Health Economics Commons^™

Put Your Money Where Your Butt Is: A Commitment Contract For Smoking Cessation, Xavier Giné, Dean Karlan, Jonathan Zinman

Dartmouth Scholarship

We designed and tested a voluntary commitment product to help smokers quit smoking. The product (CARES) offered smokers a savings account in which they deposit funds for six months, after which they take a urine test for nicotine and cotinine. If they pass, their money is returned; otherwise, their money is forfeited to charity. Of smokers offered CARES, 11 percent took up, and smokers randomly offered CARES were 3 percentage points more likely to pass the 6-month test than the control group. More importantly, this effect persisted in surprise tests at 12 months, indicating that CARES produced lasting smoking cessation. …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Singhealth Ceo Says Leadership Is About Compassion And The 'Cha Cha Cha', Knowledge@Smu

Knowledge@SMU

That a leader ought to choose compassion over profits is a position unlikely to be popular with shareholders. However, that may well be the only kind of leadership that will command a following – because people gravitate towards ethical leadership. Leaders can attempt to inspire with a show of record profits and shareholder value. Yet, such successes can still seem somewhat empty. According to Prof. Tan Ser Kiat, Group CEO of SingHealth, Singapore's largest healthcare group, leaders that possess and display compassion inspire at a different level. They tap right into the heart.

The Economic Impact Of Medicaid Spending In Arkansas, Katherine A. Deck, Viktoria Riiman

Publications and Presentations

Arkansas Medicaid is a joint federal and state program that provides necessary medical services to needy and low-income persons that is administered through the Arkansas Division of Medical Services at the Arkansas Department of Human Services. The Medicaid program is designed to provide the baseline health outcomes that are necessary for the state’s economy to function. The expenditures that are made through the Arkansas Medicaid program significantly affect the Arkansas economy. This report details the economic impacts of the direct expenditures of the Medicaid program on the Arkansas economy.

Determinants Of Child Nutritional Status In Zambia: An Analysis Of A National Survey, Felix Masiye, Chitalu Chama, Bona Chitah, Dick Jonsson

Zambia Social Science Journal

Malnutrition affects many children and is a leading cause of childhood mortality and non-fatal health loss. Zambia has one of the highest rates of malnutrition in the world. About half of the Zambian children are stunted while one in five is underweight. Prevalence of wasting is much lower. This article examines the determinants of nutritional status among children aged below five years in Zambia using data from a national cross-sectional survey conducted in 2006. Multivariate analysis is used to quantify the effects of several household and child-specific socioeconomic and demographic factors on nutritional status, as well as a geographic context …

Hospital Performance Evaluation In Uganda: A Super-Efficiency Data Envelope Analysis Model, Bruno Yawe

Zambia Social Science Journal

Standard Data Envelope Analysis models result in a large fraction of the observations becoming 100 percent efficient. The article measures the technical efficiency of 25 district referral hospitals from three regions of Uganda over the 1999-2003 period. It applies a super-efficiency Data Envelopment Analysis model. The application of a super-efficiency model was occasioned by the failure of standard data envelopment analysis models to rank the efficient set of hospitals which attain an efficiency score of unity. The results of the standard data envelopment analysis models indicate the existence of different degrees of technical and scale inefficiency in Uganda’s district referral …

The Influence Of New Medications On Prescribing Behavior By Practice Type: A Regression Analysis, Rita M. Pattarini

Renée Crown University Honors Thesis Projects - All

Objective: To determine whether the type of practice to which physicians belong influences the types of medications they prescribe

Methods: The study used data from the National Ambulatory Medical Care Survey (NAMCS) to conduct a series of regressions for two pairs of medications. The first pair was for the treatment of high cholesterol. Advicor was the new medication and Lovastatin was the competitor. The second pair was for the treatment of arthritis. Humira was the new medication and Remicade was the competitor. For each pair, there were two sets of regressions that consisted of an unrestricted regression with all patients …

Do Ct Scans Help Prevent Cancer-Related Deaths?, Auyon J. Ghosh

Renée Crown University Honors Thesis Projects - All

This paper uses a region-level estimation approach associated with medical procedures to identify the effectiveness of X-ray Computed Axial Tomography (CT) scans as a diagnostic tool in preventing cancer-related deaths. In order to measure the effects of the CT scan on cancer-related deaths, I use data from both the National Health Interview Survey and the Vital Statistics of the United States. For all four regions, we observe an increase in CT scan use after 1979 or, as illustrated specifically in the figure, from 1975 to 1980. All four regions exhibit marked increases in lung cancer-related deaths, very little fluctuation in …

Health Insurance Availability And Entrepreneurship, Philip Decicca

Upjohn Institute Working Papers

Despite a strong interest in entrepreneurship, economists have devoted little attention to the role of health insurance availability. I investigate the impact of a unique policy experiment—New Jersey’s Individual Health Coverage Plan—on self-employment. Implemented in August 1993, the IHCP included an extensive set of reforms that loosened the historical connection between traditional employment and health insurance by facilitating access to coverage that was not employer-linked. I find evidence that the IHCP increased self-employment among New Jersey residents, relative to various sets of comparison states. Consistent with key policy features, including pure community rating of premiums, I find larger behavioral responses …

