Health Economics Commons^™

American Obesity: Rooted In Uncertainty, Institutions And Public Policy, James Woodward

Theses and Dissertations--Public Policy and Administration

Despite the efforts of policymakers, medical professionals, and other stakeholders, obesity and related health problems show no signs of receding from their record-high rates. Public policy has largely taken the form of consumer advice, (e.g., USDA’s Dietary Guidelines). Since consumers bear most of the costs associated with their obesity, the goal of obesity prevention appears to be incentive-compatible, prima facie. That is, there is no a priori case for much further policy intervention unless existing advice is deficient or consumers’ exhibit systematically poor decision-making.

My review of the literature shows that scholars have long conveyed a consistent narrative regarding …

Improving Medicare & Medicaid Reimbursement Framework For Molecular Diagnostics Tests Using Gene Sequencing: A Case Study In Health Economics, Advait Apte

Dissertations and Theses

Breast cancer is the second leading cause of deaths among women, as about one in eight women in the US will develop invasive breast cancer during their lifetime. After the diagnosis of breast cancer, chemotherapy is the commonly prescribed first line of treatment. In the recent past, research has shown that molecular diagnostic tests have revealed that about 20% of the tumors carry the HER-2 mutation on cell surface, which can be treated with the drug Herceptin, or trastuzumab, improving cancer free survival rates from 71.9% to 84.2% in five years. However, in spite of the observed increase in survival …

Determining The Predictive Ability Of Rural-Urban Migration For Health Indicators In China, Christopher Rick

Dissertations and Theses

Over one hundred million rural Chinese residents have migrated to urban areas within China for work. In cities, these workers often lack access to health insurance and licensed healthcare. Migrants are also more likely to work in dangerous jobs and to participate in high-risk behaviors. This paper analyzes two health indicators, blood pressure and grip strength, to determine if migrant status can predict health. This paper determines that migrant status is a significant predictor for blood pressure and grip strength, albeit in models with low predictive ability. However, the length of time since a person migrated is not a significant …

Income And Physical Activity Choices: A Comparison Between United States And China, Xiaowen Hu

Theses and Dissertations--Agricultural Economics

The low income population often appears to make poor health choices, including physical activity deficiency. Since outdoor physical activity does not have to be monetarily costly, one explanation for this phenomenon is related to the idea of time preference. Briefly, the benefit of future good health appears to be valued less by those with low income, and they face a choice between consumption today and better health in the future. The objective of this study is to further investigate the determinants of participation in physical activity with an emphasis on the effect of annual household income. This dissertation consists of …

Years Of Good Life Based On Income And Health: Re-Engineering Cost-Benefit Analysis To Examine Policy Impact On Wellbeing And Distributive Justice, Richard Cookson, Owen Cotton-Barrett, Matthew D. Adler, Miqdad Asaria, Toby Ord

Faculty Scholarship

No abstract provided.

Does Medical Malpractice Law Improve Health Care Quality?, Michael D. Frakes, Anupam B. Jena

Faculty Scholarship

Despite the fundamental role of deterrence in justifying a system of medical malpractice law, surprisingly little evidence has been put forth to date bearing on the relationship between medical liability forces on the one hand and medical errors and health care quality on the other. In this paper, we estimate this relationship using clinically validated measures of health care treatment quality constructed using data from the 1979 to 2005 National Hospital Discharge Surveys and the 1987 to 2008 Behavioral Risk Factor Surveillance System records. Drawing upon traditional, remedy-centric tort reforms — e.g., damage caps — we estimate that the current …

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

Insurance, Race/Ethnicity, And Sex In The Search For A New Physician, Rajiv Sharma, Arnab Mitra, Miron Stano

Economics Faculty Publications and Presentations

We employed simulated patient calls to a national random sample of primary care physicians to assess appointment availability for adults who differed by insurance, race/ethnicity, and sex. The disparities we found are much larger than those reported in previous assessments, highlighting the importance of including race/ethnicity and sex in such research

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

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 …

Accounting For Indirect Costs In Public Health Cost Analyses, Melanie D. Whittington, Adam Atherly, Lisa Vanraemdonck

Frontiers in Public Health Services and Systems Research

Background. There is a gap in research regarding the resources needed to deliver public health activities, which inhibits informed decision making around investments in public health and the allocation of funds among activities. When conducting cost analyses in public health, it is important to include costs from all cost components, including personnel, non-personnel, and indirect costs. However, defining, identifying, and measuring indirect costs is challenging and can impede studies of this type. Purpose. The purpose of this pilot study is to create a catalog of the methodologies public health researchers have used to account for indirect costs. Methods. We surveyed …

Irish Gms Cost Projections And Its Implications Between 2016 And 2026, Aisling Conway Lenihan, Noel Woods

Dept. of Management & Enterprise Publications

Introduction: Ireland had one of the highest pharmaceutical spends per capita in the EU in 2012. The General Medical Services (GMS) scheme is the largest community drug scheme in Ireland with approximately 40% of the population eligible for free drugs and appliances in 2012. The total cost of GMS prescriptions increased by 414% between 1998 and 2012. This paper projects Irish GMS cost from 2016 to 2026 and examines the implications of the estimated impact on GMS expenditure.

