Health Economics Commons^™

An Analysis Of The Economic Barriers To Oral Healthcare Access In Omaha, Nebraska, Elias Witte

Theses/Capstones/Creative Projects

Existing research regarding the analysis of the distribution of oral healthcare practitioners has been conducted across large metropolitan areas within the United States in order to determine the magnitude of healthcare resource deficits. Such research has demonstrated significant deficits in access to oral healthcare predominantly in lower-income urban areas. Consequently, patients in these socioeconomically disadvantaged areas have less access to routine oral care, which impacts their overall health and well-being. While there is an abundance of studies examining this issue in other localities across the country, there is a lack of information regarding the distribution of oral healthcare practitioners in …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Center For Integration Of Science And Industry - Response To Ostp Bioeconomy Rfi, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

RESPONSE TO: AGENCY: Office of Science and Technology Policy (OSTP). ACTION: Notice of request for information (RFI) for Bioeconomy Federal Register /Vol. 84, No. 175 /Tuesday, September 10, 2019 /Notices, page 47561 Transmitted electronically to [email protected]

What specific actions could the U.S. Government take to reinforce a values-based ecosystem that will guide the transformation and expansion of the U.S. Bioeconomy, in both the shortand long-term?

This response addresses specific actions the U.S. Government could take to ensure sustainable funding for the basic research that provides the foundation for the U.S. Bioeconomy. Empirical evidence demonstrates that a mature body of basic …

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 Formation Of Physician Patient Sharing Networks In Medicare: Exploring The Effect Of Hospital Affiliation, Sebastian Linde

Open Access Publishing Support Funded Articles

This study explores the forces that drive the formation of physician patient sharing networks. In particular, I examine the degree to which hospital affiliation drives physicians' sharing of Medicare patients. Using a revealed preference framework where observed network links are taken to be pairwise stable, I estimate the physicians' pair‐specific values using a tetrad maximum score estimator that is robust to the presence of unobserved physician specific characteristics. I also control for a number of potentially confounding patient sharing channels, such as (a) common physician group or hospital system affiliation, (b) physician homophily, (c) knowledge complementarity, (d) patient side considerations …

Improving End Stage Renal Disease Quality Incentive Payment Total Performance Scores, Shelly Guyer, Gina Gregg, Bradley Warady

Posters

The End Stage Rena Disease (ESRD) Quality Incentive Program (QIP) promotes high quality, transparent, cost-efficient care in outpatient dialysis facilities by establishing performance standards that are linked to payment.

The development of a subject matter expert and the sharing of ESRD QIP knowledge resulted in buy-in from dialysis staff and physicians leading to a higher total performance score and the avoidance of payment reduction.

The Effects Of Opioids On Kentucky's Workforce, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

From the executive summary:

Opioid abuse represents a significant and growing public health issue for both the nation and Kentucky. In 2016, opioids contributed to more than 62,000 deaths nationally and 1,406 deaths in Kentucky. National studies have placed the societal costs of opioid abuse at $55.7 billion in 2007 and $78.5 billion in 2013 (Birbaum et al. (2011) and Florence et al. (2016)). These costs included increased health care expenditures, higher criminal justice costs, and lost earnings due to reduced employment and premature deaths. The While House Council of Economic Advisors (2017) estimated the societal costs of opioid abuse …

The Cost-Effectiveness Of Neonatal Versus Prenatal Screening For Congenital Toxoplasmosis, Christine Binquet, Catherine Lejeune, Valérie Seror, François Peyron, Anne-Claire Bertaux, Olivier Scemama, Catherine Quantin, Sophie Béjean, Eileen Stillwaggon, Martine Wallon

Economics Faculty Publications

Congenital Toxoplasmosis (CT) can have severe consequences. France, Austria, and Slovenia have prenatal screening programs whereas some other countries are considering universal screening to reduce congenital transmission and severity of infection in children. The efficiency of such programs is debated increasingly as seroprevalence among pregnant women and incidence of congenital toxoplasmosis show a steady decrease. In addition, uncertainty remains regarding the effectiveness of pre- and postnatal treatments.