Microeconomic Analysis Of Hours Of Informal Care Per Week For Alzheimer's Disease Patients, Elizabeth Eckert

Undergraduate Theses and Capstone Projects

As more Americans are diagnosed with Alzheimer's disease, the demand for treatment and care has been increasing. One of the most critical issues of caring for an Alzheimer's disease patient is the number of unpaid hours that many Americans are contributing to the care for Alzheimer's disease patient Providing unpaid care can cause issues for the caregivers such as high stress levels, financial problems, and difficulties at work, and thus can result in the patient not receiving the best possible care. Based on previously collected survey data, this econometric study evaluates the determinants of the average number of hours of …

Health Insurance Tax Credits And Health Insurance Coverage Of Low-Earning Single Mothers, Merve Cebi, Stephen A. Woodbury

Upjohn Institute Working Papers

No abstract provided.

The Influence Of Retiree Health Benefits On Retirement Patterns, James Marton, Stephen A. Woodbury

Upjohn Institute Working Papers

We estimate the effect of employer offers of retiree health benefits (RHBs) on the timing of retirement using a sample of Health and Retirement Study (HRS) men observed over a period of up to 12 years. We hypothesize that the effect of RHBs differs for workers of different ages-a hypothesis we can test now that the main HRS cohort has aged sufficiently. We apply three well-known panel data estimators and find that, for men in their 50s, RHBs have little or no effect on retirement decisions; however, a substantial effect emerges for men in their early 60s. We use simulations …

America's Health Care Economics: Probing Questions And Second Opinions, Second Edition, Don P. Diffine Ph.D.

Belden Center Monographs

No abstract provided.

Fragmentation In Mental Health Benefits And Services: A Preliminary Examination Into Consumption And Outcomes, Barak D. Richman, Daniel Grossman, Frank Sloan

Faculty Scholarship

In this chapter, we examine consumption patterns and health outcomes within a health insurance system in which mental health benefits are administered under a carved-out insurance plan. Using a comprehensive dataset of health claims, including insurance claims for both mental and physical health services, we examine both heterogeneity of consumption and variation in outcomes. Consumption variation addresses the regularly overlooked question of how equal insurance and access does not translate into equitable consumption. Outcomes variation yields insights into the potential harms of disparate consumption and of uncoordinated care. We find that even when insurance and access are held constant, consumption …

Are Brand Name Medicine Prices Really Lower In Ciudad Juárez?, Thomas M. Fullerton Jr., Osvaldo Miranda

Border Region Modeling Project

Relatively high brand name pharmaceutical prices have led many United States residents to cross the border into Mexico as “medical tourists.” To examine the savings potentially available to consumers willing to cross into Mexico, data are collected and analyzed for brand name prescription medicines sold in El Paso, Texas and Ciudad Juárez, Mexico. Retail pharmacy prices are generally lower on the south side of the border and substantial savings result for some medicines. For some products, however, shelf prices are lower on the north side of the border.

Empirical Essays On The Impact Of Health-Aid On Health Outcomes, Elsy Thomas Kizhakethalackal

Dissertations

This dissertation consists of three essays that empirically explore the impact of multilateral health-aid on health outcomes like infant mortality rate (IMR) and incidences of an infectious disease, Tuberculosis, in developing economies. The first essay uses parametric and semiparametric mean regressions (additive and non-additive specifications) to capture the impact of education and health-aid on the IMR, after controlling for other covariates. Both specifications confirm education as an important factor in reducing IMR. However, the effect of health-aid on IMR is not significant. In our additive model, we do see a threshold level of health-aid after which the impacts of health-aid …

Compassion: Why It Is Better To Eat Fish, Knowledge@Smu

Knowledge@SMU

Compassion was probably the farthest notion from Colonel Sanders’ mind when he became the global poster boy for delicious fried chicken. He had started his business in the early twentieth century – a period marked by the great depression and two world wars. Prejudices festered under the hostile global climate then, where little consideration was given to the suffering of human beings, much less animals. However, with the progress of time, scientific advancements have urged us, increasingly, to be kinder to fellow humans, animals, the environment… and that we really ought to be munching on fried fish instead.

Booty Calls: Is It Just About Sex?, Knowledge@Smu

Knowledge@SMU

It may seem that booty calls serve men more so than women. After all, men desire sex more than women – a notion often rationalised by the lower biological cost of sex to men, compared to women. However, if booty calls favour men more than women, why might women be inclined to entertain calls for casual sex? Psychology professor Norman Li believes that booty calls should be looked upon as more than just sex; that it is, in fact, a strategy employed by both sexes in negotiating between their needs.

Male Metal Goat Wanted: Why Our Children’S Futures May Lie In The Stars, Knowledge@Smu

Knowledge@SMU

The birth of a child is usually a joyous occasion. In many Asian societies, it also represents an important milestone for families - so important that spiritual mediums have to be consulted and fortunes told, for there are auspicious and inauspicious times to bear a child. While the idea of birth planning by means of star-gazing may sound ludicrous, research has shown that ‘auspicious children’ do indeed fare better. Are there mystical powers at play? A study of child births and children in Vietnam provides an unusual take on the motivating factors behind a child’s future.

