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International Journal of Health Economics and Management

Aig Unuigbe
During the 1990s and early 2000s many states expanded Medicaid eligibility for parents particularly after the 1996 welfare reform. At the same time, welfare reform also put in place policies that limited the eligibility of recent immigrants for public programs including Medicaid. This paper evaluates the effects of these changes in Medicaid eligibility policy on the private and public health insurance coverage of immigrants as well as the overall insurance rate. It also looks at the effect on health care use and measures of health status...
January 31, 2019: International Journal of Health Economics and Management
Maria Kaneva, Christopher J Gerry, Nikolay Avxentiev, Valerii Baidin
As for all health systems, in Russia, the demand for medical care is greater than its health system is able to guarantee the supply of. In this context, removing services from the state guaranteed package is an option that is receiving serious consideration. In this paper, we examine the attitudes of the Russian population to such a reform. Exploiting a widely-used methodology, we explore the population's willingness to pay for cooperative health insurance. Distinguishing between socioeconomic and demographic factors, health-related indicators and risk aversion we find, consistent with other literature, positive income and risk aversion effects...
January 22, 2019: International Journal of Health Economics and Management
Gisléia Benini Duarte, André de Souza Melo, Diego Firmino Costa da Silva
The paper examines the relationship between the supervision carried out in the municipalities by the main Brazilan supervisory institution (Controladoria Geral da União-CGU, in portuguese) and the incidence of dengue cases in them. Since the audited municipalities were randomized, this allows the identification of a control group that adequately represents the counterfactual of the treated group. The sample was composed of all municipalities that could be selected for that CGU inspection cycle, that is, 1520 municipalities, of which 70 were drawn and therefore belong to the study treatment group...
December 17, 2018: International Journal of Health Economics and Management
Jean M Abraham, Anne B Royalty, Coleman Drake
Using the 2010-2015 Medical Expenditure Panel Survey-Insurance Component, this study investigates the effect of the Affordable Care Act's Medicaid eligibility expansion on four employer-sponsored insurance (ESI) outcomes: offers of health insurance, eligibility, take-up, and the out-of-pocket premium paid by employees for single coverage. Using a difference-in-differences identification strategy, we cannot reject the hypothesis of a zero effect of the Medicaid eligibility expansion on an establishment's probability of offering ESI, the percentage of an establishment's workforce that takes up coverage, or the out-of-pocket premium for single coverage...
December 15, 2018: International Journal of Health Economics and Management
Abhijit Sharma, Salvatore di Falco, Iain Fraser
This paper uses a leading UK supermarket's loyalty card database to assess the effectiveness and impact of the 2004 UK reduced salt campaign. We present an econometric analysis of purchase data to assess the effectiveness of the Food Standard Agency's (FSA) 'reduced salt campaign'. We adopt a general approach to determining structural breaks in the time series of purchase data, using unit root tests whereby structural breaks are endogenously determined from the data. We find only limited evidence supporting the effectiveness of the FSA's reduced salt campaign...
December 14, 2018: International Journal of Health Economics and Management
Thomas M Selden, Zeynal Karaca, Sandra Decker
The past decade witnessed a dramatic increase in inpatient hospital payment rates for patients with private insurance relative to payment rates for those covered by Medicare. A natural question is whether the widening private-Medicare payment rate difference had implications for the hospital care received by patients just before and after turning 65-the age at which there is a substantial shift from private to Medicare coverage. Using a large discharge dataset covering the period 2001-2011, we tracked changes at age 65 in the following dimensions of hospital care: overall hospitalization rates, case mix, referral-sensitive surgeries, length of stay, full established charges, number of procedures, mortality, and composite measures of inpatient quality and patient safety...
December 2018: International Journal of Health Economics and Management
Margit Malmmose, Karoline Mortensen, Claus Holm
Maryland implemented one of the most aggressive payment innovations the nation has seen in several decades when it introduced global budgets in all its acute care hospitals in 2014. Prior to this, a pilot program, total patient revenue (TPR), was established for 8 rural hospitals in 2010. Using financial hospital report data from the Health Services Cost Review Commission from 2007 to 2013, we examined the hospitals' financial results including revenue, costs, and profit/loss margins to explore the impact of the adoption of the TPR pilot global budget program relative to the remaining hospitals in the state...
December 2018: International Journal of Health Economics and Management
Junfang Xu, Jian Wang, Madeleine King, Ruiyun Liu, Fenghua Yu, Jinshui Xing, Lei Su, Mingshan Lu
Reducing rural-urban disparities in health and health care has been a key policy goal for the Chinese government. With mental health becoming an increasingly significant public health issue in China, empirical evidence of disparities in the use of mental health services can guide steps to reduce them. We conducted this study to inform China's on-going health-care reform through examining how health insurance might reduce rural-urban disparities in the utilization of mental health inpatient services in China...
December 2018: International Journal of Health Economics and Management
Elena Andreyeva, Benjamin Ukert
This study evaluates the effect of minimum wage on risky health behaviors, healthcare access, and self-reported health. We use data from the 1993-2015 Behavioral Risk Factor Surveillance System, and employ a difference-in-differences strategy that utilizes time variation in new minimum wage laws across U.S. states. Results suggest that the minimum wage increases the probability of being obese and decreases daily fruit and vegetable intake, but also decreases days with functional limitations while having no impact on healthcare access...
December 2018: International Journal of Health Economics and Management
Donata Bessey
This research note analyzes the relationship between experimentally elicited, incentivized economic preference parameters, personality traits, and three health behaviors: smoking, drinking, and physical activity. While there is a strand of economic research that uses proxy measures of risk and time preference that are not derived from an incentivized experiment and personality traits at the same time, and a considerably smaller one that uses experimentally elicited measures of risk and time preference only, the innovation of my work is to use experimentally elicited, incentivized preference measures and personality traits at the same time to explain a range of health behaviors...