Effects Of Innovations In Health Care Provision And Financing, Hoda Nouri Khajavi

Dissertations, Theses, and Capstone Projects

This dissertation consists of four chapters that study the impacts of innovations in health care provision and financing. The relentless rise in US health care costs has led the Centers for Medicare and Medicaid Services to launch various pilot programs to create financial incentives for health care providers, suppliers, and local communities to improve the efficiency of the health care system. The fist chapter of this manuscript reviews the main pilot programs implemented and/or funded by the Centers for Medicare and Medicaid Services since the 111th United States Congress passed the Patient Protection and Affordable Care Act, also known as …

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).

Out-Of-Pocket Expenditure For Home And Facility Based Delivery Among Rural Women In Zambia: A Mixed-Methods, Cross-Sectional Study, Jeanette L. Kaiser, Kathleen L. Mcglasson, Peter C. Rockers, Rachel M. Fong, Thandiwe Ngoma, Davidson H. Hamer, Taryn Vian, Godfrey Biemba, Jody R. Lori, Nancy A. Scott

Nursing and Health Professions Faculty Research and Publications

Purpose: Out-of-pocket expenses associated with facility-based delivery are a well-known barrier to health care access. However, there is extremely limited contemporary information on delivery-related household out-of-pocket expenditure in sub-Saharan Africa. We assess the financial burden of delivery for the most remote Zambian women and compare differences between delivery locations (primary health center, hospital, or home).

Methods: We conducted household surveys and in-depth interviews among randomly selected remote Zambian women who delivered a baby within the last 13 months. Women reported expenditures for their most-recent delivery for delivery supplies, transportation, and baby clothes, among others. Expenditures were converted to …

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

To Extubate Or Not To Extubate: Risk Factors For Extubation Failure And Deterioration With Further Mechanical Ventilation, Jingui Xie, Guang Cheng, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Background: Extubation is a critical step in the intensive care unit (ICU). In this study, we aim to investigate the risk factors for both extubation failure and deterioration with further mechanical ventilation (MV). Methods: Data were collected from a cardiothoracic ICU in a tertiary hospital. The risk factors for extubation failure and deterioration with further MV were investigated by multivariate logistic regression. Results: A total of 676 patients were enrolled in the study. Patients with extubation failure had a longer ICU length of stay and a higher mortality rate than patients without extubation failure. An age greater than 65 years, …

Better Understanding Human Capital In West Virginia, Christiadi, John Deskins

Bureau of Business & Economic Research

No abstract provided.

Medicaid Coverage Across The Income Distribution Under The Affordable Care Act, Charles J. Courtemanche, James Marton, Aaron Yelowitz

Institute for the Study of Free Enterprise Working Papers

This chapter examines trends in Medicaid enrollment across the income distribution after the ACA’s Medicaid expansion.Using data from the American Community Survey between 2012and 2017, we compare Medicaid coverage over time in 9 states that expanded Medicaid in 2014 with no previous expansion for able-bodied, working-age adults with 12 states that had not expanded Medicaid by 2019 and also had no previous expansion for such adults. A difference-in-differences model is used to formalize this comparison. Similar to many previous studies, we find that Medicaid coverage increased dramatically for income-eligible adults under 138% of the federal poverty level (FPL). In addition, …

Perhitungan Biaya Satuan Pada Tindakan Intensive Unit Care Di Rumah Sakit X Di Jember Melalui Metode Activity Based Costing (Abc), Eri Witcahyo

Jurnal Ekonomi Kesehatan Indonesia

Hospital X in Jember is one of the government hospitals with C type status. In National Health Insurance (JKN) era, the payment scheme in hospital by using the INA CBG’s tariff package. Hospital could have profit or even loss, therefore health services effiency was needed. The objective of study was to identify service product and calculate of service product unit cost at Intensive Care Unit (ICU) in Hospital X in Jember. The type of this research was observational descriptive with cross sectional approach. The unit of analysis was ICU at Hospital X in Jember. The unit cost calculation method is …

Ekuitas Layanan Rawat Inap Rumah Sakit Di Indonesia, Devi Senja Ariani, Pujiyanto Pujiyanto

