Health Economics via MedWorm.com MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Health Economics' source. Thu, 09 Feb 2012 10:12:53 +0100 VOLUNTARY PRIVATE HEALTH INSURANCE AMONG THE OVER 50s IN EUROPE http://www.medworm.com/index.php?rid=5672484&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.2800 ABSTRACTUsing data from Survey of Health, Ageing and Retirement in Europe (SHARE), we investigate the determinants of voluntary private health insurance (VPHI) among the over 50s in 11 European countries and their effects on healthcare spending. First, we find that the main determinants of VPHI are different in each country, reflecting differences in the underlying healthcare systems, but in most countries, education levels and cognitive abilities have a strong positive effect on holding a VPHI policy. We also analyse the effect of holding a voluntary additional health insurance policy on out‐of‐pocket (OOP) healthcare spending. We adopt a simultaneous equations approach to control for self‐selection into VPHI policy holding and find that, only in the Netherlands, VPHI policyholders ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5672484 Thu, 09 Feb 2012 14:51:30 +0100 5672484 Valuing the economic benefits of complex interventions: when maximising health is not sufficient http://www.medworm.com/index.php?rid=5663387&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.2795 ABSTRACTComplex interventions, involving interlinked packages of care, challenge the application of current methods of economic evaluation that focus on measuring only health gain. Complex interventions may be problematic on two levels. The complexity means the intervention may not fit into one of the current appraisal systems, and/or maximising health is not the only objective. This paper discusses the implications of a programme of work that focused on clinical genetics services, as an example of a complex intervention, and aimed to identify the following: the attributes that comprise both health and non‐health aspects of benefits and whether it is possible to evaluate such an intervention using current National Institute for Health and Clinical Excellence appraisal processes. Genetic ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5663387 Mon, 06 Feb 2012 14:42:10 +0100 5663387 Mortality and morbidity risks and economic behavior http://www.medworm.com/index.php?rid=5663388&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.2797 SUMMARYThere are theoretical reasons to expect that high risk of mortality or morbidity during young adulthood decreases investment in human capital. However, investigation of this hypothesis is complicated by a variety of empirical challenges, including difficulties in inferring causation due to omitted variables and reverse causation. For example, to compare two groups with substantially different mortality rates, one typically has to use samples from different countries or periods, making it difficult to control for other relevant variables. Reverse causation is important because human capital investment can affect mortality and morbidity. To counter these problems, we collected data on human capital investments, fertility decisions, and other economic choices of people at risk for Hunt... Health Economics journals http://www.medworm.com/rss/comments.php?id=5663388 Sun, 05 Feb 2012 05:00:00 +0100 5663388 Setting pay for performance targets: do poor performers give up? http://www.medworm.com/index.php?rid=5654825&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.2773 ABSTRACTWe examine the effect of a health plan's pay for performance incentives on the percentage of outpatient drug prescriptions that are filled with generic rather than brand‐name drugs in physicians' practices in an established physician network – the generic prescription rate (GPR). The financial reward was based on the performance of the entire network, but the network implemented rewards at the practice level. Practice‐level rewards were awarded on an all‐or‐nothing basis if the GPR met or exceeded specialty‐specific targets that increased each year. Although that design gave the practices a strong incentive to meet the target, practices performing far below the target might ‘give up’, costing the network its reward. Using a partial adjustment model, we estimate that... Health Economics journals http://www.medworm.com/rss/comments.php?id=5654825 Fri, 03 Feb 2012 15:00:40 +0100 5654825 The price sensitivity of Medicare beneficiaries: a regression discontinuity approach http://www.medworm.com/index.php?rid=5633858&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1814 ABSTRACTWe use 4 years of data from the retiree health benefits program of the University of Michigan to estimate the effect of price on the health plan choices of Medicare beneficiaries. During the period of our analysis, changes in the University's premium contribution rules led to substantial price changes. A key feature of this ‘natural experiment’ is that individuals who had retired before a certain date were exempted from having to pay any premium contributions. This ‘grandfathering’ creates quasi‐experimental variation that is ideal for estimating the effect of price. Using regression discontinuity methods, we compare the plan choices of individuals who retired just after the grandfathering cutoff date and were therefore exposed to significant price changes to the choices ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5633858 Fri, 27 Jan 2012 15:10:45 +0100 5633858 Testing procedural invariance in the context of health http://www.medworm.com/index.php?rid=5633859&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.2796 This article reports two experiments that aim to test for preference reversals over outcomes defined by health status, using both ‘open’ and ‘assisted’ valuation procedures. Although systematic preference reversals in the direction generally reported in the literature were not observed, the rates of non‐systematic reversal were substantial, measuring 35–40%. By analysing the respondents' explanations for their answers, it is clear that many of them used heuristics to answer the questions, and they may have good reasons to do so, which undermines the notion that preferences are always fixed and stable. These results, and others like it, pose a challenge to those who unquestioningly assume procedural invariance and maintain that population preferences should be used to inform hea... Health Economics journals http://www.medworm.com/rss/comments.php?id=5633859 Wed, 25 Jan 2012 05:00:00 +0100 5633859 Sf‐6d population norms http://www.medworm.com/index.php?rid=5602729&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1823 ABSTRACTThe derivation of population norms using simple generic health‐related quality of life measures to inform policy has been recommended in the literature. This letter illustrates the derivation of population norms for the SF‐6D in the United Kingdom. It uses a sample of 22,166 respondents from the 2010 wave of the study Understanding Society. Understanding Society is a national representative sample of British citizens. The survey of this study contains the SF‐12. It is possible to derive health state utilities from the SF‐12 (and from the SF‐36) using a relatively new instrument, the SF‐6D. The SF‐12 and the SF‐36 belong to the most widely used generic health‐related quality of life measures.Mean SF‐6D utility scores for males and females are 0.81 and 0.79, respe... Health Economics journals http://www.medworm.com/rss/comments.php?id=5602729 Wed, 18 Jan 2012 15:53:11 +0100 5602729 Incorporating financial protection into decision rules for publicly financed healthcare treatments http://www.medworm.com/index.php?rid=5591071&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.2774 ABSTRACTAlmost all health systems seek to offer some form of publicly financed healthcare insurance, and governments must therefore choose the size of the benefit package and the types of treatments to cover. Conventionally, the usual approach of economists has been to recommend choices on the basis of cost effectiveness of treatments, using metrics such as the ‘cost per quality adjusted life year’. However, this approach is based on the assumption of health maximization subject to a budget constraint and ignores the potential impact of any additional concern with protecting individuals from the financial consequences of a health shock. Furthermore, it does not take account of the possible availability of complementary privately funded health care. This paper develops a model in which ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5591071 Sun, 15 Jan 2012 04:08:50 +0100 5591071 Risk perception, prevention and diagnostic tests http://www.medworm.com/index.php?rid=5591073&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1822 The objective of this paper is to study the impact of risk perception and diagnostic information on medical prevention decisions. The intertemporal preferences of individuals are represented by a model of recursive rank dependent utility, which has the advantage of allowing risk perceptions to vary over time and with health status. The main results of the paper are the following. Concerning the impact of risk perception on prevention, two types of pessimists have to be distinguished: the moderate pessimists and the fatalists. Both types overestimate the probability of disease, but the fatalists underestimate the reduction of the disease probability by prevention. Risk perception modification after the occurrence of the disease influences prevention decisions. Indeed, we show that moderate ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5591073 Wed, 11 Jan 2012 05:00:00 +0100 5591073 On the uses of routine patient‐reported health outcome data http://www.medworm.com/index.php?rid=5591072&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.2793 ABSTRACTIt has long been standard practice to ask patients in clinical trials about their health status, but the practice is now being extended to patients receiving treatment on a routine basis. In this paper, we examine four types of analyses that these health data might inform: comparisons of alternative treatments for the same condition, of health care providers, of changes in performance over time and of treatments of different types of condition. Analytical challenges arise because counterfactuals cannot be observed and because health status cannot be measured continuously. The implications of these challenges and the ability to meet them vary according to the comparative exercise. We argue that, provided with a sufficient number of health status measures for each patient and proper ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5591072 Wed, 11 Jan 2012 05:00:00 +0100 5591072 Height and cognitive function at older ages: is height a useful summary measure of early childhood experiences? http://www.medworm.com/index.php?rid=5591074&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1827 SUMMARYPrevious research using US data suggests that height, as a marker for early investments in health, is associated with better cognitive functioning in later life, but this association disappears once education is controlled for. Using an English cohort of men and women older than 50 years, we find that the association between height and cognitive outcomes remains significant after controlling for education suggesting that height affects cognitive functioning not simply via higher educational attainment. Furthermore, the significant association between height and cognitive function remains even after controls for early life indicators have been included. Copyright © 2012 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5591074 Tue, 10 Jan 2012 05:00:00 +0100 5591074 Missing data in trial‐based cost‐effectiveness analysis: the current state of play http://www.medworm.com/index.php?rid=5567202&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1693 SUMMARYRandomised controlled trial (RCT)‐based cost‐effectiveness analyses, which are prone to missing data, are increasingly used in healthcare technology assessment. This has highlighted the need for appropriate methodological approaches to the handling of missing data. This paper reviews missing data methodology used in RCT‐based cost‐effectiveness analyses since 2003. Complete case analysis, which may lead to inappropriate conclusions, is still the most popular approach and its use has increased with time.The degree of missing data in cost‐effectiveness analyses was often poorly reported and the methodology was often unclear. Reporting of missing data sensitivity analyses would improve article transparency. Copyright © 2010 John Wiley & Sons, Ltd. (Source: Health Economi... Health Economics journals http://www.medworm.com/rss/comments.php?id=5567202 Fri, 06 Jan 2012 19:52:12 +0100 5567202 Differences in length of stay for hip replacement between public hospitals, specialised treatment centres and private providers: selection or efficiency? http://www.medworm.com/index.php?rid=5567164&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1826 ABSTRACTWe investigate differences in patients' length of stay between National Health Service (NHS) public hospitals, specialised public treatment centres and private treatment centres that provide elective (non‐emergency) hip replacement to publicly funded patients. We find that the specialised public treatment centres and private treatment centres have, on average, respectively 18% and 40% shorter length of stay compared with NHS public hospitals, even after controlling for differences in age, gender, number and type of diagnoses, deprivation and regional variation. Therefore, we interpret such differences as because of efficiency as opposed to selection of less complex patients. Quantile regression suggests that the proportional differences between different provider types are larger... Health Economics journals http://www.medworm.com/rss/comments.php?id=5567164 Fri, 06 Jan 2012 19:50:01 +0100 5567164 An evaluation of the uk food standards agency's salt campaign http://www.medworm.com/index.php?rid=5567165&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.2772 ABSTRACTExcessive salt intake is linked to cardiovascular disease and several other health problems around the world. The UK Food Standards Agency initiated a campaign at the end of 2004 to reduce salt intake in the population. There is disagreement over whether the campaign was effective in curbing salt intake or not. We provide fresh evidence on the impact of the campaign, by using data on spot urinary sodium readings and socio‐demographic variables from the Health Survey for England over 2003–2007 and combining it with food price information from the Expenditure and Food Survey. Aggregating the data into a pseudo‐panel, we estimate fixed effects models to examine the trend in salt intake over the period and to deduce the heterogeneous effects of the policy on the intake of socio... Health Economics journals http://www.medworm.com/rss/comments.php?id=5567165 Fri, 06 Jan 2012 05:00:00 +0100 5567165 The effect of national health insurance on mortality and the ses–health gradient: evidence from the elderly in taiwan http://www.medworm.com/index.php?rid=5567171&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1815 ABSTRACTUsing the difference‐in‐difference‐in‐differences method, we examine the effect of the National Health Insurance (NHI) on mortality, self‐assessed health, and functional limitations of the elderly and seek to determine whether the effect is spread equally across health classes. We find that the NHI only has an effect on the death hazard, and it is the least healthy who benefit the most. The death hazard falls by 16–48% and 3–9% for the least health and the healthiest, respectively. The decline in the hazard ratio for the least healthy among the uninsured is 58% greater than that of their counterparts among the insured. Moreover, female participants benefit more from the NHI than male participants. We find no significant effect of the NHI in the SES–health gradient e... Health Economics journals http://www.medworm.com/rss/comments.php?id=5567171 Tue, 03 Jan 2012 05:00:00 +0100 5567171 Examining the link between cash flow, market value, and research and development investment spending in the medical device industry http://www.medworm.com/index.php?rid=5567172&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1825 ABSTRACTUnlike the pharmaceutical industry, no empirical research has focused on the factors influencing research and development (R&D) spending in the medical device industry. To fill that gap, this study examines how R&D spending is influenced by prior year cash flow and corporate market value using multiple regression analysis and a panel data set of medical device companies over the period 1962–2008. The empirical findings suggest that the elasticities of R&D spending with respect to cash flow and corporate market value equal 0.58 and 0.31, respectively. Moreover, based upon these estimates, simulations show that the recently enacted excise tax on medical devices, taken alone, will reduce R&D spending by approximately $4 billion and thereby lead to a minimum loss of $... Health Economics journals http://www.medworm.com/rss/comments.php?id=5567172 Mon, 02 Jan 2012 05:00:00 +0100 5567172 The impact of mental health insurance laws on state suicide rates http://www.medworm.com/index.php?rid=5531398&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1816 SUMMARYIn the 1990s and early 2000s, a number of states passed laws requiring mental health benefits to be included in health insurance coverage. The variation in the characteristics and enactment date of the laws provides an opportunity to measure the impact of increasing access to mental health care on mental health outcomes, as evidenced by state suicide rates. In contrast with previous research, results show that when states enact laws requiring insurance coverage to include mental health benefits at parity with physical health benefits, the suicide rate decreases significantly by 5%. The findings are robust to a number of specifications and falsification tests. