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Full-Text Articles in Health Economics

Identifying Marginal Treatment Effects In The Presence Of Sample Selection, Otávio Bartalotti, Desire Kedagni, Vitor Possebom Sep 2019

Identifying Marginal Treatment Effects In The Presence Of Sample Selection, Otávio Bartalotti, Desire Kedagni, Vitor Possebom

Otávio Bartalotti

This article presents identification results for the marginal treatment effect (MTE) when there is sample selection. We show that the MTE is partially identified for individuals who are always observed regardless of treatment, and we derive sharp bounds on this parameter under four sets of assumptions. The first identification result combines the standard MTE assumptions without any restrictions to the sample selection mechanism. The second result imposes monotonicity of the sample selection variable with respect to the treatment, considerably shrinking the identified set. Third, we incorporate a stochastic dominance assumption which tightens the lower bound for the MTE. Finally, we ...


Identifying Marginal Treatment Effects In The Presence Of Sample Selection, Otávio Bartalotti, Desire Kedagni, Vitor Possebom Sep 2019

Identifying Marginal Treatment Effects In The Presence Of Sample Selection, Otávio Bartalotti, Desire Kedagni, Vitor Possebom

Desire Kedagni

This article presents identification results for the marginal treatment effect (MTE) when there is sample selection. We show that the MTE is partially identified for individuals who are always observed regardless of treatment, and we derive sharp bounds on this parameter under four sets of assumptions. The first identification result combines the standard MTE assumptions without any restrictions to the sample selection mechanism. The second result imposes monotonicity of the sample selection variable with respect to the treatment, considerably shrinking the identified set. Third, we incorporate a stochastic dominance assumption which tightens the lower bound for the MTE. Finally, we ...


Identifying Marginal Treatment Effects In The Presence Of Sample Selection, Otávio Bartalotti, Desire Kedagni, Vitor Possebom Sep 2019

Identifying Marginal Treatment Effects In The Presence Of Sample Selection, Otávio Bartalotti, Desire Kedagni, Vitor Possebom

Economics Working Papers

This article presents identification results for the marginal treatment effect (MTE) when there is sample selection. We show that the MTE is partially identified for individuals who are always observed regardless of treatment, and we derive sharp bounds on this parameter under four sets of assumptions. The first identification result combines the standard MTE assumptions without any restrictions to the sample selection mechanism. The second result imposes monotonicity of the sample selection variable with respect to the treatment, considerably shrinking the identified set. Third, we incorporate a stochastic dominance assumption which tightens the lower bound for the MTE. Finally, we ...


Out-Of-Pocket Expenditure For Home And Facility Based Delivery Among Rural Women In Zambia: A Mixed-Methods, Cross-Sectional Study, Jeanette L. Kaiser, Kathleen L. Mcglasson, Peter C. Rockers, Rachel M. Fong, Thandiwe Ngoma, Davidson H. Hamer, Taryn Vian, Godfrey Biemba, Jody R. Lori, Nancy A. Scott Aug 2019

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

Nursing and Health Professions Faculty Research and Publications

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

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


Better Understanding Human Capital In West Virginia, Christiadi, John Deskins Jul 2019

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

Bureau of Business & Economic Research

No abstract provided.


Preferred Pharmacy Networks: Health Care Savings On The Margins, Ashley Swanson May 2019

Preferred Pharmacy Networks: Health Care Savings On The Margins, Ashley Swanson

Wharton Public Policy Initiative Issue Briefs

While policymakers have talked a lot recently about finding a comprehensive fix for escalating health care costs, such as Medicare-for-all, many economists have been exploring the possibility that the answer for excessive health care spending may rest instead in series of smaller adjustments. This issue brief presents research on one such small fix: preferred pharmacy networks. This is a relatively new tool whereby health insurers aim to steer consumers to lower cost “preferred” pharmacies, where insurers are able to negotiate lower drug prices. The research concludes that preferred pharmacy contracting results in a roughly 1 percent decrease in Medicare Part ...


Health Care's Market Bureaucracy, Allison K. Hoffman May 2019

Health Care's Market Bureaucracy, Allison K. Hoffman

Faculty Scholarship at Penn Law

The last several decades of health law and policy have been built on a foundation of economic theory. This theory supported the proliferation of market-based policies that promised maximum efficiency and minimal bureaucracy. Neither of these promises has been realized. A mounting body of empirical research discussed in this Article makes clear that leading market-based policies are not efficient — they fail to capture what people want. Even more, this Article describes how the struggle to bolster these policies — through constant regulatory, technocratic tinkering that aims to improve the market and the decision-making of consumers in it — has produced a massive ...


The Effect Of Disability Status On Parental Input: A Study From India, Susann Skjoldhorne May 2019

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

Master's Theses

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


The Impact Of Cleft Lip/Palate And Clp Surgical Intervention On The Social Integration Of Adolescents In India, Mustafa Zahid May 2019

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

Master's Theses

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


Are Menstrual Cycles A Biological Determinant Of Well-Being Amongst Sierra Leonean Schoolchildren?, Ashwini Shridhar May 2019

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

Master's Theses

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


A Correction For Regression Discontinuity Designs With Group-Specific Mismeasurement Of The Running Variable, Otávio Bartalotti, Quentin Brummet, Steven Dieterle May 2019

A Correction For Regression Discontinuity Designs With Group-Specific Mismeasurement Of The Running Variable, Otávio Bartalotti, Quentin Brummet, Steven Dieterle

Economics Working Papers

When the running variable in a regression discontinuity (RD) design is measured with error, identification of the local average treatment effect of interest will typically fail. While the form of this measurement error varies across applications, in many cases the measurement error structure is heterogeneous across different groups of observations. We develop a novel measurement error correction procedure capable of addressing heterogeneous mismeasurement structures by leveraging auxiliary information. We also provide adjusted asymptotic variance and standard errors that take into consideration the variability introduced by the estimation of nuisance parameters, and honest confidence intervals that account for potential misspecification. Simulations ...