Jurnal Ekonomi Kesehatan Indonesia

In order to encourage the achievement of UHC in Indonesia, the government organized National Health Insurance (JKN) program. One of the objectives of the JKN program is the improvement of access and equity utilization of health services. This study aims to analyze Equity of Inpatient Utilization in Health Service in second and third year of JKN program implementation in 2015 and 2016. This study uses secondary data of SUSENAS in 2015 and 2016 with analysis using concentration curve and concentration index. The results showed that the Utilization of inpatient services in hospitals in the JKN group of participants increased in …

Determinan Sosial Ekonomi Konsumsi Minuman Berpemanis Di Indonesia: Analisis Data Susenas 2017, Widi Astutty Casimira Daeli, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

Sugar-Sweetened Beverages (SSBs) are added liquids with various of sugar. Consumption of SSBs contributes to Non-Communicable Diseases (NCDs) such as weight gain, increasing the risk of type 2 diabetes mellitus and cardiovascular diseases. NCDs can be prevent ed as early as possible by reducing the consumption of calories in sugar. WHO recommends adults and children to reduce sugar intake to less than 10% of total energy intake and continue to less than 5% of total energy intake. This study aims to determine the socio-eco nomic factors consumption of SSBs. We employed secondary data from the 2017 National Socio-Economic Survey (Susenas) …

Penghitungan Biaya Satuan Pada Instalasi Rawat Jalan Di Rumah Sakit X Jambi Menggunakan Metode Step Down, Susilo Wulan, Ade Herman Surya Direja, Dian Reflisiani

Jurnal Ekonomi Kesehatan Indonesia

Hospital has a responsibility to provide quality and affordable health care to the community. Therefore, determining tariffs by calcu lating the actual cost is very important, especially for internal stakeholders in undergoing cost analysis, performance evaluation and decision making, including tariff negotiation with external stakeholders. This research objective is to calculate unit costs and compar atively analyzing costs between units in an outpatient installation using the step-down method. This research used a partial economic evaluation which only portrays the description of cost object without comparing the output from the analyzed unit. The stages of data analysis include identifying the resource …

Determinan Cakupan Imunisasi Dasar Lengkap Pada Penerima Program Keluarga Harapan, Wulansari Wulansari, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Poverty is a multidimensional social problem and related to the problems of health, education and other social welfare. National Basic Immunization Coverage (IDL) reached 57.9%, with 32.9% was incomplete and 9.2% were not immunized, while national coverage indicators were at least 90%. This study aims to determine the determinants that affects basic complete immunization coverage for babies receiving the Family Hope Program (PKH). The study design used was cross sectional. The research was located in 34 provinces. The total population is 9,205 respondents using secondary data from the National Socio-Economic Survey (Susenas) in 2017. The research shows that the achievement …

The Effects Of Traditional Cigarette And E-Cigarette Taxes On Adult Tobacco Product Use, Michael F. Pesko, Charles J. Courtemanche, Joanna Catherine Maclean

Institute for the Study of Free Enterprise Working Papers

We study the effects of traditional cigarette tax rate changes and e-cigarette tax adoption on use of these products among US adults. Data are drawn from the Behavioral Risk Factor Surveillance System and National Health Interview Survey data over the period 2011to 2017. Using a difference-in-differences model, we find that higher traditional cigarette taxes reduce adult traditional cigarette use and increase adult e-cigarette use, suggesting that the products are economic substitutes. E-cigarette tax adoption reduces e-cigarette use, with some heterogeneity across groups, and dilutes the own-tax responsiveness of traditional cigarettes.