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5531398 Fri, 23 Dec 2011 03:56:52 +0100 5531398 Understanding heterogeneity in price elasticities in the demand for alcohol for older individuals http://www.medworm.com/index.php?rid=5499931&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1817 ABSTRACTThis paper estimates the price elasticity of demand for alcohol using Health and Retirement Study data. To account for unobserved heterogeneity in price responsiveness, we use finite mixture models. We recover two latent groups, one is significantly responsive to price, but the other is unresponsive. The group with greater responsiveness is disadvantaged in multiple domains, including health, financial resources, education and perhaps even planning abilities. These results have policy implications. The unresponsive group drinks more heavily, suggesting that a higher tax would fail to curb the negative alcohol‐related externalities. In contrast, the more disadvantaged group is more responsive to price, thus suffering greater deadweight loss, yet this group consumes fewer drinks pe... Health Economics journals http://www.medworm.com/rss/comments.php?id=5499931 Wed, 14 Dec 2011 04:21:32 +0100 5499931 Acknowledgement to reviewers http://www.medworm.com/index.php?rid=5481765&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1824 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481765 Thu, 08 Dec 2011 03:49:03 +0100 5481765 How can we increase resources for health care in the developing world? Is (subsidized) voluntary health insurance the answer? http://www.medworm.com/index.php?rid=5481764&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1811 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481764 Thu, 08 Dec 2011 03:49:02 +0100 5481764 Divide et impera: protecting the growth of health care incomes (COSTS) http://www.medworm.com/index.php?rid=5481763&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1813 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481763 Thu, 08 Dec 2011 03:49:01 +0100 5481763 Competition, incentives and the English NHS http://www.medworm.com/index.php?rid=5481762&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1804 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481762 Thu, 08 Dec 2011 03:48:59 +0100 5481762 A little learning: reflections on 10 years of NICE technology appraisals http://www.medworm.com/index.php?rid=5481761&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1820 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481761 Thu, 08 Dec 2011 03:48:58 +0100 5481761 The developmental origins of health http://www.medworm.com/index.php?rid=5481760&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1802 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481760 Thu, 08 Dec 2011 03:48:56 +0100 5481760 Let the data be our guide: trends and tools for research on health care utilization http://www.medworm.com/index.php?rid=5481759&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1809 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481759 Thu, 08 Dec 2011 03:48:55 +0100 5481759 ‘Health Economics’ and the evolution of economic evaluation of health technologies http://www.medworm.com/index.php?rid=5481758&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1818 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481758 Thu, 08 Dec 2011 03:48:54 +0100 5481758 The powers and pitfalls of payment for performance http://www.medworm.com/index.php?rid=5481757&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1810 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481757 Thu, 08 Dec 2011 03:48:52 +0100 5481757 Twenty‐first anniversary issue of Health Economics http://www.medworm.com/index.php?rid=5481756&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1819 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481756 Thu, 08 Dec 2011 03:48:51 +0100 5481756 On the cardinal measurement of health inequality when only ordinal information is available on individual health status http://www.medworm.com/index.php?rid=5481755&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1821 ABSTRACTThis paper suggests new indices of health inequality which may be used when only ordinal information is available on individual health status. We borrow ideas from the literature on the measurement of occupational or residential segregation and show that indices of ordinal segregation which have been recently proposed may be also applied to the measurement of health inequality. We also prove that these indices satisfy four axioms introduced to measure inequality with ordered response health data so that the new indices presented in this paper are consistent with the inequality ordering proposed by Allison and Foster. We also suggest an extension of the family of indices proposed by Abul Naga and Yalcin. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5481755 Thu, 08 Dec 2011 03:46:50 +0100 5481755 Neighbourhood social capital and individual self‐rated health in wales http://www.medworm.com/index.php?rid=5446485&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1808 ABSTRACTAlthough neighbourhood social capital can be beneficial for individual health, supporting evidence in the UK is scant. We aim to find the net effect of neighbourhood social capital and deprivation on individual health beyond sociodemographic composition of neighbourhood. We propose a multilevel path analytic model of health to delineate complex pathways involving neighbourhoods (measured as local super output area) and individuals. Analysis of the most recent data containing independent measures of neighbourhood social capital shows that neighbourhood social capital appears to be associated with benefits in some aspects of individual health in the Welsh setting. The improvement stands beyond individual determinants and neighbourhood deprivation. Social scientists and public health ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5446485 Sat, 26 Nov 2011 03:33:10 +0100 5446485 Cost‐minimisation analysis versus cost‐effectiveness analysis, revisited http://www.medworm.com/index.php?rid=5436271&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1812 ABSTRACTWe aim to establish whether it is ever appropriate to conduct cost‐minimisation analysis (CMA) rather than cost‐effectiveness analysis.We perform a literature review to examine how the use of CMA has changed since Briggs & O'Brien announced its death in 2001. Examples of simulated and trial data are presented: firstly to illustrate the advantages and disadvantages of CMA in the context of non‐inferiority trials and those finding no significant difference in efficacy and secondly to assess whether CMA gives biased results.We show that CMA is still used and will bias measures of uncertainty, causing overestimation or underestimation of the value of information and the probability that treatment is cost‐effective. Although bias will be negligible for non‐inferiority stud... Health Economics journals http://www.medworm.com/rss/comments.php?id=5436271 Wed, 23 Nov 2011 03:13:02 +0100 5436271 Are anchoring vignettes ratings sensitive to vignette age and sex? http://www.medworm.com/index.php?rid=5415772&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1806 ABSTRACTAnchoring vignettes are commonly used to study and correct for differential item functioning and response bias in subjective survey questions. Self‐assessed health status is a leading example. A crucial assumption of the vignette methodology is ‘vignette equivalence’: The health status of the person described in the vignette must be perceived by all respondents in the same way. We use data from a survey experiment conducted with a sample of almost 5000 older Americans to validate this assumption. We find weak evidence that respondents' vignette ratings may be sensitive to the sex and, for older respondents, also to the age (implied by the first name) of the person described in the vignette. Our findings suggest that vignette equivalence may not hold, at least if the potential... Health Economics journals http://www.medworm.com/rss/comments.php?id=5415772 Thu, 17 Nov 2011 17:58:02 +0100 5415772 Los(t) in long‐term care: empirical evidence from german data 2000–2009 http://www.medworm.com/index.php?rid=5415773&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1805 ABSTRACTUsing microdata, that is, representative samples of 114,403 German long‐term care dependants (LTCDs) observed from 2000 to 2009, we give a comprehensive insight into the length of stay (LOS) in long‐term care (LTC). Furthermore, this paper evaluates the effects of longevity on the LOS, thus revisiting the debate on the validity of the competing theories of compression or expansion of morbidity in LTC. The analysis finds significant effects on the LOS when AGE is controlled for, albeit do not confirm the time‐to‐death hypothesis. However, controlling for ASSESSMENT LEVEL suggests an improved health status of LTCDs over time, thus supporting the time‐to‐death hypothesis. An analysis of the mortality rates of LTCDs is to give insight into the opposing results. But the regr... Health Economics journals http://www.medworm.com/rss/comments.php?id=5415773 Sun, 13 Nov 2011 05:00:00 +0100 5415773 Public Preferences for Responsibility Versus Public Preferences for Reducing Inequalities http://www.medworm.com/index.php?rid=5394699&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1799 SUMMARYIn cost‐utility analysis, the numbers of quality‐adjusted life years (QALYs) gained are aggregated by placing the same weight on each QALY. Deviations from this rubric have been proposed on a number of grounds, including the degree to which persons might be deemed responsible for the illness faced, and inequality in lifetime health between groups. Most research has looked at these factors in isolation. This paper analyses public preferences about the relative importance of these factors. Over 500 members of the general public in the UK are interviewed in their homes. Where “blameworthy” groups experience a moderate drop in quality of life due to their behaviour, they appear to receive higher priority than an otherwise “trustworthy” group f they also experience poorer hea... Health Economics journals http://www.medworm.com/rss/comments.php?id=5394699 Fri, 11 Nov 2011 04:02:15 +0100 5394699 Research decisions in the face of heterogeneity: what can a new study tell us? http://www.medworm.com/index.php?rid=5372348&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1797 SUMMARYWillan and Eckermann describe a method for dealing with heterogeneity in value of information (VOI) calculations for prioritising and designing new research. Their article raises three fundamental (inter‐related) issues for VOI methods: (1) how to make sense of the concept of uncertainty in a cost‐effectiveness analysis (CEA) model, (2) the interpretation of heterogeneity in CEA, and (3) the relationship between data from a new study and the CEA model when there is heterogeneity. We discuss these three issues using an illustrative example meta‐analysis of magnesium for myocardial infarction. Careful consideration of the relationship between existing (and future) evidence and the CEA model is required to provide practical VOI methods that can help research funders prioritise ne... Health Economics journals http://www.medworm.com/rss/comments.php?id=5372348 Fri, 04 Nov 2011 12:12:20 +0100 5372348 Copula bivariate probit models: with an application to medical expenditures http://www.medworm.com/index.php?rid=5353826&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1801 ABSTRACTThe bivariate probit model is frequently used for estimating the effect of an endogenous binary regressor (the ‘treatment’) on a binary health outcome variable. This paper discusses simple modifications that maintain the probit assumption for the marginal distributions while introducing non‐normal dependence using copulas. In an application of the copula bivariate probit model to the effect of insurance status on the absence of ambulatory health care expenditure, a model based on the Frank copula outperforms the standard bivariate probit model. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5353826 Thu, 27 Oct 2011 17:28:19 +0100 5353826 Labor Mobility of the Direct Care Workforce: Implications for the Provision of Long‐Term Care http://www.medworm.com/index.php?rid=5353827&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1798 This study provides the first comprehensive analysis of the dynamics of labor supply of direct care workers, the lower‐skill nursing workers who provide the bulk of long‐term care for the elderly in the USA. Our estimates from the 1996 and 2001 panels of the Survey of Income and Program Participation (SIPP) show that the mean (median) duration of employment spells for the same direct care employer is only 9.7 (5.0) months. We find that fewer than one‐third of direct care workers leave a job to take another job in the direct care field. There is also little indication of upward mobility in the health sector; direct care workers are approximately equally likely to transition to working as Registered Nurses as they are to working in household service jobs. Additionally, the rate at whic... Health Economics journals http://www.medworm.com/rss/comments.php?id=5353827 Tue, 25 Oct 2011 04:00:00 +0100 5353827 Pricing of medical devices under coverage uncertainty—a modelling approach http://www.medworm.com/index.php?rid=5342200&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1807 SUMMARYProduct vendors and manufacturers are increasingly aware that purchasers of health care will fund new clinical treatments only if they are perceived to deliver value‐for‐money. This influences companies' internal commercial decisions, including the price they set for their products. Other things being equal, there is a price threshold, which is the maximum price at which the device will be funded and which, if its value were known, would play a central role in price determination. This paper examines the problem of pricing a medical device from the vendor's point of view in the presence of uncertainty about what the price threshold will be. A formal solution is obtained by maximising the expected value of the net revenue function, assuming a Bayesian prior distribution for the p... Health Economics journals http://www.medworm.com/rss/comments.php?id=5342200 Sun, 23 Oct 2011 18:49:31 +0100 5342200 Fighting transient epidemics—optimal vaccination schedules before and after an outbreak http://www.medworm.com/index.php?rid=5353828&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1803 SUMMARYEpidemic diseases afflict all countries, and all epidemics are costly to society. The present paper examines optimal vaccination trajectories before and after an outbreak of a special class of epidemics where the disease normally eradicates itself. The focus is on epidemics where mortality may be ignored, influenza being the prime example. One important insight is that there may be increasing returns to scale in vaccination. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5353828 Sun, 23 Oct 2011 04:00:00 +0100 5353828 Learning healthy behavior? the impact of training in healthcare professions on lifestyles http://www.medworm.com/index.php?rid=5309551&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1800 SUMMARYThis paper analyzes the empirical relationship between health knowledge and the probability of adopting the lifestyles known as the ‘Alameda Seven’. I test whether having accumulated such knowledge during training in a healthcare profession changes individual lifestyles using the Swiss Health Survey. The results suggest that there are indeed effects of health knowledge on smoking for university graduates and on alcohol consumption and eating behavior for graduates of both university level and vocational medical training programs. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5309551 Thu, 13 Oct 2011 04:41:27 +0100 5309551 Productivity costs revisited: toward a new us policy http://www.medworm.com/index.php?rid=5300929&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1795 ABSTRACTIn 1996, the Washington Panel recommended that the productivity costs that are not directly related to obtaining care be captured in the quality‐of‐life weights used to construct the quality‐adjusted life years (QALYs) in American cost–utility analyses. This paper revisits the original justification of the Panel and the critiques that appeared in the literature at the time. It then analyzes how productivity costs would be viewed from a cost–benefit analysis perspective to identify their welfare implications and then translates these implications into what they mean for how to express productivity costs in a cost–utility analysis. Next, three consistency issues are identified: (i) consistency between the welfare implications and the health status questionnaires used to c... Health Economics journals http://www.medworm.com/rss/comments.php?id=5300929 Mon, 10 Oct 2011 03:03:50 +0100 5300929 Lowering the ‘floor’ of the sf‐6d scoring algorithm using a lottery equivalent method http://www.medworm.com/index.php?rid=5291522&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1792 SUMMARYThis paper presents a new scoring algorithm for the SF‐6D, one of the most popular preference‐based health status measures. Previous SF‐6D value sets have a minimum (a floor), which is substantially higher than the lowest value generated by the EQ‐5D model. Our algorithm expands the range of SF‐6D utility scores in such a way that the floor is significantly lowered. We obtain the wider range because of the use of a lottery equivalent method through which preferences from a representative sample of Spanish general population are elicited. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5291522 Fri, 07 Oct 2011 02:55:42 +0100 5291522 Minimum savings requirements in shared savings provider payment http://www.medworm.com/index.php?rid=5291524&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1793 ABSTRACTPayer (insurer) sharing of savings is a way of motivating providers of medical services to reduce cost growth. A Medicare shared savings program is established for accountable care organizations in the 2010 Patient Protection and Affordable Care Act. However, savings created by providers cannot be distinguished from the normal (random) variation in medical claims costs, setting up a classic principal–agent problem. To lessen the likelihood of paying undeserved bonuses, payers may pay bonuses only if observed savings exceed minimum levels. We study the trade‐off between two types of errors in setting minimum savings requirements: paying bonuses when providers do not create savings and not paying bonuses when providers create savings. Copyright © 2011 John Wiley & Sons, Ltd.... Health Economics journals http://www.medworm.com/rss/comments.php?id=5291524 Mon, 03 Oct 2011 04:00:00 +0100 5291524 Unfit for service: the implications of rising obesity for us military recruitment http://www.medworm.com/index.php?rid=5291523&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1794 AbstractThis paper contributes to the literature on the labor market consequences of unhealthy behaviors and poor health by examining a previously underappreciated consequence of the rise in obesity in the USA: challenges for military recruitment. Specifically, this paper estimates the percentage of the US military‐age population that exceeds the US Army's current active duty enlistment standards for weight‐for‐height and percent body fat, using data from the series of National Health and Nutrition Examination Surveys that spans 1959–2008. We calculate that the percentage of military‐age adults ineligible for enlistment because they are overweight and overfat more than doubled for men and tripled for women during that time. As of 2007–2008, 5.7 million men and 16.5 million wome... Health Economics journals http://www.medworm.com/rss/comments.php?id=5291523 Mon, 03 Oct 2011 04:00:00 +0100 5291523 Evaluation of variance estimators for the concentration and health achievement indices: a monte carlo simulation http://www.medworm.com/index.php?rid=5266986&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1796 This article is a US Government work and is in the public domain in the USA. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5266986 Fri, 30 Sep 2011 05:11:26 +0100 5266986 Parallel imports and innovation in an emerging economy: the case of indian pharmaceuticals http://www.medworm.com/index.php?rid=5244827&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1790 SUMMARYThis paper studies the impact of the re‐importation of imitated pharmaceuticals as a by‐product of an open policy toward parallel import (PI) on process innovation. Foreign investment by a firm to exploit a new unregulated market with weak intellectual property rights can give rise to imitation. These products can potentially re‐enter the original country when PI is allowed influencing research and development (R&D) incentives. In an emerging economy with technologically heterogeneous firms, trade costs shift PI‐related market share losses from the more to the less R&D efficient firm, inducing the former to strategically increase R&D. PI accompanied by tariffs also induces higher R&D effort by the technologically inferior firm when it results in an expansion ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5244827 Fri, 23 Sep 2011 04:09:12 +0100 5244827 What factors influence the earnings of general practitioners and medical specialists? evidence from the medicine in australia: balancing employment and life survey http://www.medworm.com/index.php?rid=5231433&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1791 SummaryTo date, there has been little data or empirical research on the determinants of doctors' earnings despite earnings having an important role in influencing the cost of health care, decisions on workforce participation and labour supply. This paper examines the determinants of annual earnings of general practitioners (GPs) and specialists using the first wave of the Medicine in Australia: Balancing Employment and Life, a new longitudinal survey of doctors. For both GPs and specialists, earnings are higher for men, for those who are self‐employed and for those who do after‐hours or on‐call work. GPs have higher earnings if they work in larger practices, in outer regional or rural areas, and in areas with lower GP density, whereas specialists earn more if they have more working e... Health Economics journals http://www.medworm.com/rss/comments.php?id=5231433 Mon, 19 Sep 2011 17:12:56 +0100 5231433 Easing the pain of an economic downturn: macroeconomic conditions and excessive alcohol consumption http://www.medworm.com/index.php?rid=5216679&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1788 This article investigates the effect of changing macroeconomic conditions (measured by the unemployment rate in the state of residence) on one type of risky behavior: excessive alcohol consumption. Using unique and recent panel data from waves 1 and 2 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) and estimating fixed‐effects models, we find that changes in the unemployment rate are positively related to changes in binge drinking, alcohol‐involved driving, and alcohol abuse and/or dependence. Some differences are present among demographic groups, primarily in the magnitude of the estimated effects. These results contradict previous studies and suggest that problematic drinking may be an indirect and unfortunate consequence of an economic downturn. Cop... Health Economics journals http://www.medworm.com/rss/comments.php?id=5216679 Wed, 14 Sep 2011 08:03:36 +0100 5216679 The effect of taiwan's national health insurance on mortality of the elderly: revisited http://www.medworm.com/index.php?rid=5202356&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1787 SUMMARYA recent paper estimates the effects of Taiwan's National Health Insurance (NHI) on the elderly and concludes that NHI greatly increased the medical care utilization of the elderly but did not reduce their mortality. Using more recent and more accurate mortality data of the same group of elderly, this note re‐estimates the NHI effect on mortality and finds that the mortality hazard of the previously uninsured elderly in the post‐NHI period was on average 24% lower than it would have been in the absence of NHI. However, the NHI effect on the mortality hazard is only evident in the first 6 years following the enactment of NHI, suggesting that it may be difficult to undo the damage caused by the lack of insurance in early life. Copyright © 2011 John Wiley & Sons, Ltd. (Source:... Health Economics journals http://www.medworm.com/rss/comments.php?id=5202356 Sun, 11 Sep 2011 01:55:21 +0100 5202356 The effects of insurance mandates on choices and outcomes in infertility treatment markets http://www.medworm.com/index.php?rid=5202360&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1776 SUMMARYFor the 10% to 15% of American married couples who experience reproductive problems, in vitro fertilization (IVF) is the leading technologically advanced treatment procedure. However, IVF's expense may prevent many couples from receiving treatment, and those who are treated may take an overly aggressive approach to reduce the probability of failure. Aggressive treatment, which occurs through an increase in the number of embryos transferred during IVF, can lead to medically dangerous multiple births. We evaluated the principle policy proposal—insurance mandates—for improving IVF access and outcomes. We used data from US markets during 1995–2003 to show that broad insurance mandates for IVF result in not only large increases in treatment access but also significantly less aggres... Health Economics journals http://www.medworm.com/rss/comments.php?id=5202360 Fri, 09 Sep 2011 04:00:00 +0100 5202360 The role of private medical insurance in socio‐economic inequalities in cancer screening uptake in ireland http://www.medworm.com/index.php?rid=5202359&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1784 This study examines differences in the uptake of cancer screening in Ireland related to socio‐economic status. Data were extracted from SLÁN 2007 concerning uptake of breast, cervical, colorectal and prostate cancer screening in the preceding 12 months. Concentration indices were calculated and decomposed. Particular emphasis was placed in the decomposition upon the impact of private health insurance, evidenced in other work to impact on access to care within the mixed public–private Irish health system. This study found that significant differences related to socio‐economic status exist with respect to uptake of cancer screening and that the main determinant of difference for breast, colorectal and prostate cancer screening was possession of private insurance. This may have profo... Health Economics journals http://www.medworm.com/rss/comments.php?id=5202359 Fri, 09 Sep 2011 04:00:00 +0100 5202359 Spoilt for choice: implications of using alternative methods of costing hospital episode statistics http://www.medworm.com/index.php?rid=5202358&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1785 SUMMARYIn the absence of a ‘gold standard’ to estimate the economic burden of disease, a decision about the most appropriate costing method is required. Researchers have employed various methods to cost hospital stays, including per diem or diagnosis‐related group (DRG)‐based costs. Alternative methods differ in data collection and costing methodology. Using data from Scotland as an illustrative example, costing methods are compared, highlighting the wider implications for other countries with a publicly financed healthcare system.Five methods are compared using longitudinal data including baseline survey data (Midspan) linked to acute hospital admissions. Cost variables are derived using two forms of DRG‐type costs, costs per diem, costs per episode—using a novel approach that... Health Economics journals http://www.medworm.com/rss/comments.php?id=5202358 Fri, 09 Sep 2011 04:00:00 +0100 5202358 Quality of life, treatments, and patients' willingness to pay for a complete remission of cervical cancer in taiwan http://www.medworm.com/index.php?rid=5202357&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1786 ABSTRACTCervical cancer is one of the leading causes of cancer deaths in Taiwan. To investigate the disease cost and then raise awareness of the importance of screening for cervical cancer and promote early detection, this paper employs contingent valuation and willingness to pay (WTP) method to study how health‐related quality of life, disease severity, and after‐treatment disease status affect patients' WTP for a complete remission of the disease. The inclusive criteria for the study were primary case outpatients at least 3 months after they had received therapy at the time of our study period. Face‐to‐face interviews were conducted for the retrospective format of the survey. The result of the study indicates a lifetime WTP of $US21 221.96 for Taiwanese cervical cancer patien... Health Economics journals http://www.medworm.com/rss/comments.php?id=5202357 Fri, 09 Sep 2011 04:00:00 +0100 5202357 When Do Fat Taxes Increase Consumer Welfare? http://www.medworm.com/index.php?rid=5189844&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1789 AbstractPrevious analyses of fat taxes have generally worked within an empirical framework in which it is difficult to determine whether consumers benefit from the policy. This note outlines on simple means to determine whether consumers benefit from a fat tax by comparing the ratio of expenditures on the taxed good to the weight effect of the tax against the individual's willingness to pay for a one‐pound weight reduction. Our empirical calculations suggest that an individual would have to be willing to pay about $1500 to reduce weight by one pound for a tax on sugary beverages to be welfare enhancing. The results suggest either that a soda tax is very unlikely to increase individual consumer welfare or that the policy must be justified on some other grounds that abandon standard ration... Health Economics journals http://www.medworm.com/rss/comments.php?id=5189844 Thu, 01 Sep 2011 23:00:00 +0100 5189844 Accounting for between‐study variation in incremental net benefit in value of information methodology http://www.medworm.com/index.php?rid=5189847&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1781 ABSTRACTPrevious applications of value of information methods for determining optimal sample size in randomized clinical trials have assumed no between‐study variation in mean incremental net benefit. By adopting a hierarchical model, we provide a solution for determining optimal sample size with this assumption relaxed. The solution is illustrated with two examples from the literature. Expected net gain increases with increasing between‐study variation, reflecting the increased uncertainty in incremental net benefit and reduced extent to which data are borrowed from previous evidence. Hence, a trial can become optimal where current evidence is sufficient assuming no between‐study variation. However, despite the expected net gain increasing, the optimal sample size in the illustrated... Health Economics journals http://www.medworm.com/rss/comments.php?id=5189847 Wed, 31 Aug 2011 23:00:00 +0100 5189847 Response to regulatory stringency: the case of antipsychotic medication use in nursing homes http://www.medworm.com/index.php?rid=5189846&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1775 SUMMARYThis paper studies the impact of regulatory stringency, as measured by the statewide deficiency citation rate over the past year, on the quality of care provided in a national sample of nursing homes from 2000 to 2005. The quality measure used is the proportion of residents who are using antipsychotic medication. Although the changing case‐mix of nursing home residents accounts for some of the increase in the use of antipsychotics, we find that the use of antipsychotics by nursing homes is responsive to state regulatory enforcement in a manner consistent with the multitasking incentive problem. Specifically, the effect of the regulations is dependent on the degree of complementarity between the regulatory deficiency and the use of antipsychotics. Copyright © 2011 John Wiley &... Health Economics journals http://www.medworm.com/rss/comments.php?id=5189846 Wed, 31 Aug 2011 23:00:00 +0100 5189846 Measuring the effect of policy interventions at the population level: some methodological concerns http://www.medworm.com/index.php?rid=5189845&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1783 SUMMARYHealth policy evaluations estimate the response of population aggregate outcomes to interventions. However, clarity on the form of the expected causal relationship, the parameter identification strategy, and the mode of hypothesis testing is required to overcome a number of conceptual and methodological problems. We use the New Jersey statewide smoking ban as an example. We examine statewide admission rates for acute myocardial infarctions, strokes and lower limb fractures, and emergency room encounter rates for asthma exacerbations before and after the smoking ban. We discuss the identification options and show the sensitivity of estimates of the response function to different specifications of the stochastic and intervention components and to different modes of inference. Model mi... Health Economics journals http://www.medworm.com/rss/comments.php?id=5189845 Wed, 31 Aug 2011 23:00:00 +0100 5189845 A markov model to estimate salmonella morbidity, mortality, illness duration, and cost http://www.medworm.com/index.php?rid=5189843&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1779 ABSTRACTApproximately 690 000–1 790 000 Salmonella cases, 20 000 hospitalizations, and 400 deaths occur in the USA annually, costing approximately $2.6bn. Existing models estimate morbidity, mortality, and cost solely from incidence. They do not estimate illness duration or use time as an independent cost predictor. Existing models may underestimate physician visits, hospitalizations, deaths, and associated costs. We developed a Markov chain Monte Carlo model to estimate illness duration, physician/emergency room visits, inpatient hospitalizations, mortality, and resultant costs for a given Salmonella incidence. Interested parties include society, third‐party payers, health providers, federal, state and local governments, businesses, and individual patients and their families. ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5189843 Wed, 31 Aug 2011 23:00:00 +0100 5189843 Health service use among the previously uninsured: is subsidized health insurance enough? http://www.medworm.com/index.php?rid=5167630&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1780 This study uses Medicare claims data linked to two different surveys—the National Health Interview Survey and the Health and Retirement Study—to describe the relationship between insurance status before age 65 years and the use of Medicare‐covered services beginning at age 65 years. Although we do not find statistically significant differences in Medicare expenditures or in the number of hospitalizations by previous insurance status, we do find that individuals who were uninsured before age 65 years continue to use the healthcare system differently from those who were privately insured. Specifically, they have 16% fewer visits to office‐based physicians but make 18% and 43% more visits to hospital emergency and outpatient departments, respectively. A key question for the futu... Health Economics journals http://www.medworm.com/rss/comments.php?id=5167630 Sun, 28 Aug 2011 00:01:13 +0100 5167630 The effect of childhood conduct disorder on human capital http://www.medworm.com/index.php?rid=5136828&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1767 SUMMARYThis paper estimates the longer‐term effects of childhood conduct disorder on human capital accumulation and violent and criminal behavior later in life using data of Australian twins. We measure conduct disorder with a rich set of indicators based on diagnostic criteria from psychiatry. Using ordinary least squares and twin fixed effects estimation approaches, we find that early‐age (pre‐18) conduct disorder problems significantly affect both human capital accumulation and violent and criminal behavior over the life course. In addition, we find that conduct disorder is more deleterious if these behaviors occur earlier in life. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5136828 Wed, 17 Aug 2011 14:49:26 +0100 5136828 A smooth mixture of Tobits model for healthcare expenditure http://www.medworm.com/index.php?rid=5115685&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1777 AbstractThis paper develops a smooth mixture of Tobits (SMTobit) model for healthcare expenditure. The model is a generalization of the smoothly mixing regressions framework of Geweke and Keane (J Econometrics 2007; 138: 257–290) to the case of a Tobit‐type limited dependent variable. A Markov chain Monte Carlo algorithm with data augmentation is developed to obtain the posterior distribution of model parameters. The model is applied to the US Medicare Current Beneficiary Survey data on total medical expenditure. The results suggest that the model can capture the overall shape of the expenditure distribution very well, and also provide a good fit to a number of characteristics of the conditional (on covariates) distribution of expenditure, such as the conditional mean, variance and pro... Health Economics journals http://www.medworm.com/rss/comments.php?id=5115685 Thu, 11 Aug 2011 15:53:44 +0100 5115685 Anticipatory ex ante moral hazard and the effect of medicare on prevention http://www.medworm.com/index.php?rid=5115684&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1778 AbstractThis paper extends the ex ante moral hazard model to allow healthy lifestyles to reduce the probability of illness in future periods, so that current preventive behaviour may be affected by anticipated changes in future insurance coverage. In the United States, Medicare is offered to almost all the population at the age of 65. We use nine waves of the US Health and Retirement Study to compare lifestyles before and after 65 of those insured and not insured pre 65. The double‐robust approach, which combines propensity score and regression, is used to compare trends in lifestyle (physical activity, smoking, drinking) of the two groups before and after receiving Medicare, using both difference‐in‐differences and difference‐in‐differences‐in‐differences. There is no clear ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5115684 Thu, 11 Aug 2011 15:53:43 +0100 5115684 Editors' Introduction http://www.medworm.com/index.php?rid=5115683&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1761 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5115683 Thu, 11 Aug 2011 15:53:41 +0100 5115683 Discounting health and cost‐effectiveness analysis: a response to nord http://www.medworm.com/index.php?rid=5115682&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1782 SUMMARYNord (2011) criticizes standard arguments which assert that consistency requires that future health benefits must be discounted at the same rate as future costs in cost‐effectiveness analysis (CEA). He suggests these arguments are misguided because they require transitivity of preferences across decision contexts and that it can be appropriate to discount health at different rates depending on the programs to be compared. I claim that rejecting transitivity is unwarranted and would sharply diminish the utility of CEA. Factors that tempt Nord to reject consistency can be accommodated by recognizing that CEA does not perfectly mimic normative social preferences because it omits factors (like distribution of health in a population) that can be normatively significant. A better approa... Health Economics journals http://www.medworm.com/rss/comments.php?id=5115682 Thu, 11 Aug 2011 15:52:58 +0100 5115682 The effect of retirement on cognitive functioning http://www.medworm.com/index.php?rid=5101802&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1771 SUMMARYCognitive impairment has emerged as a major driver of disability in old age, with profound effects on individual well‐being and decision making at older ages. In the light of policies aimed at postponing retirement ages, an important question is whether continued labour supply helps to maintain high levels of cognition at older ages. We use data of older men from the US Health and Retirement Study to estimate the effect of continued labour market participation at older ages on later‐life cognition. As retirement itself is likely to depend on cognitive functioning and may thus be endogenous, we use offers of early retirement windows as instruments for retirement in econometric models for later‐life cognitive functioning. These offers of early retirement are legally required to ... Health Economics journals http://www.medworm.com/rss/comments.php?id=5101802 Sun, 31 Jul 2011 23:00:00 +0100 5101802 Affording to wait: medicare initiation and the use of health care http://www.medworm.com/index.php?rid=5084535&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1772 SUMMARYDelays in receipt of necessary diagnostic and therapeutic medical procedures related to the timing of Medicare initiation at age 65 years have potentially broad welfare implications. We use 2005–2007 data from Florida and North Carolina to estimate the effect of initiation of Medicare benefits on healthcare utilization across procedures that differ in urgency and coverage. In particular, we study trends in the use of elective procedures covered by Medicare to treat conditions that vary in symptoms; these are compared with elective surgical procedures not eligible for Medicare reimbursement, and to a set of urgent and emergent procedures. We find large discontinuities in health services utilization at age 65 years concentrated among low‐urgency, Medicare‐reimbursable proced... Health Economics journals http://www.medworm.com/rss/comments.php?id=5084535 Sun, 31 Jul 2011 23:00:00 +0100 5084535 Perceptions of health risk and smoking decisions of young people http://www.medworm.com/index.php?rid=5075124&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1760 SUMMARYUsing the Annenberg Perception of Tobacco Risk Survey 2, this paper finds that perceived risk deters smoking among persons aged 14–22 years who think that it is relatively difficult to quit smoking and that onset of deleterious health effects occurs relatively quickly. Perceived health risk, however, does not affect the smoking status of young people who hold the opposite beliefs. These results are consistent with predictions of rational addiction models and suggest that young people, who view smoking as more addictive and health effects as more immediate, may have greater incentive to consider long‐term health effects in their decision to smoke. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5075124 Fri, 29 Jul 2011 23:25:24 +0100 5075124 Surrogates, meta‐analysis and cost‐effectiveness modelling: a combined analytic approach http://www.medworm.com/index.php?rid=5075125&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1741 SUMMARYEstimates of cost‐effectiveness analyses are typically obtained either directly from ‘trial’ based analyses or indirectly via surrogate endpoints in ‘model’ based analyses. Data from clinical trials that include both surrogate and final endpoints can be used in a joint analysis that combines these two approaches. This joint approach allows the inclusion of information regarding the effects of treatment on surrogate endpoints while relaxing the strong assumption of ‘conditional independence’ associated with indirect model‐based analyses. An example cost‐effectiveness analysis of Chronic Disease Self‐Management Programme is used to compare the different approaches. It is shown that despite using a common data set, the different analytic approaches produce differing... Health Economics journals http://www.medworm.com/rss/comments.php?id=5075125 Wed, 27 Jul 2011 23:00:00 +0100 5075125 The impact of voluntary health insurance on health care utilization and out‐of‐pocket payments: new evidence for vietnam http://www.medworm.com/index.php?rid=5046653&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1768 SUMMARYVietnam aims to achieve full coverage of health insurance in 2015. An increasing type of health insurance in Vietnam is voluntary health insurance. Although there are many studies on the implementation of voluntary health insurance in Vietnam, little is known on the causal impact of voluntary health insurance. This paper measures the impact of voluntary health insurance on health care utilization and out‐of‐pocket payments using Vietnam Household Living Standard Surveys in 2004 and 2006. It was found out that voluntary health insurance helps the insured people increase the annual outpatient and inpatient visits by around 45% and 70%, respectively. However, the effect of voluntary health insurance on out‐of‐pocket expenses on health care services is not statistically signific... Health Economics journals http://www.medworm.com/rss/comments.php?id=5046653 Thu, 21 Jul 2011 22:08:34 +0100 5046653 The effects of hiv medications on the quality of life of older adults in new york city http://www.medworm.com/index.php?rid=5046654&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1774 SUMMARYA three‐equation model is used to estimate the multiple effects of antiretroviral medications (ARVs) on the quality of life (QoL) of the elderly with HIV in New York City. The transmission mechanism involves the ARVs having a direct effect on QoL via the side effects of the medications and two other effects (one indirect and one reverse) both working through feelings of depression. On a scale of 0 to 100, ARVs raise the QoL by 1 percentage point. This was because there was a large positive indirect effect of ARVs on QoL of 28 percentage points via the reduction in depression, which offsets both the 24 percentage‐point reduction due to the direct effect and the 3 percentage‐point decline from the reverse effect. Now, QoL effects can be applied to the additional life years gener... Health Economics journals http://www.medworm.com/rss/comments.php?id=5046654 Sun, 17 Jul 2011 23:00:00 +0100 5046654 The oh‐so straight and narrow path: can the health care expenditure curve be bent? http://www.medworm.com/index.php?rid=5025795&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1765 SUMMARYAlthough there is much talk about whether or not the current health care reform will ‘bend’ the health care expenditure ‘curve’, exactly which ‘curve’ is to be ‘bent’ is often ill‐specified. This essay notes that the ‘curve’ defined by the log of US national health care expenditures per capita plotted against the log of the US gross domestic product per capita has been remarkably straight since 1929 despite Medicare and Medicaid and all of the more recent reform attempts. After establishing stationarity and considering cointegration and endogeneity, the slope of this log–log relationship suggests a per capita expenditure–income elasticity of 1.388.The authors suggest two explanatory hypotheses consistent with the observed constant slope. First, many new tec... Health Economics journals http://www.medworm.com/rss/comments.php?id=5025795 Thu, 14 Jul 2011 18:25:07 +0100 5025795 How price responsive is the demand for specialty care? http://www.medworm.com/index.php?rid=5025796&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1759 Conclusion: A significant increase in specialty visit co‐payments reduced specialty expenditures among patients obtaining medications at the Veterans Affairs medical centers. Longitudinal expenditure analysis may be improved using recent advances in two‐part model methods. Published 2011. This article is a US Government work and is in the public domain in the USA. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=5025796 Wed, 13 Jul 2011 23:00:00 +0100 5025796 Methods used to identify and measure resource use in economic evaluations: a systematic review of questionnaires for older people http://www.medworm.com/index.php?rid=5016087&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1766 SUMMARYThis paper presents the findings of a systematic review of full or partial economic evaluations that included questions to service users or their carers to elicit information on the types, amounts or costs of community‐based formal social care support provided to people 65 years and older. We have found that studies seldom report use of published validated questions for eliciting information from older people in the UK about their use of formal social care services. Given the political prominence of the debate over funding social care for older people, there remains a need for analysis of policy options. This requires reliable data on the receipt and payment for care. We recommend the development of improved questions on care that are clear, robust and up‐to‐date with develo... Health Economics journals http://www.medworm.com/rss/comments.php?id=5016087 Tue, 12 Jul 2011 18:54:02 +0100 5016087 Do French low‐income GPs choose to work less? http://www.medworm.com/index.php?rid=4996769&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1770 AbstractIn France, a significant number of General Practitioners (GPs) earn less than 1.5 times the French minimum salary. Using a representative panel of self‐employed GPs over the years 1993–2004, this paper tests whether these low‐income GPs choose to work less than all other GPs or whether they are constrained to do so. The test is based on measuring reactions to positive and negative demand shocks. As low‐income GPs do not increase activity in response to a positive demand shock but decrease activity in response to a negative demand shock, it appears that their low‐income status is attributable to a strong preference for leisure. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4996769 Mon, 04 Jul 2011 21:39:09 +0100 4996769 Workplace smoking ban effects on unhappy smokers http://www.medworm.com/index.php?rid=4996770&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1763 AbstractEconomists usually draw a distinction between smokers. They distinguish ‘happy addicts’ à la Becker–Murphy from ‘unhappy addicts’ who state that smoking is a mistake and call for some help to quit. When evaluating tobacco control policies, it might be important to distinguish their effects on those two types of population. Indeed, such policies are welfare improving only if they help unhappy addicts to quit. We investigate the effect of the French workplace smoking ban on a sample of presumably ‘unhappy addicts’, smokers who consult tobacco cessation services. We show that the ban caused an increase in the demand for such services, and that this increase was larger in cold and rainy areas. It also induced an increase in the percentage of successful attempts to quit. ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4996770 Sun, 03 Jul 2011 23:00:00 +0100 4996770 Endogenous treatment effects for count data models with endogenous participation or sample selection http://www.medworm.com/index.php?rid=4981288&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1764 AbstractIn this paper, we propose an estimator for models in which an endogenous dichotomous treatment affects a count outcome in the presence of either sample selection or endogenous participation using maximum simulated likelihood. We allow for the treatment to have an effect on the participation or the sample selection rule and on the main outcome. Applications of this model are frequent in–but no limited to–health economics. We show an application of the model using data from Kenkel and Terza (2001), who investigate the effect of physician advice on the amount of alcohol consumption. Our estimates suggest that in these data (i) neglecting treatment endogeneity leads to a wrongly signed effect of physician advice on drinking intensity, (ii) accounting for treatment endogeneity but n... Health Economics journals http://www.medworm.com/rss/comments.php?id=4981288 Thu, 30 Jun 2011 03:57:46 +0100 4981288 The concentration index of a binary outcome revisited http://www.medworm.com/index.php?rid=4930648&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1752 SUMMARYThe binary variable is one of the most common types of variables in the analysis of income‐related health inequalities. I argue that while the binary variable has some unusual properties, it shares many of the properties of the ratio–scale variable and hence lends itself to both relative and absolute inequality analyses, albeit with some qualifications. I argue that criticisms of the normalization I proposed in an earlier paper, and of the use of the binary variable for inequality analysis, stem from a misrepresentation of the properties of the binary variable, as well as a switch of focus away from relative inequality to absolute inequality. I concede that my normalization is not uncontentious, but, in a way, that has not previously been noted. Copyright © 2011 John Wiley &amp... Health Economics journals http://www.medworm.com/rss/comments.php?id=4930648 Thu, 16 Jun 2011 17:05:31 +0100 4930648 Reply to guido erreygers and tom van ourti's comment on ‘the concentration index of a binary outcome revisited’ http://www.medworm.com/index.php?rid=4930650&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1753 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4930650 Tue, 14 Jun 2011 23:00:00 +0100 4930650 Putting the cart before the horse. a comment on wagstaff on inequality measurement in the presence of binary variables http://www.medworm.com/index.php?rid=4930649&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1754 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4930649 Tue, 14 Jun 2011 23:00:00 +0100 4930649 The choice of detecting down syndrome: does money matter? http://www.medworm.com/index.php?rid=4930651&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1762 AbstractThe prenatal diagnosis of Down syndrome (amniocentesis) presents parents with a complex dilemma which requires comparing the risk of giving birth to an affected child and the risk of losing an unaffected child through amniocentesis‐related miscarriage. Building on the specific features of the French Health insurance system, this paper shows that variation in the monetary costs of the diagnosis procedure may have a very significant impact on how parents solve this ethical dilemma. The French institutions make it possible to compare otherwise similar women facing very different reimbursement schemes and we find that eligibility to full reimbursement has a largely positive effect on the probability of taking an amniocentesis test. By contrast, the sole fact of being labelled ‘high... Health Economics journals http://www.medworm.com/rss/comments.php?id=4930651 Sun, 12 Jun 2011 23:00:00 +0100 4930651 Reserve capacity of public and private hospitals in response to demand uncertainty http://www.medworm.com/index.php?rid=4919032&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1755 SUMMARYA feature of hospitals is that they face uncertain demand for the services they offer. To cover fluctuations in demand, they need to maintain reserve service capacity in the form of beds, equipment, personnel, etc. to minimize the probability of excess queuing or turning away patients, creating a trade‐off between reserve service capacity and economic costs. Using a simple theoretical framework, we show how the reserve capacity established depends on institutional characteristics that can affect the objective of the hospital. In particular, we show that private and public hospitals may provide different levels of reserve capacity. In an empirical application using a panel data set of Spanish hospitals over the period 1996–2006, we model reserve service capacity using a distance ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4919032 Sat, 11 Jun 2011 00:47:39 +0100 4919032 Improving food choices among supplemental nutrition assistance program recipients http://www.medworm.com/index.php?rid=4909420&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1758 SUMMARYWe used a principal–agent framework to examine the feasibility of two proposed modifications to the Supplemental Nutrition Assistance Program with the goal of encouraging healthier food choices among program participants. Specifically, we analyzed two types of contract: a restricted contract and an incentive contract. The restricted contract did not allow the purchase of unhealthy foods with program benefits, but compensated participants by increasing total benefits. The incentive contract provided increased benefits that varied according to the percentage of healthy foods purchased with program benefits. The theoretical results revealed the mechanisms for the two alternative contracts, the conditions under which each would be effective, and the key empirical questions to be exami... Health Economics journals http://www.medworm.com/rss/comments.php?id=4909420 Wed, 08 Jun 2011 21:23:27 +0100 4909420 Ownership and financial sustainability of german acute care hospitals http://www.medworm.com/index.php?rid=4900204&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1750 SUMMARYThis paper considers the role of ownership form for the financial sustainability of German acute care hospitals over time. We measure financial sustainability by a hospital‐specific yearly probability of default (PD) trying to mirror the ability of hospitals to survive in the market in the long run. The results show that private ownership is associated with significantly lower PDs than public ownership. Moreover, path dependence in the PD is substantial but far from 100%, indicating a large number of improvements and deteriorations in financial sustainability over time. Yet, the general public hospitals have the highest path dependence. Overall, this indicates that public hospitals, which are in a poor financial standing, remain in that state or even deteriorate over time, which m... Health Economics journals http://www.medworm.com/rss/comments.php?id=4900204 Mon, 06 Jun 2011 16:41:51 +0100 4900204 Estimating adverse selection and moral hazard effects with hospital invoices data in a government‐controlled healthcare system http://www.medworm.com/index.php?rid=4900205&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1756 SUMMARYWe use invoices for hospital services from a regional hospital in Croatia to test for adverse selection and moral hazard. There are three categories of patients: with no supplemental insurance, who bought it, and who are entitled to it for free. Our identification procedure relies on the premise that the difference in the observed medical care consumption between the patients who bought the insurance and those entitled to free insurance is caused by pure selection effect, whereas the difference in healthcare consumption between the group that received the free insurance and the group that has no insurance is due to moral hazard. Results show favorable selection for patients in 20‐ to 30‐year‐old cohort and significant moral hazard for all age cohorts. The selection effect reve... Health Economics journals http://www.medworm.com/rss/comments.php?id=4900205 Sun, 05 Jun 2011 23:00:00 +0100 4900205 A matching method for improving covariate balance in cost‐effectiveness analyses http://www.medworm.com/index.php?rid=4890418&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1748 SUMMARYIn cost‐effectiveness analyses (CEA) that use randomized controlled trials (RCTs), covariates of prognostic importance may be imbalanced and warrant adjustment. In CEA that use non‐randomized studies (NRS), the selection on observables assumption must hold for regression and matching methods to be unbiased. Even in restricted circumstances when this assumption is plausible, a key concern is how to adjust for imbalances in observed confounders. If the propensity score is misspecified, the covariates in the matched sample will be imbalanced, which can lead to conditional bias. To address covariate imbalance in CEA based on RCTs and NRS, this paper considers Genetic Matching. This matching method uses a search algorithm to directly maximize covariate balance.We compare Genetic and ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4890418 Fri, 03 Jun 2011 06:36:24 +0100 4890418 Assessing the impact of high deductible health plans on health‐care utilization and cost: a changes‐in‐changes approach http://www.medworm.com/index.php?rid=4890419&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1757 AbstractHigh deductible health plans (HDHPs) have become an increasingly common form of benefit design used by employers to manage health‐care costs. Numerous studies have evaluated the uptake and impact of HDHPs on health‐care utilization. Most studies have employed the standard difference‐in‐differences (DID) methodology. In this paper, we employ three alternative methodologies to evaluate a natural experiment in which a traditional health plan was fully replaced by a HDHP. We implement the standard DID and the quantile difference‐in‐differences (QDID) estimators to evaluate the impact of the HDHP on following six outcomes: overall cost, medical cost, pharmacy cost, outpatient visit count, inpatient visit count and emergency room visit count. We compare these results to a cha... Health Economics journals http://www.medworm.com/rss/comments.php?id=4890419 Tue, 31 May 2011 23:00:00 +0100 4890419 Valuing states from multiple measures on the same visual analogue sale: a feasibility study http://www.medworm.com/index.php?rid=4869586&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1740 SUMMARYPrevious methods of empirical mapping involve using regressions on patient or general population self‐reported data from datasets involving two or more measures. This approach relies on overlap in the descriptive systems of the measures and assumes it is appropriate to use different measures on the same population, which may not always be the case. This paper presents a feasibility study for a new approach to mapping between preference‐based measures (PBM) using general population visual analogue scale (VAS) values as a common yardstick. We use data from a valuation study of 502 members of the UK general population, where, using ranking and VAS tasks, interviewees simultaneously valued health states defined by three of six PBM: EQ‐5D (generic), SF‐6D (generic), HUI2 (generic... Health Economics journals http://www.medworm.com/rss/comments.php?id=4869586 Fri, 27 May 2011 21:25:11 +0100 4869586 Symposium on genetic data in health economics research http://www.medworm.com/index.php?rid=4860106&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1747 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4860106 Wed, 25 May 2011 21:42:03 +0100 4860106 Comparing and decomposing differences in preventive and hospital care: USA versus Taiwan http://www.medworm.com/index.php?rid=4860110&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1743 SUMMARYAs the USA expands health insurance coverage, comparing utilization of healthcare services with countries like Taiwan that already have universal coverage can highlight problematic areas of each system. The universal coverage plan of Taiwan is the newest among developed countries, and it is known for readily providing access to care at low costs. However, Taiwan experiences problems on the supply side, such as inadequate compensation for providers, especially in the area of preventive care. We compare the use of preventive, hospital, and emergency care between the USA and Taiwan. The rate of preventive care use is much higher in the USA than in Taiwan, whereas the use of hospital and emergency care is about the same. Results of our decomposition analysis suggest that higher levels o... Health Economics journals http://www.medworm.com/rss/comments.php?id=4860110 Mon, 23 May 2011 23:00:00 +0100 4860110 The validity of genes related to neurotransmitters as instrumental variables http://www.medworm.com/index.php?rid=4860109&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1744 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4860109 Mon, 23 May 2011 23:00:00 +0100 4860109 The promise and pitfalls of combining genetic and economic research http://www.medworm.com/index.php?rid=4860108&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1745 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4860108 Mon, 23 May 2011 23:00:00 +0100 4860108 Mendelian randomization: the use of genes in instrumental variable analyses http://www.medworm.com/index.php?rid=4860107&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1746 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4860107 Mon, 23 May 2011 23:00:00 +0100 4860107 Weight‐loss dieting behavior: an economic analysis http://www.medworm.com/index.php?rid=4810999&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1751 SUMMARYIn light of the widespread phenomena of diet failure and excessive dieting, this paper presents a theoretical economic analysis of the decision‐making process of weight‐loss dieting. The paper incorporates behavioral elements involved in the process of dieting: effort exerted in dieting, influence of social norms concerning body weight, time‐inconsistent present biased preferences, and a distinction between naiveté and sophistication. The model explains cyclic dieting and provides interesting insights on the extent of weight‐loss dieting. The extent of dieting is an increasing function of initial body weight and a decreasing function of the effort exerted in dieting and the strength of social norms concerning ideal weight. Income and diet strictness have an ambiguous effect... Health Economics journals http://www.medworm.com/rss/comments.php?id=4810999 Thu, 12 May 2011 03:20:23 +0100 4810999 Quantile regression analysis of body mass and wages http://www.medworm.com/index.php?rid=4811001&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1736 AbstractUsing the National Longitudinal Survey of Youth 1979, we explore the relationship between body mass and wages. We use quantile regression to provide a broad description of the relationship across the wage distribution. We also allow the relationship to vary by the degree of social skills involved in different jobs. Our results find that for female workers body mass and wages are negatively correlated at all points in their wage distribution. The strength of the relationship is larger at higher‐wage levels. For male workers, the relationship is relatively constant across wage distribution but heterogeneous across ethnic groups. When controlling for the endogeneity of body mass, we find that additional body mass has a negative causal impact on the wages of white females earning mor... Health Economics journals http://www.medworm.com/rss/comments.php?id=4811001 Mon, 09 May 2011 23:00:00 +0100 4811001 The determinants of Chinese provincial government health expenditures: evidence from 2002–2006 data http://www.medworm.com/index.php?rid=4811000&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1742 SUMMARYThere is great divergence in provincial government health expenditures in China. Real per capita provincial government health expenditures (GHE) over the period 2002–2006 are examined using panel regression analysis. Key determinants of real per capita provincial GHE are real provincial per capita general budget revenue, real provincial per capita transfers from the central government, the proportion of provincial population under age 15, urban employee basic health insurance coverage, and proportion of urban population. Roughly equal and relatively low elasticities of budget revenue and transfers imply that the GHE is a necessity rather than a luxury good, and transfers have yet to become efficient instruments for the fair allocation of health resources by policy makers. Moreover... Health Economics journals http://www.medworm.com/rss/comments.php?id=4811000 Mon, 09 May 2011 23:00:00 +0100 4811000 Economic consequences of maternal illness in rural Bangladesh http://www.medworm.com/index.php?rid=4801156&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1749 SUMMARYWe use panel data on household consumption combined with information taken from the medical records of women who gave birth in health facilities to explore the economic consequences of maternal ill health, in the context of a rural population in Bangladesh. The findings suggest that there is a large reduction in household resources associated with maternal illness, driven almost entirely by spending on health care. In spite of this loss of resources, we find that households are able to fully insure consumption against maternal ill health, although confidence intervals are unable to rule out a small effect. Households in our study area are shown to have good access to informal credit (whether it be from local money lenders or family relatives), and this appears critical in helping to... Health Economics journals http://www.medworm.com/rss/comments.php?id=4801156 Mon, 09 May 2011 21:13:05 +0100 4801156 Using qualitative methods for attribute development for discrete choice experiments: issues and recommendations http://www.medworm.com/index.php?rid=4793509&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1739 SUMMARYAttribute generation for discrete choice experiments (DCEs) is often poorly reported, and it is unclear whether this element of research is conducted rigorously. This paper explores issues associated with developing attributes for DCEs and contrasts different qualitative approaches. The paper draws on eight studies, four developed attributes for measures, and four developed attributes for more ad hoc policy questions. Issues that have become apparent through these studies include the following: the theoretical framework for random utility