victims in 23 states in 2000. Moreover, given different malpractice environments across states, we witness variations in defensive medicine practices leading to differences in health care expenditures.

The Political Economy Of Health Care Reforms, Huizhong Zhou Editor

Upjohn Press

A leading group of health care economists propose solutions to problems related to Medicare, managed care, health insurance, coverage for the uninsured, and the role of tax policy in health care.

The Economics Of Medicare Reform, Andrew J. Rettenmaier, Thomas Robert Saving

Employment Research Newsletter

No abstract provided.

The Economics Of Medicare Reform, Andrew J. Rettenmaier, Thomas Robert Saving

Upjohn Press

The authors propose a means for preserving Medicare as we know it. After detailing the reasons for Medicare's financial troubles, they present a cohort-based financing plan for Medicare that represents a fundamental departure from the generation transfer method currently used.

Improving Access To Health Care: What Can The States Do?, John Henry Goddeeris Editor, Andrew J. Hogan Editor

Upjohn Press

Health care cost increases may seem under control but the issue of access remains a serious problem. This text features a dozen essays addressing that issue from the states' perspective.