Penny For Your Pint: The Tricky Art Of Buying Kindness, Knowledge@Smu

Knowledge@SMU

Do material incentives influence blood donations? A commonly held view is that people donate their blood out of a pro-social motivation. But not everyone is willing to offer their blood for nothing. Material incentives might persuade some to step forward, yet they could very well alienate those who believe that such acts must not be motivated by selfish gains. Indeed, blood banks thread a fine line between motivating the ‘selfish’ and pandering to the ‘selfless’. Economist Alois Stutzer shares the results of a field experiment involving more than 10,000 potential blood donors with Singapore Management University.

Complexity, Cofactors, And The Failure Of Aids Policy In Africa, Eileen Stillwaggon

Economics Faculty Publications

Global AIDS policy still treats HIV as an exceptional case, abstracting from the context in which infection occurs. Policy is based on a simplistic theory of HIV causation, and evaluated using outdated tools of health economics. Recent calls for a health systems strategy – preventing and treating HIV within a programme of comprehensive health care – have not yet influenced the silo approach of AIDS policy.

Evidence continues to accumulate, showing that multiple factors, such as malnutrition, malaria and helminthes, increase the risk of sexual and vertical transmission of HIV. Moreover, complementary interventions that reduce viral load, improve immune response, …

Opportunities For Comparative Research In Public Health Pbrns : A Baseline Analysis Of Local Practice Settings, Glen P. Mays, Sharla A. Smith, Elaine B. Wootten, Sylvia J. Porchia

Health Management and Policy Presentations

This analysis describes the organizational and operational characteristics of local public health agencies participating in an initial cohort of five (5) public health PBRNs in the U.S. We examine variation in practice settings within and between PBRNs; compare practice settings to state and national norms; and identify opportunities for comparative research that can be conducted through PBRNs.

A Critique Of Neoclassical Theory Of Health Care Consumption, Xiao Jiang

Electronic Theses and Dissertations

The purpose of this thesis is to display an internal critique of the neoclassical theory of health care consumption with the intention of understanding its true merits and limitations. To avoid arbitrariness, instead of criticizing it directly, this thesis first explores the existing scholarly critiques, as well as the developments of this theory in response to these criticisms. What is interestingly observed is that the neoclassical responses tend to systematically fall into two problematic categories – the trade-off between reality and theoretical determinacy, and free-market behavior resolution. Such observation suggests that there is something fundamentally problematic with this theory, which …

Children's Health Insurance Program: The Dynamics Of Federalism And Health Care Policy, Erik White

Political Science Theses and Capstones

On February 4^th, 2009, President Obama signed into law the reauthorization of the Children Health Insurance Program. The federal government will now spend 30 billion dollars towards the goal of ensuring that more children in the United States are insured. I investigate this particular health care policy and look at the different dynamics that affect the ultimate goal of universal health insurance for children. Because this program allows for state flexibility under broad federal guidelines, one is able to look at individual states, and their particular actions and characteristics, to determine the best approach to insuring the most …

Health Insurance Tax Credits And Health Insurance Coverage Of Low-Income Single Mothers, Merve Cebi, Stephen A. Woodbury

Employment Research Newsletter

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 …

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Value-Based Purchasing Newsletter

No abstract provided.

Governance And Value-Based Purchasing: What Employers Need To Know, Valerie Pracilio

Value-Based Purchasing Newsletter

In the current economy, employers are increasingly aware of the need to employ value-based purchasing strategies. Similar strategies can also be used by health care organization governing boards.

Today, more health care providers are accepting positions at the boardroom table than in the past. These providers are well trained in the clinical aspects of health care but not the business of health care delivery. It is not surprising that providers often find themselves unprepared for a board member’s role as a decision-maker and steward. It has become clear that education is essential to prepare providers for board positions.

The Patient Centered Medical Home-What Employers Need To Know, Richard Jacoby Md

Value-Based Purchasing Newsletter

In their capacity as payers for their employees’ medical services, employers need to be aware of trends that impact the provision and payment of healthcare services. One such trend in primary care healthcare services – specifically, the Patient Centered Medical Home (PCMH) - meets both of these criteria by providing financial incentives to physicians for meeting certain quality criteria. In the following paragraphs, I’ll elaborate on the concepts underlying the PCMH, its potential to impact quality and cost of patient care, and some of the barriers to its implementation.

Consumer Health Websites Accelerate Consumer-Driven Healthcare, Richard Toner

Value-Based Purchasing Newsletter

Consumer health websites (sites) have been around for more than a decade now. WebMD, RevolutionHealth, MyOptumHealth, HealthCentral, Everydayhealth, QualityHealth… the list of sites goes on and on. Employers, employees, health plans, providers, and general healthcare consumers have had varying reactions to these sites and buy-in remains largely a personal preference.