theory and the need for attributes that are neither too close to the latent construct nor too intrinsic to people's personality; the need to think about attribute development as a two‐stage process involving conceptual development followed by ref... Health Economics journals http://www.medworm.com/rss/comments.php?id=4793509 Sat, 07 May 2011 03:20:21 +0100 4793509 Intended and unintended consequences of a proposed national tax on sugar‐sweetened beverages to combat the U.S. obesity problem http://www.medworm.com/index.php?rid=4766953&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1738 AbstractMonthly data derived from the Nielsen Homescan Panel for calendar years 1998 through 2003 are used to estimate the effects of a proposed tax on sugar‐sweetened beverages (SSBs). Most arguments in describing the ramifications of a tax fail to consider demand interrelationships among various beverages. To circumvent this shortcoming we employ a variation of Quadratic Almost Ideal Demand System (QUAIDS) model. The consumption of isotonics, regular soft drinks and fruit drinks, the set of SSBs, is negatively impacted by the proposed tax, while the consumption of fruit juices, low‐fat milk, coffee, and tea is positively affected. Diversion ratios are provided identifying where the volumes of the SSBs are directed as a result of the tax policy. The reduction in the body weight as a r... Health Economics journals http://www.medworm.com/rss/comments.php?id=4766953 Sat, 30 Apr 2011 09:57:44 +0100 4766953 Benefits and costs of substance abuse treatment programs for state prison inmates: results from a lifetime simulation model http://www.medworm.com/index.php?rid=4730871&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1735 AbstractReflecting drug use patterns and criminal justice policies throughout the 1990s and 2000s, prisons hold a disproportionate number of society's drug abusers. Approximately 50% of state prisoners meet the criteria for a diagnosis of drug abuse or dependence, but only 10% receive medically based drug treatment. Because of the link between substance abuse and crime, treating substance abusing and dependent state prisoners while incarcerated has the potential to yield substantial economic benefits. In this paper, we simulate the lifetime costs and benefits of improving prison‐based substance abuse treatment and post‐release aftercare for a cohort of state prisoners. Our model captures the dynamics of substance abuse as a chronic disease; estimates the benefits of substance abuse tre... Health Economics journals http://www.medworm.com/rss/comments.php?id=4730871 Wed, 20 Apr 2011 11:42:47 +0100 4730871 Do people become healthier after being promoted? http://www.medworm.com/index.php?rid=4730874&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1734 AbstractThis paper examines the hypothesis that greater job status makes a person healthier. It begins by successfully replicating the well‐known cross‐section association between health and job seniority. Then, however, it turns to longitudinal patterns. Worryingly for the hypothesis, the data–on a large sample of randomly selected British workers through time–suggest that people who start with good health go on later to be promoted. The paper can find relatively little evidence that health improves after promotion. In fact, promoted individuals suffer a significant deterioration in their psychological well‐being (on a standard General Health Questionnaire (GHQ) mental ill‐health measure). Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4730874 Mon, 18 Apr 2011 23:00:00 +0100 4730874 Should medicare adopt the veterans health administration formulary? http://www.medworm.com/index.php?rid=4730873&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1733 AbstractSince January 2006 all Medicare beneficiaries have been eligible to obtain outpatient prescription drug coverage through private stand‐alone drug plans (PDPs). We estimate a model of beneficiary demand for PDPs and use it to compute the loss of consumer surplus due to tightening PDP formularies to the level found in the Veterans Health Administration (VA). Under a generous assumption of cost savings attributed to increased bargaining leverage associated with exclusion of more drugs from formularies, we find the loss in consumer surplus to be smaller than the financial savings that could be shared between Medicare and beneficiaries. According to our estimates, Medicare beneficiaries could be compensated for the loss in consumer surplus associated with tighter PDP formularies with ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4730873 Mon, 18 Apr 2011 23:00:00 +0100 4730873 Customization in prescribing for bipolar disorder http://www.medworm.com/index.php?rid=4730872&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1737 AbstractFor many disorders, patient heterogeneity requires physicians to customize their treatment to each patient's needs. We test for the existence of customization in physicians' prescribing for bipolar disorder, using data from a naturalistic clinical effectiveness trial of bipolar disorder treatment (STEP‐BD), which did not constrain physician prescribing. Multinomial logit is used to model the physician's choice among five combinations of drug classes. We find that our observed measure of the patient's clinical status played only a limited role in the choice among drug class combinations, even for conditions such as mania that are expected to affect class choice. However, treatment of a patient with given characteristics differed widely depending on which physician was seen. The ex... Health Economics journals http://www.medworm.com/rss/comments.php?id=4730872 Mon, 18 Apr 2011 23:00:00 +0100 4730872 Parental income and child health in Germany http://www.medworm.com/index.php?rid=4730875&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1732 AbstractUsing newly available data from Germany, we study the relationship between parental income and child health. We find a strong gradient between parental income and subjective child health as has been documented earlier in the United States, Canada, and the United Kingdom. The relationship in Germany is about as strong as in the United States and stronger than in the United Kingdom. However, in contrast to US results, we do not find consistent evidence that the disadvantages associated with low parental income accumulate as the child ages, nor that children from low socioeconomic background are more likely to suffer from doctor‐diagnosed conditions. There is some evidence, however, that high‐income children are better able to cope with the adverse consequences of chronic conditio... Health Economics journals http://www.medworm.com/rss/comments.php?id=4730875 Sun, 17 Apr 2011 23:00:00 +0100 4730875 Patient complexity and GPS' income under mixed remuneration http://www.medworm.com/index.php?rid=4702535&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1731 The objective is to assess how patient heterogeneity affects list size, income and total utility of GPs operating under a mixed remuneration scheme. We adapt the model by Iversen (2004) as a theoretical framework for analysing the consequences of patient heterogeneity in a mixed remuneration system. We use a data set of Danish solo practitioners to analyse the effect of patient complexity on list size and income. From the theoretical model we find that higher levels of patient complexity lead GPs to choose a lower list size, whereas the effect on income is ambiguous. The effect on total utility (income and leisure) is, however, shown to be negative. Using empirical data from 1039 solo practices we find that patient complexity reduces both list size and income and conclude that a mixed per ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4702535 Wed, 13 Apr 2011 02:55:51 +0100 4702535 Impact of the smoking ban on the volume of bar sales in Ireland – evidence from time series analysis http://www.medworm.com/index.php?rid=4681779&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1728 AbstractThis paper is the first to estimate the economic impact of a comprehensive smoking ban in all enclosed public places of work, on bars in Ireland. The demand in bars, represented by a monthly index of sales volume, is explained by relative prices in bars, prices of alcohol sold in off‐licences and the aggregate retail sales (ARS) as a proxy for general economic activity and incomes. The smoking ban is included into the model as a step dummy and the modelling is done using ARIMAX strategy. The results show a reduction in the volume of sales in bars by −4.6% (p<0.01) following the ban. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4681779 Thu, 07 Apr 2011 14:13:16 +0100 4681779 Quality of life lost due to non‐fatal road traffic injuries http://www.medworm.com/index.php?rid=4675304&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1729 The objective of this paper is to evaluate the effect of a non‐fatal road crash on the health‐related quality of life of injured people. A new approach based on the cardinalization of categorical Self‐Assessed Health valuations is suggested. Health losses have been estimated by using different Time Trade‐off and Visual Analogue Scale tariffs, in order to assess the robustness of the results. The methodology is based on the existing literature about treatment effects. Our main contribution focuses on evaluating the loss of health up to 1 year after the non‐fatal accident, for those who are non‐institutionalized, which aids the appropriate estimation of the aggregated health losses in quality‐of‐life terms. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economi... Health Economics journals http://www.medworm.com/rss/comments.php?id=4675304 Tue, 05 Apr 2011 03:30:47 +0100 4675304 Time is up: increasing shadow price of time in primary‐care office visits http://www.medworm.com/index.php?rid=4640359&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1726 AbstractA physician's own time is a scarce resource in primary care, and the physician must constantly evaluate the gain from spending more time with the current patient against moving to address the health‐care needs of the next. We formulate and test two alternative hypotheses. The first hypothesis is based on the premise that with time so scarce, physicians equalize the marginal value of time across patients. The second, alternative hypothesis states that physicians allocate the same time to each patient, regardless of how much the patient benefits from the time at the margin. For our empirical work, we examine the presence of a sharply increasing subjective shadow price of time around the ‘target’ time using video recordings of 385 visits by elderly patients to their primary care... Health Economics journals http://www.medworm.com/rss/comments.php?id=4640359 Mon, 28 Mar 2011 15:51:43 +0100 4640359 Budget allocation and the revealed social rate of time preference for health http://www.medworm.com/index.php?rid=4635261&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1730 AbstractAppropriate decisions based on cost‐effectiveness evaluations of health‐care technologies depend upon the cost‐effectiveness threshold and its rate of growth as well as some social rate of time preference for health. A more traditional approach to this problem is outlined before a social decision‐making approach is developed, which demonstrates that social time preference for health is revealed through the budget allocations made by a socially legitimate higher authority. The relationship between the social time preference rate for health, the growth rate of the cost‐effectiveness threshold and the rate at which the higher authority can borrow or invest is then examined. We establish that the social time preference rate for health is implied by the budget allocation and t... Health Economics journals http://www.medworm.com/rss/comments.php?id=4635261 Sat, 26 Mar 2011 03:48:15 +0100 4635261 New drugs and the growth of health expenditure: evidence from diabetic patients in Taiwan http://www.medworm.com/index.php?rid=4573923&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1724 AbstractThis paper contributes to the growing body of literature that debates whether the adoption of pharmaceutical innovation increases the overall expenditure on health care. By examining data obtained from Taiwan and focusing on diabetic patients, we use a new class of drugs, namely, thiazolidinediones, as an example to investigate the effect on health expenditure of prescribing new drugs to patients by focusing on the impact of treatment substitution and treatment expansion. Overall, our results indicate that the introduction of new drugs mainly impacts the outpatient drug expenditure and does not give rise to any offsetting effect on other outpatient and inpatient health expenditures. This suggests that the adoption of pharmaceutical innovation in treating diabetic patients is expend... Health Economics journals http://www.medworm.com/rss/comments.php?id=4573923 Thu, 10 Mar 2011 00:00:00 +0100 4573923 Benefit‐incidence analysis: are government health expenditures more pro‐rich than we think? http://www.medworm.com/index.php?rid=4573922&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1727 AbstractAuthors of benefit‐incidence analyses (BIA) have to impute subsidies using assumptions about the relationship between unobserved subsidies ‘captured’ by the household and what can be observed at the household and aggregate levels. This paper shows that one of the two assumptions used in BIA studies to date will necessarily produce a more pro‐rich (or less pro‐poor) picture of government health spending than the other, depending on whether utilization is more pro‐rich or pro‐poor than fees paid to public providers. Both assumptions have their disadvantages, and the paper suggests a couple of alternatives that explicitly link fees paid to the costliness of care. It shows that in the most likely case where fees are distributed in a more pro‐rich fashion than utilizatio... Health Economics journals http://www.medworm.com/rss/comments.php?id=4573922 Thu, 10 Mar 2011 00:00:00 +0100 4573922 Health status and the allocation of time http://www.medworm.com/index.php?rid=4564656&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1725 AbstractWe consider the relationship between health and time allocation in the American Time Use Survey. Better health is associated with large positive effects on home production and larger positive effects on market production, but less consumption of leisure. Theoretically, if market‐ and home‐produced goods are perfect substitutes, the positive correlation between health and home production implies that health exerts larger effects on home than on market efficiency. Notably, these correlations are higher for single people than for married people, perhaps reflecting a lack of market substitutes for the time of married people. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4564656 Tue, 08 Mar 2011 00:00:00 +0100 4564656 Does managed care affect the diffusion of psychotropic medications? http://www.medworm.com/index.php?rid=4558421&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1723 AbstractNewer technologies to treat many mental illnesses have shown substantial heterogeneity in diffusion rates across states. In this paper, I investigate whether variation in the level of managed care penetration is associated with changes in state‐level diffusion of three newer classes of psychotropic medications in fee‐for‐service Medicaid programs from 1991 to 2005. Three different types of managed care programs are examined: capitated managed care, any type of managed care and behavioral health carve‐outs. A fourth‐order polynomial fixed effect regression model is used to model the diffusion path of newer antidepressant and antipsychotic medications controlling for time‐varying state characteristics. Substantial differences are found in the diffusion paths by the degree... Health Economics journals http://www.medworm.com/rss/comments.php?id=4558421 Mon, 07 Mar 2011 00:00:00 +0100 4558421 The effect of waiting time and distance on hospital choice for English cataract patients http://www.medworm.com/index.php?rid=4558420&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1720 AbstractThis paper applies latent‐class multinomial logit models to the choice of hospital for cataract operations in the UK NHS. We concentrate on the effects of travel time and waiting time and especially on estimating the waiting time elasticity of demand. Models including hospital fixed effects rely on changes over time in waiting time to indentify coefficients. We show how using a latent‐class multinomial logit model characterises the unobserved heterogeneity in GP practices' choice behaviour and affects the estimated elasticities of travel time and waiting time. The models estimate waiting time elasticities of demand of approximately −0.1, comparable with previous waiting time‐demand models. For the average waiting time elasticity, the simple multinomial logit models are good... Health Economics journals http://www.medworm.com/rss/comments.php?id=4558420 Mon, 07 Mar 2011 00:00:00 +0100 4558420 Overweight and obesity and the utilization of primary care physicians http://www.medworm.com/index.php?rid=4516149&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1711 AbstractWe investigate whether overweight or obese individuals utilize more medical care than normal weight individuals by estimating a finite mixture model which splits the population into frequent and non‐frequent users of primary care physician (GP) services. Based on a survey sample aged 25–60 years