December 2018: International Journal of Health Economics and Management
George L Wehby, Dan Shane
We provide the first investigation into whether and how much genes explain having health insurance coverage or not and possible mechanisms for genetic variation. Using a twin-design that compares identical and non-identical twins from a national sample of US twins from the National Survey of Midlife Development in the United States, we find that genetic effects explain over 40% of the variation in whether a person has any health coverage versus not, and nearly 50% of the variation in whether individuals younger than 65 have private coverage versus whether they have no coverage at all...
November 12, 2018: International Journal of Health Economics and Management
Sean Shenghsiu Huang, John R Bowblis
Since the 2000s, private equity (PE) firms have been actively acquiring nursing homes (NH). This has sparked concerns that with stronger profit motive and aggressive use of debt financing, PE ownership may tradeoff quality for higher profits. To empirically address this policy concern, we construct a panel dataset of all for-profit NHs in Ohio from 2005 to 2010 and link it with detailed resident-level data. We compare the quality of care provided to long-stay residents at PE NHs and other for-profit (non-PE) NHs...
October 24, 2018: International Journal of Health Economics and Management
Alejandro F Rodríguez, M Nieves Valdés
This paper provides empirical evidence of the existence of a long-run causal relationship between GDP and health care expenditures, for a group of Latin American and the Caribbean countries and for OECD countries for the period 1995-2014. We estimated the income elasticity of health expenditure to be equal to unity for both groups of countries, that is, health care in Latin American and OECD countries is a necessity rather than a luxury. We did not find evidence of a causal effect in the opposite direction, i...
September 28, 2018: International Journal of Health Economics and Management
Alaitz Artabe, Waleska Sigüenza
The paper seeks to analyse the evolution of expenditure on private health insurance (PHI) in Spain. We consider the factors that influence PHI demand and level of spending before and during the economic recession, along with identifying the effect of the recession on these factors. The data is obtained from the Spanish Family Budget Survey (SFBS) for 2006 and 2012. Due to the data structure and the demand function, the analysis is performed using a sample selection model in order to avoid sample selection bias...
September 22, 2018: International Journal of Health Economics and Management
Ying Zhang, Jacques Vanneste, Jiaxin Xu, Xiaoxing Liu
Currently, a high percentage of China's households face financial catastrophe as a direct result of excessive out-of-pocket (OOP) health expenditures. To alleviate this, China has set up the Critical Illness Insurance (CII) program since 2012. However, the current CII is still in an experimental phase and tested in 8 (out of 34) provinces, which has not been proved to be effective. This paper develops a health financing system for reducing catastrophic medical spending using a two-layer model for CII. This model partly compensates expenses exceeding the cap line of the Social Resident Basic Medical Insurance scheme to maintain the ratio of OOP expenses to total medical expenditure approximately at 20%...
September 21, 2018: International Journal of Health Economics and Management
Muhammad Arshad Khan, Muhammad Iftikhar Ul Husnain
This study investigates long run relationship between health care expenditure and real income in fifteen selected Asian countries over the period 1995-2014 using the panel cointegration tests and controlling for cross-sectional dependence through unobserved common correlated factors (UCFs). The results show that health care expenditure and income are cointegrated. It is found that the income elasticity scales down when UCFs are controlled, which implies that ignoring UCFs produces biased and inconsistent estimates...
September 21, 2018: International Journal of Health Economics and Management
Michael F Seibold
An employer coalition in Indiana sponsored a study by the Rand Corporation examining commercial insurer payments as a percent of Medicare. The employers sought to understand why their health care costs were high and increasing. The study showed that, on average, their insurer was paying three times what Medicare pays for the same services. In this, a follow-up study, we demonstrate that these high payments resulted in very high profit margins for central Indiana's major health systems, along with elevated costs and poor performance on key efficiency measures...
September 6, 2018: International Journal of Health Economics and Management
Robert Nathenson, Michael R Richards
Direct-to-consumer advertising (DTCA) for prescription drugs is a relatively unique feature of the US health care system and a source of tens of billions of dollars in annual spending. It has also garnered the attention of researchers and policymakers interested in its implications for firm and consumer behavior. However, few economic studies have explored the DTCA response to public policies, especially those mandating coverage of these products. We use detailed advertising expenditure data to assess if pharmaceutical firms increase their marketing efforts after the implementation of relevant state and federal health insurance laws...
September 2018: International Journal of Health Economics and Management
Thang Dang
In 1991, Vietnam implemented a compulsory primary schooling reform that provides this study a natural experiment to estimate the causal effect of education on health care utilization with a regression discontinuity design. This paper finds that education causes statistically significant impacts on health care utilization, although the signs of the impacts change with specific types of health care services examined. In particular, education increases the inpatient utilization of the public health sector, but it reduces the outpatient utilization of both the public and private health sectors...
September 2018: International Journal of Health Economics and Management
Asankha Pallegedara
This article examines the effects of chronic non-communicable diseases (NCDs) on households' out-of-pocket health expenditures in Sri Lanka. We explore the disease specific impacts on out-of-pocket health care expenses from chronic NCDs such as heart diseases, hypertension, cancer, diabetics and asthma. We use nationwide cross-sectional household income and expenditure survey 2012/2013 data compiled by the department of census and statistics of Sri Lanka. Employing propensity score matching method to account for selectivity bias, we find that chronic NCD affected households appear to spend significantly higher out-of-pocket health care expenditures and encounter grater economic burden than matched control group despite having universal public health care policy in Sri Lanka...
September 2018: International Journal of Health Economics and Management
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