Method: Central Statistics Office (CSO) population projections (2013) and HSE-PCRS GMS population prescription data (2012) were used to develop four variables; population, …

Estimating Health & Economic Gains From Public Health Delivery System Transformation, Glen P. Mays

Health Management and Policy Presentations

Objectives: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities, which we use as indicators of public health system change; and (2) the effects of these changes on preventable mortality and resource use. Methods: …

Estimating The Economic Impact Of The Construction And Operation Of The Plains And Eastern Clean Line Project, Katherine A. Deck, Mervin Jebaraj

Publications and Presentations

Clean Line Energy Partners LLC (Clean Line) is proposing to build the Plains & Eastern Clean Line project, an approximately 700-mile, high voltage direct current transmission line and associated facilities with the capacity to deliver 4,000 megawatts (MW) of wind power from the Oklahoma Panhandle region to utilities and customers in Arkansas, Tennessee, and other markets in the Mid-South and Southeast, areas that lack access to low-cost renewable power. The project will deliver enough energy to power more than one million homes annually in the MidSouth and Southeastern United States.

Living Arrangements And Psychological Well-Being Of The Elderly After The Economic Transition In Vietnam, Ken Yamada, Bussarawan Teerawichitchainan

Research Collection School of Social Sciences

Objectives: We examine the relationship between living arrangements and psychological well-being of the older adults in Vietnam, where there is an influence of Confucian values and a lack of close substitutes for family care of the older adults, by exploiting a great deal of regional variation in economic development. We also examine the role of living arrangements in well-being differentials across regions. Method: We estimate a triangular simultaneous-equation discrete-response model, which accounts for the simultaneity between living arrangements and psychological well-being (happiness, depression, loneliness, poor appetite, and sleep disorder), using a nationally representative sample of 2,225 adults aged 60 and …

Kentucky’S Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays

Health Management and Policy Presentations

This session examines recent progress toward the 2012 Institute of Medicine recommendation to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be available across the U.S. Research about the health and economic benefits of Foundational Public Health Services has begun to shape Kentucky's strategic plan for transforming the public health system.

Analytic Approaches For Causal Inference With Complex Multi-Component Interventions, Glen P. Mays, Arnold J. Stromberg, Jing Li, Mark V. Williams

Health Management and Policy Presentations

Estimating the causal effects of complex, multi-component health interventions is a task with many challenges in measurement and methodology. This presentation profiles the methods being used as part of the PCORI-funded Project Achieve, a national study to estimate the comparative effectiveness of heterogeneous care transition programs designed to help hospitalized patients and their caregivers navigate care delivery systems effectively and return back to the community with optimal health and wellbeing.

Policy Options For Recruiting And Retaining Rural Primary Care Physicians In Maine, Casey Lancaster

Muskie School Capstones and Dissertations

Maine faces a challenge providing primary care services to over half of its residents, as they live in rural areas – even though Maine has enough primary care physicians practicing in the state to service the needs of the population. Maine has a primary care physician distribution problem. Androscoggin, Oxford, Sagadahoc, Somerset, Waldo, Washington, and York Counties, all fall well below the national average of primary care physicians per 100,000 residents. Maine has no true financial incentive program to help rural area’s recruit and retain primary care physicians, though Maine does have two programs that attempt to get primary care …

Eligibility Recertification And Dynamic Opt-In Incentives In Income-Tested Social Programs: Evidence From Medicaid/Chip, Zhuan Pei

Upjohn Institute Working Papers

Conventional labor supply studies assume constant eligibility monitoring of income-tested program participants, but this is not true for most programs. For example, states can allow children to enroll in Medicaid/CHIP for 12 months regardless of family income changes. A long recertification period reduces monitoring costs but is predicted to induce program participation by temporary income adjustments. However, I find little evidence of strategic behavior from the 2001 and 2004 Survey of Income and Program Participation. Given the lack of dynamic responses, I propose a framework to compute the optimal recertification period and find 12 months to be its lower bound.

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.