from the National Health Interview (NHI) 2000 merged to Danish register data, we compare differences in the impact of being overweight and obese relative to being normal weight on the utilization of GP services. Estimated bodyweight effects vary across latent classes and show that being obese or overweight does not increase the utilization of GP services among infrequent users but does so among frequent users. Obese (and to a lesser extent, overweight) infrequent users are observed 5 ye... Health Economics journals http://www.medworm.com/rss/comments.php?id=4516149 Wed, 23 Feb 2011 00:00:00 +0100 4516149 Food insecurity and the relationship between household income and children's health and nutrition in Brazil http://www.medworm.com/index.php?rid=4511089&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1722 AbstractEmpirical evidence indicates that children living in wealthier households have better health. Food insecurity could be related to lack of adequate nutrition experienced by poor children and may be pointed out as one of the possible explanations for this relationship. This paper investigates the association between food insecurity and children's health and nutrition and the role of the former in the child health income gradient. Using data from the 2006 Brazilian Demographic and Health Survey, the results show that children living in households with food insecurity have worse nutrition and health indicators. In addition, the relationship between household income and many children's health and nutrition measures weakens but remains significant when controlling for food insecurity. Co... Health Economics journals http://www.medworm.com/rss/comments.php?id=4511089 Wed, 23 Feb 2011 00:00:00 +0100 4511089 Is there a health penalty of China's rapid urbanization? http://www.medworm.com/index.php?rid=4505990&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1717 AbstractWhile highly pertinent to the human welfare consequences of development, the impact of rapid urbanization on population health is not obvious. This paper uses community and individual‐level longitudinal data from the China Health and Nutrition Survey to estimate the net health impact of China's unprecedented urbanization. We construct an index of urbanicity from a broad set of community characteristics and define urbanization in terms of movements across the distribution of this index. We use difference‐in‐differences estimators to identify the treatment effect of urbanization on the self‐assessed health of individuals. We find that urbanization raises the probability of reporting of poor health and that a greater degree of urbanization has a larger effect. The effect may, ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4505990 Mon, 21 Feb 2011 00:00:00 +0100 4505990 Waiting times for elective surgery and the decision to buy private health insurance http://www.medworm.com/index.php?rid=4493866&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1707 In this study, we investigate the effect of waiting on individual decisions to buy private health insurance. Individuals are assumed to form an expectation of their own waiting time as a function of their demographics and health status. We model waiting times using administrative data on the population hospitalised for elective procedures in public hospitals and use the parameter estimates to impute the expected waiting time and the probability of a long wait for a representative sample of the population. We find that expected waiting time does not increase the probability of buying insurance but a high probability of experiencing a long wait does. On average, waiting time has no significant impact on insurance. In addition, we find that favourable selection into private insurance, measure... Health Economics journals http://www.medworm.com/rss/comments.php?id=4493866 Thu, 17 Feb 2011 00:00:00 +0100 4493866 Comparing costs and outcomes across programmes of health care http://www.medworm.com/index.php?rid=4476371&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1716 AbstractThis paper examines the expenditure choices of local health authorities operating under fixed budget constraints. It applies a theoretical model of budgeting to a data set from 303 English Primary Care Trusts (PCTs) across ten broad programmes of health care to derive estimates of the elasticity of expenditure in each programme with respect to the total income of the PCT. The results suggest quite similar income elasticities across most programmes, in the range 0.644–1.128. The only outlier is the musculoskeletal programme with an elasticity of about 0.46. The modelling also derives estimates of spending elasticities with respect to medical needs and thereby permits calculation of the implicit cost of saving a life year in five programmes of care. The results are important as the... Health Economics journals http://www.medworm.com/rss/comments.php?id=4476371 Mon, 14 Feb 2011 00:00:00 +0100 4476371 The effect of job loss and unemployment duration on suicide risk in the United States: a new look using mass‐layoffs and unemployment duration http://www.medworm.com/index.php?rid=4476370&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1719 AbstractWe examine the link between employment status and suicide risk using a panel of US states from 1996 to 2005 with monthly data on suicides, the duration of unemployment spells and the number of job losses associated with mass‐layoff events. The use of aggregate data at the monthly level along with the distribution of unemployment duration allows us to separate the effect of job loss from the effect of unemployment duration, an important distinction for policy purposes, especially for the timing of potential interventions. Our results are consistent with unemployment duration being the dominant force in the relationship between job loss and suicide. Nevertheless, mass‐layoffs may be powerful localized events where suicide risk increases shortly afterward. Implications for the des... Health Economics journals http://www.medworm.com/rss/comments.php?id=4476370 Mon, 14 Feb 2011 00:00:00 +0100 4476370 Does retirement trigger ill health? http://www.medworm.com/index.php?rid=4476369&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1712 AbstractThis paper investigates the effects of retirement on various health outcomes. Data stem from the first three waves of the English Longitudinal Study of Ageing (ELSA). With these informative data, non‐parametric matching and instrumental variable (IV) methods are applied to identify causal effects. It is found that retirement significantly increases the risk of being diagnosed with a chronic condition. In particular, it raises the risk of a severe cardiovascular disease and cancer. This is also reflected in increased risk factors (e.g. BMI, cholesterol, blood pressure) and increased problems in physical activities. Furthermore, retirement worsens self‐assessed health and an underlying health stock. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4476369 Mon, 14 Feb 2011 00:00:00 +0100 4476369 Does the EU sugar policy reform increase added sugar consumption? An empirical evidence on the soft drink market http://www.medworm.com/index.php?rid=4476368&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1721 AbstractWhereas National Health authorities recommend a decrease in the consumption of ‘added’ sugar, a reform on the sugar market will lead to a 36% decrease of the sugar price in the EU. Using French data on soft drinks purchases, this paper investigates the anticipated impact of this reform on the consumption of sugar‐sweetened beverages. The reform of the EU sugar policy leads to a decrease in regular soft drink prices by 3% and varies across brands. To assess substitution within this food category, we use a random‐coefficients logit model that takes into account a large number of differentiated products and heterogeneity in consumers' behavior. Results suggest that price changes would lead to an increase in market shares of regular products by 7.5% and to substitutions between... Health Economics journals http://www.medworm.com/rss/comments.php?id=4476368 Mon, 14 Feb 2011 00:00:00 +0100 4476368 A model to correct for short‐run inefficiencies in economic evaluations in healthcare http://www.medworm.com/index.php?rid=4476367&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1705 AbstractImportant assumptions that underlie cost‐effectiveness analysis (CEA) are that production technologies are convex and that production processes always perform at constant returns to scale. However, in the short run these assumptions are likely to be violated. Therefore, CEAs might overestimate cost‐effectiveness in the short run. To come up with a more precise cost‐effectiveness outcome, we present a model that is able to correct the long‐run incremental net benefit (INB) for short‐run inefficiencies. This provides decision makers with a more realistic view of the expected efficiency gains. This model starts by determining the initial efficiency losses inflicted by inflexible resources. Then the model is made dynamic in order to adjust the efficiency losses by allowing fo... Health Economics journals http://www.medworm.com/rss/comments.php?id=4476367 Mon, 14 Feb 2011 00:00:00 +0100 4476367 The impact of long‐term participation in the supplemental nutrition assistance program on child obesity http://www.medworm.com/index.php?rid=4454293&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1714 AbstractParticipation in the Supplemental Nutrition Assistance Program (SNAP) reached an all‐time high of 40.2 million persons in March 2010, which means the program affects a substantial fraction of Americans. A significant body of research has emerged suggesting that participation in SNAP increases the probability of being obese for adult women and has little effect on the probability for adult men. However, studies addressing the effects of participation on children have produced mixed results. This paper examines the effect of long‐term SNAP participation on the Body Mass Index (BMI) percentile and probability of being overweight or obese for children ages 5–18 using data from the National Longitudinal Survey of Youth 1979 Children and Young Adults data set. An instrumental varia... Health Economics journals http://www.medworm.com/rss/comments.php?id=4454293 Tue, 08 Feb 2011 00:00:00 +0100 4454293 Demand, selection and patient outcomes in German acute care hospitals http://www.medworm.com/index.php?rid=4435848&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1706 AbstractThis paper examines the effects of variation in unexpected demand on patient outcomes in acute care German hospitals. Naturally, an unexpected surge in demand may negatively affect the quality of care and thus patient outcomes, such as in‐hospital mortality. We estimate models explaining patient outcomes depending on demand, unobservable patient selection and seasonal factors, as well as patient‐specific risk factors and unobservable hospital and department fixed‐effects. The main message of this analysis is that hospitals are well prepared to deal with this unexpected volatility in demand, as by and large it does not negatively affect patient outcomes. Hospitals seem to deal with high unexpected workload by steering the patients' length of stay relating to their severity of ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4435848 Fri, 04 Feb 2011 00:00:00 +0100 4435848 What is driving the black–white difference in low birthweight in the US? http://www.medworm.com/index.php?rid=4435847&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1715 AbstractThis is a first effort to quantify the contribution of different factors in explaining racial difference in low birthweight rate (LBW). Mother's health, child characteristics, prenatal care, socioeconomic status (SES), and the socioeconomic and healthcare environment of mother's community are important inputs into the birthweight production function, and a vast literature has delved into obtaining causal estimates of their effect on infant health. What is unknown is how much of the racial gap in LBW is explained by all these inputs together. We apply a nonlinear extension of the Oaxaca–Blinder method proposed by Fairlie to decompose this gap into the portion explained by differences in observed characteristics and the portion that remains unexplained. Data are obtained from sever... Health Economics journals http://www.medworm.com/rss/comments.php?id=4435847 Fri, 04 Feb 2011 00:00:00 +0100 4435847 Socioeconomic status and health outcomes in a developing country http://www.medworm.com/index.php?rid=4417994&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1703 AbstractAlthough the relationship between socioeconomic status (SES) and health is well documented for developed countries, less evidence has been presented for developing countries. The aim of this paper is to analyse this relationship at the household level for Fiji, a developing country in the South Pacific, using original household survey data. To allow for the endogeneity of SES status in the household health production function, we utilize a simultaneous equation approach where estimates are achieved by full information maximum likelihood. By restricting our sample to one, relatively small island, and including area and district hospital effects, physical geography effects are unpacked from income effects. We measure SES, as permanent income which is constructed using principal compo... Health Economics journals http://www.medworm.com/rss/comments.php?id=4417994 Mon, 31 Jan 2011 00:00:00 +0100 4417994 Human health care and selection effects. Understanding labor supply in the market for nursing1 http://www.medworm.com/index.php?rid=4417993&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1713 AbstractThe aim of this paper is to study (adverse) selection in a labor supply model where potential applicants are characterized by different vocational levels and skills. We look at how the composition of the pool of active workers changes as the wage rate increases. Contrary to what would expect, average productivity does not necessarily increase monotonically in the wage rate. We identify conditions in which a wage increase reduces the average productivity and/or average vocation of active workers. Our results help understand the potential impact of wage increases as a policy designed to resolving shortages in the labor market for nurses. Copyright © 2011 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4417993 Mon, 31 Jan 2011 00:00:00 +0100 4417993 Physicians' perception of demand‐induced supply in the information age: a latent class model analysis http://www.medworm.com/index.php?rid=4417992&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1710 AbstractThis paper introduces a concept called ‘demand‐induced supply’ that reflects the excess supply of services due to an increase in demand initiated by patients. We examine its association with the proportion of information‐savvy patients in physicians' practice. Using data from a national representative physician survey, we apply latent class models to analyze this association. Our analyses categorize physicians into three ‘types’ according to the frequency with which they provided additional medical services at their patients' requests: frequent, occasional, and rare. The proportion of information‐savvy patients is significantly and positively correlated with demand‐induced supply for the frequent or occasional type, but not among physicians in the rare type. Efforts... Health Economics journals http://www.medworm.com/rss/comments.php?id=4417992 Mon, 31 Jan 2011 00:00:00 +0100 4417992 Intergenerational cohabitation in modern Indonesia: filial support and dependence http://www.medworm.com/index.php?rid=4410529&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1708 AbstractInformal filial care plays an important role for elderly parents facing health challenges. Ageing, however, exacerbates the burden of filial care because the ratio of older to younger individuals is higher and disabled parents live longer. The well‐being of elderly parents is even more insecure in Asian developing countries that are undergoing unprecedented ageing and drastic changes in social norms and values, whereas old‐age support systems have yet to be developed. In this paper, we investigate factors that influence cohabitation decision by elderly parents and their adult children using the longitudinal Indonesian Family Life Survey (IFLS). Focusing on new cohabitation in which a parent who lives independently starts to cohabitate with a child, we conduct transition analysi... Health Economics journals http://www.medworm.com/rss/comments.php?id=4410529 Fri, 28 Jan 2011 00:00:00 +0100 4410529 Disentangling WTP per QALY data: different analytical approaches, different answers http://www.medworm.com/index.php?rid=4376454&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1709 AbstractA large random sample of the Danish general population was asked to value health improvements by way of both the time trade‐off elicitation technique and willingness‐to‐pay (WTP) using contingent valuation methods. The data demonstrate a high degree of heterogeneity across respondents in their relative valuations on the two scales. This has implications for data analysis. We show that the estimates of WTP per QALY are highly sensitive to the analytical strategy. For both open‐ended and dichotomous choice data we demonstrate that choice of aggregated approach (ratios of means) or disaggregated approach (means of ratios) affects estimates markedly as does the interpretation of the constant term (which allows for disproportionality across the two scales) in the regression anal... Health Economics journals http://www.medworm.com/rss/comments.php?id=4376454 Thu, 20 Jan 2011 00:00:00 +0100 4376454 Twentieth European Workshop on Econometrics and Health Economics http://www.medworm.com/index.php?rid=4336213&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1702 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4336213 Wed, 12 Jan 2011 23:22:16 +0100 4336213 Willingness‐to‐pay for predictive tests with no immediate treatment implications: a survey of US residents http://www.medworm.com/index.php?rid=4292323&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1704 AbstractWe assessed how much, if anything, people would pay for a laboratory test that predicted their future disease status. A questionnaire was administered via an internet‐based survey to a random sample of adult US respondents. Each respondent answered questions about two different scenarios, each of which specified: one of four randomly selected diseases (Alzheimer's, arthritis, breast cancer, or prostate cancer); an ex ante risk of developing the disease (randomly designated 10 or 25%); and test accuracy (randomly designated perfect or ‘not perfectly accurate’). Willingness‐to‐pay (WTP) was elicited with a double‐bounded, dichotomous‐choice approach. Of 1463 respondents who completed the survey, most (70‐88%, depending on the scenario) were inclined to take the test. ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4292323 Tue, 28 Dec 2010 00:00:00 +0100 4292323 Discrete choice experiments in health economics: a review of the literature http://www.medworm.com/index.php?rid=4270739&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1697 AbstractDiscrete choice experiments (DCEs) have become a commonly used instrument in health economics. This paper updates a review of published papers between 1990 and 2000 for the years 2001–2008. Based on this previous review, and a number of other key review papers, focus is given to three issues: experimental design; estimation procedures; and validity of responses. Consideration is also given to how DCEs are applied and reported. We identified 114 DCEs, covering a wide range of policy questions. Applications took place in a broader range of health‐care systems, and there has been a move to incorporating fewer attributes, more choices and interview‐based surveys. There has also been a shift towards statistically more efficient designs and flexible econometric models. The reportin... Health Economics journals http://www.medworm.com/rss/comments.php?id=4270739 Sun, 19 Dec 2010 00:00:00 +0100 4270739 Inheritances, health and death http://www.medworm.com/index.php?rid=4270738&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1695 AbstractWe examine how wealth shocks, in the form of inheritances, affect the mortality rates, health status and health behaviors of older adults, using data from eight waves of the Health and Retirement Survey. Our main finding is that bequests do not have substantial effects on health, although improvements in quality‐of‐life are possible. This absence occurs despite increases in out‐of‐pocket spending on healthcare and in the utilization of medical services, especially discretionary and non‐lifesaving types such as dental care. Nor can we find a convincing indication of changes in lifestyles that offset the benefits of increased medical care. Inheritances are associated with higher alcohol consumption, but with no change in smoking or exercise and a possible decrease in obesit... Health Economics journals http://www.medworm.com/rss/comments.php?id=4270738 Sun, 19 Dec 2010 00:00:00 +0100 4270738 A modified measure of health care disparities applied to birth weight disparities and subsequent mortality http://www.medworm.com/index.php?rid=4263127&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1699 We describe how a modified Gini index serves as an improved method of estimating health care disparities. The method, although general, is applied to an example of birth weight disparities and to their effect on subsequent mortality. The method provides the between‐group results obtainable from current methods (i.e. how Hispanics generally fare relative to non‐Hispanic Whites) but adds measures of within‐group disparities (i.e. which specific Hispanics experience the greatest disparate treatment). Our application to birth weights and receipt of prenatal care, which may provide an upper bound because of omitted variables, shows that the time‐of‐birth disparities are associated with increased infant mortality within the first year of life. Copyright © 2010 John Wiley & Sons, L... Health Economics journals http://www.medworm.com/rss/comments.php?id=4263127 Wed, 15 Dec 2010 00:00:00 +0100 4263127 Regional variations in medical spending and utilization: a longitudinal analysis of US Medicare population http://www.medworm.com/index.php?rid=4263126&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1700 This study uses the Continuous Medicare History Sample, a large longitudinal 5% sample of all Medicare beneficiaries from 1974 to 2003, to study the issue. We show that the spending and utilization disparities are significant at the aggregate state level. More importantly, the variation shows signs of narrowing over time, particularly in the earlier years of the sample period and in some cases following major reforms. However, it remains significant even after an array of demographic, demand and supply side factors are controlled for. Copyright © 2010 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4263126 Wed, 15 Dec 2010 00:00:00 +0100 4263126 Missing data in trial‐based cost‐effectiveness analysis: the current state of play† http://www.medworm.com/index.php?rid=4263125&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1693 AbstractRandomised controlled trial (RCT)‐based cost‐effectiveness analyses, which are prone to missing data, are increasingly used in healthcare technology assessment. This has highlighted the need for appropriate methodological approaches to the handling of missing data. This paper reviews missing data methodology used in RCT‐based cost‐effectiveness analyses since 2003. Complete case analysis, which may lead to inappropriate conclusions, is still the most popular approach and its use has increased with time.The degree of missing data in cost‐effectiveness analyses was often poorly reported and the methodology was often unclear. Reporting of missing data sensitivity analyses would improve article transparency. Copyright © 2010 John Wiley & Sons, Ltd. (Source: Health Econom... Health Economics journals http://www.medworm.com/rss/comments.php?id=4263125 Wed, 15 Dec 2010 00:00:00 +0100 4263125 Erratum: Estimating lifetime or episode‐of‐illness costs under censoring http://www.medworm.com/index.php?rid=4244162&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1684 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4244162 Thu, 09 Dec 2010 23:16:01 +0100 4244162 Acknowledgement to reviewers http://www.medworm.com/index.php?rid=4244161&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1694 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4244161 Thu, 09 Dec 2010 23:16:01 +0100 4244161 Editorial http://www.medworm.com/index.php?rid=4244160&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1701 (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4244160 Thu, 09 Dec 2010 23:15:57 +0100 4244160 Public and private health‐care financing with alternate public rationing rules http://www.medworm.com/index.php?rid=4244158&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1698 AbstractWe develop a model to analyze parallel public and private health‐care financing under two alternative public sector rationing rules: needs‐based rationing and random rationing. Individuals vary in income and severity of illness. There is a limited supply of health‐care resources used to treat individuals, causing some individuals to go untreated. Insurers (both public and private) must bid to obtain the necessary health‐care resources to treat their beneficiaries. Given individuals' willingnesses‐to‐pay for private insurance are increasing in income, the introduction of private insurance diverts treatment from relatively poor to relatively rich individuals. Further, the impact of introducing parallel private insurance depends on the rationing mechanism in the public sec... Health Economics journals http://www.medworm.com/rss/comments.php?id=4244158 Thu, 09 Dec 2010 00:00:00 +0100 4244158 Social capital and self‐rated health in Argentina http://www.medworm.com/index.php?rid=4244159&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1696 AbstractThe potential link between social capital and health suggests important pathways by which health may be improved. We examine this relationship using a unique data set from Argentina. This national survey allows us to determine whether the relationships between social capital and health that have been found in the US and Europe also apply to countries in South America (Argentina is the second‐largest country in South America with a population of approximately 40 million). We estimate a causal effect of individual‐level social capital on health using a measure of informal social interactions as our measure of social capital. Using information about access to public transportation as instrumental variables, we find that both men and women with higher levels of social capital repor... Health Economics journals http://www.medworm.com/rss/comments.php?id=4244159 Wed, 08 Dec 2010 00:00:00 +0100 4244159 Do associations between employee self‐reported organizational assessments and attitudinal outcomes change over time? An analysis of four Veterans Health Administration surveys using structural equation modelling http://www.medworm.com/index.php?rid=4240719&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1692 AbstractThis paper evaluates relationships between healthcare employees' perceptions of three hospital organizational constructs (Leadership, Support and Resources), and their assessment of two employee‐related outcomes (employee satisfaction and retention) and two patient‐related outcomes (patient satisfaction and quality of care). Using four all‐employee surveys conducted by the Veterans Health Administration in the United States between 1997 and 2006, we examine the strength of these relationships and their changes over time. Exposure and outcome measures are employee‐assessed in all the surveys. Because it can accommodate both latent and measured variables into the model, Structural Equation Modelling (SEM) is used to capture and quantify the relationship structure. The aim of ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4240719 Mon, 06 Dec 2010 00:00:00 +0100 4240719 Labor adjustment in the Japanese health care industry: some empirical evidence http://www.medworm.com/index.php?rid=4195453&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1691 AbstractThis paper examines the labor adjustment costs in the health care industry. Using Japanese data, we find that the cost of hiring new health care workers is the largest component of labor adjustment costs in the health care industry. Hence, it is difficult for employers in this industry to immediately increase the number of workers since this employment adjustment is extremely expensive. Copyright © 2010 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4195453 Wed, 24 Nov 2010 13:15:19 +0100 4195453 Scope insensitivity in contingent valuation studies of health care services: should we ask twice? http://www.medworm.com/index.php?rid=4195457&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1690 AbstractThe main purpose of the present study was to test for outcome scope insensitivity. Respondents were initially asked to value one of two severe health states by way of a time‐trade‐off (TTO) exercise. Subsequent to the TTO exercise all respondents were asked to value an intervention, which offered a reduction in risk of falling into the health state they had evaluated. All respondents were subsequent to this initial CV exercise asked to value the same risk reduction, but in this case the outcome was death. Although our study passes the internal scope test, there is not a high degree of sensitivity to outcome. As many as 68% of respondents stated an identical maximum WTP in first and second CV valuation exercise implying that they value the interventions equally despite the fact ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4195457 Wed, 24 Nov 2010 00:00:00 +0100 4195457 Preferences for new and existing contraceptive products http://www.medworm.com/index.php?rid=4195456&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1686 AbstractNew contraceptive methods provide greater choice in terms of effectiveness, management of side‐effects, convenience and frequency of administration and flexibility, but make the decisions about contraception more complex. There are limited data on the factors that determine women's choices among these alternatives, to inform providers about the factors which are most important to women, or to predict uptake of new products. This paper reports on a choice experiment designed to elicit women's preferences in relation to prescribed contraception and to forecast the impact of the introduction of two new products into the Australian market. A generalised multinomial logit model is estimated and used in the simulation exercise. The model forecasts that the hormonal patch would be well ... Health Economics journals http://www.medworm.com/rss/comments.php?id=4195456 Wed, 24 Nov 2010 00:00:00 +0100 4195456 Information asymmetry and performance tilting in hospitals: a national empirical study http://www.medworm.com/index.php?rid=4195455&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1689 Conclusion: Information asymmetry offers hospitals an advantageous position in achieving profit maximization. The study also documented the presence of performance tilting by health‐care management. Whether increased information demands from a society accustomed to significant disclosure will reduce this agency problem is not yet clear. Copyright © 2010 John Wiley & Sons, Ltd. (Source: Health Economics) Health Economics journals http://www.medworm.com/rss/comments.php?id=4195455 Wed, 24 Nov 2010 00:00:00 +0100 4195455 The intergenerational transmission of height: evidence from rural Vietnam http://www.medworm.com/index.php?rid=4195454&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1688 AbstractA growing body of work suggests that health may be transferred across generations. The aim of this paper is to examine the mechanisms that might account for observed intergenerational associations in health outcomes. Using data from Vietnam, this study analyzes intergenerational correlations in height, a measure of long‐run health status, between parents and their children. Insights from biology and economics are used to motivate several strategies that collectively provide insight on the role and importance of different mechanisms. The results illustrate strong intergenerational associations in height, which remain stable with the inclusion of controls for parent and household characteristics. Maternal height is more strongly associated with the heights of boys than girls, while... Health Economics journals http://www.medworm.com/rss/comments.php?id=4195454 Wed, 24 Nov 2010 00:00:00 +0100 4195454 The effect of diabetes on female labor force decisions: new evidence from the National Health Interview Survey http://www.medworm.com/index.php?rid=4181866&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1685 AbstractThis paper estimates the effect of diabetes on labor‐force participation, hours worked, days‐out‐of‐work due to illness, and earnings using data from the National Health Interview Survey. Findings indicate that diabetes, estimated wholly, is significantly detrimental to most labor market outcomes. However, separation of type I and II diabetes shows that much of the negative effect is due to type II diabetes. On average a female with type II diabetes can experience a wage penalty of almost 50% relative to a healthy individual. Additionally, estimates of specifically type II diabetes may be subject to endogeneity bias. To account for this, I utilize whether an individual's biological mother has been diagnosed with diabetes as an instrumental variable. This instrument provides... Health Economics journals http://www.medworm.com/rss/comments.php?id=4181866 Fri, 19 Nov 2010 15:36:51 +0100 4181866 Non‐monotonicity in the episodic random utility model http://www.medworm.com/index.php?rid=4181867&cid=s_33632_51_f&fid=33632&url=http%3A%2F%2Fdx.doi.org%2F10.1002%252Fhec.1683 AbstractThe time trade‐off (TTO) is widely used in population‐based surveys to estimate health‐state valuations. Typically, respondents may characterize states as being better than or worse than dead. However, worse‐than‐dead responses can produce strongly negative mean values, so various analytic transformations of these responses have been suggested. The episodic random utility model (eRUM), operationalized using a linear regression estimator, was proposed as an alternative to these transformations, in part because of its theoretical appeal. We analyzed the eRUM estimator's mathematical properties and found that it violates monotonicity under certain patterns of survey responses, such that improvement in some individual valuations would imply a lower overall valuation for a giv... Health Economics journals http://www.medworm.com/rss/comments.php?id=4181867 Thu, 18 Nov 2010 00:00:00 +0100 4181867