Prevention And Mitigation Of Congenital Toxoplasmosis: Economic Costs And Benefits In Diverse Settings, Branko Bobić, Isabelle Villena, Eileen Stillwaggon

Economics Faculty Publications

Congenital toxoplasmosis (CT), the result of a primary infection of pregnant women with Toxoplasma gondii which was transmitted to the fetus, may result in mild to deep injuries occurring in the newborn or later in its development or in adolescence. The visual and cognitive impairment that can result imposes substantial economic costs on the individual and society. Numerous observational studies favor the conclusion that, with preventive measures currently available, it is possible to reduce the incidence of infections in pregnant women, the incidence of fetal infection by preventing transplacental transmission, and the gravity of injury in infected newborns. Treatment of …

The Aging Of A Young Nation: Population Aging In Singapore, Rahul Malhotra, Andre M. Muller, Su Aw, Gerald Choon Huat Koh, Yin-Leng Theng, Stephen James Hoskins, Chek Hooi Wong, Chunyan Miao, Wee-Shiong Lim, Chetna Malhotra, Angelique Chan

Research Collection School Of Economics

The juxtaposition of a young city-state showing relative maturity as a rapidly aging society suffuses the population aging narrative in Singapore and places the “little red dot” on the spotlight of international aging. We first describe population aging in Singapore, including the characteristic events that shaped this demographic transition. We then detail the health care and socioeconomic ramifications of the rapid and significant shift to an aging society, followed by an overview of the main aging research areas in Singapore, including selected population-based data sets and the main thrust of leading aging research centers/institutes. After presenting established aging policies and …

The Effect Of Disability Status On Parental Input: A Study From India, Susann Skjoldhorne

Master's Theses

Human capital has for a long time been an important factor in economic growth theory. Previous literature shows a strong connection between parental input and the level of human capital attained by a child. The investment in child health and education has a positive effect on building human capital. When resources are scarce the allocation of resources will affect the opportunities that a child is given to achieve their potential. Gender preferences, birth order, and disabilities could all be factors that explain how parents chose to allocate their resources. Previous studies show that the distribution of parental input based on …

The Impact Of Cleft Lip/Palate And Clp Surgical Intervention On The Social Integration Of Adolescents In India, Mustafa Zahid

Master's Theses

Cleft Lip/Palate, a congenital orofacial anomaly, carries an incidence rate of approximately 1 in every 1000 births. In addition to the stigma associated with the condition, the varying levels of cleft severity might result in lower life outcomes which could include lower cognitive ability, physical and psychological well-being, social and behavioral outcomes of adolescents. This paper focuses on the social integration element of life outcomes, which is composed of the social inclusion and prosocial behavior of the adolescent. Despite the affordability of restorative surgeries, patients in rural areas of Low and Middle-Income Countries (LMICs) such as India face accessibility and …

Are Menstrual Cycles A Biological Determinant Of Well-Being Amongst Sierra Leonean Schoolchildren?, Ashwini Shridhar

Master's Theses

The influence of hormones and biology on behavior is a topic that is rife with controversy, especially when it comes to sexual hormones. There is even more murkiness when it comes to the topic of menstruation and knowledge about women’s menstrual cycles. Recent research on this topic have seen a link between the hormonal fluctuations during menstrual cycles and various behavioral implications on competition, cooperation, and risk behavior. This study tries to expand existing knowledge by examining whether there is a link between hormonal fluctuations during menstrual cycles and risk preferential behavior using economic experiments in the largely understudied context …

The Economics Of Weight Loss, Shivani Pandey

Undergraduate Economic Review

Obesity is now being considered one of the biggest health concerns globally. Ironically, while India records the largest no. of underweight population in the world along with China, it has also been placed in the top five countries in terms of obesity as per a new study by the Lancet Journal. Obesity entails various direct and indirect costs in terms of lower productivity and higher medical expenditure and has the potential to lower economic growth. This paper analyses the need for strengthening government regulations in the weight loss industry. After analyzing the causes of obesity and its negative effects on …

Impacts Of Contraception On Women’S Decision-Making Agency In Indonesia, Michaela J. Fogarty

Undergraduate Economic Review

Increasing access to contraception has the potential to empower women and improve the economic standing of families across the globe. Many researchers have explored the impacts of contraception on families and the determinants of women’s level of empowerment, but little scholarship exists on their direct relationship. This paper explores the impacts of contraceptive use on women’s empowerment, measured by a sum of women’s household decision-making agency. Panel data from three rounds of the Indonesian Family Life Survey is used to run multiple regressions with household fixed effects. Results suggest that women who use contraception have input on two additional types …

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.