The Economics Of Weight Loss, Shivani Pandey May 2019

The Economics Of Weight Loss, Shivani Pandey

Undergraduate Economic Review

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


Impacts Of Contraception On Women’S Decision-Making Agency In Indonesia, Michaela J. Fogarty May 2019

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

Undergraduate Economic Review

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


The Impact Of Step Parenting On The Health, Behavior And Development Of School-Aged Children, Emmanuel Botwe May 2019

The Impact Of Step Parenting On The Health, Behavior And Development Of School-Aged Children, Emmanuel Botwe

School of Arts & Sciences Theses

The American family structure has changed rapidly over the years, from the traditional two-biological-parent household to a variety of other family configurations, leading to a substantial number of children growing up in step-families. This paper examines the impact of step-parenting on child health outcomes among school-aged children.


An Evaluation Of The Impact Of Leading Pedestrian Interval Signals In Nyc, Jeremy J. Sze May 2019

An Evaluation Of The Impact Of Leading Pedestrian Interval Signals In Nyc, Jeremy J. Sze

School of Arts & Sciences Theses

I evaluated the impact of the phased introduction of Leading Pedestrian Interval Signals (LPIs) on collision and injury outcomes at 12,987 signalized traffic intersections in New York City over the course of 25 quarters from 2012 to 2018. An intersection is treated when a LPIs is installed to give pedestrians lead time to cross the street before vehicles are allowed to move. Outcomes from NYPD’s Motor Vehicle Collisions data were matched to signalized intersections. I hypothesize that LPIs would reduce collisions and reduce injuries for pedestrians at intersections. A difference in difference fixed effects panel regression was used ...


The Effects Of The Affordable Care Act Medicaid Expansion On Breast And Cervical Cancer Screening Rates On Low-Income Childless Women, Michelle Raissa Kobou Wafo May 2019

The Effects Of The Affordable Care Act Medicaid Expansion On Breast And Cervical Cancer Screening Rates On Low-Income Childless Women, Michelle Raissa Kobou Wafo

Economics

In 2010, the Obama administration passed the Patient Protection and Affordable Care Act (ACA) commonly known as Obamacare. However, it is in 2014 that several key parts of the ACA went into effect. Among those key parts is the Medicaid expansion program. States that chose to adopt the policy, expanded Medicaid access to everyone under 138 percent of the federal poverty line. This extension had the largest impact on childless adults who previously were not covered by the program. Moreover, ACA made it mandatory for all health plans (private and public) to include the ten essential health benefits in their ...


Differences In Tsimane Children’S Growth Outcomes And Associated Determinants As Estimated By Who Standards Vs. Within-Population References, Melanie Martin, Aaron Blackwell, Hillard Kaplan, Michael Gurven Apr 2019

Differences In Tsimane Children’S Growth Outcomes And Associated Determinants As Estimated By Who Standards Vs. Within-Population References, Melanie Martin, Aaron Blackwell, Hillard Kaplan, Michael Gurven

Economics Faculty Articles and Research

Anthropometric measures are commonly converted to age stratified z-scores to examine variation in growth outcomes in mixed-age and sex samples. For many study populations, z-scores will differ if calculated from World Health Organization (WHO) growth standards or within-population references. The specific growth reference used may influence statistical estimates of growth outcomes and their determinants, with implications for biological inference. We examined factors associated with growth outcomes in a sample of 152 Tsimane children aged 0–36 months. The Tsimane are a subsistence-scale population in the Bolivian Amazon with high rates of infectious disease and growth faltering. To examine the influence ...


Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander Mar 2019

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the ...


Climate Change And Occupational Health: Can We Adapt?, Marcus Dillender Mar 2019

Climate Change And Occupational Health: Can We Adapt?, Marcus Dillender

Upjohn Institute Policy Briefs

No abstract provided.


The Economic Impact Of The Health Sector On The Economy Of Appanoose County, Iowa, Daniel Otto, Georgeanne Artz Feb 2019

The Economic Impact Of The Health Sector On The Economy Of Appanoose County, Iowa, Daniel Otto, Georgeanne Artz

Economics Working Papers

The importance of medical and health facilities as community service providers is well

established, yet their role in generating significant economic impacts for the community is less often acknowledged. Health care facilities, such as hospitals and nursing homes, not only employ many people with a sizeable payroll, but also draw a large number of people from rural areas into the community for medical services. In this study, we attempt to identify and measure the economic importance of the health sector for the economy of Appanoose County, Iowa. The specific objectives of this report are to:

1. summarize the direct economic ...


Effects Of Physician-Hospital Integration On Malpractice Claims, Elizabet Shvets Feb 2019

Effects Of Physician-Hospital Integration On Malpractice Claims, Elizabet Shvets

School of Arts & Sciences Theses

Recent increases in physician-hospital (i.e., vertical) integration has spurred both opposition on the grounds of anti-trust concerns and support on the basis of lowering transaction costs and improving communication. This paper examines the effects of vertical integration on quality of care as measured by malpractice claims.The study employs four data sets from the state of Florida (FL AHCA Financial Data, AHA Survey Data, FL AHCA Discharge Data, and FL Malpractice Claims from the Office of Insurance Regulation) culminating in an unbalanced panel dataset for the years 1998 to 2013. I utilize a linear model with hospital and year ...


The Effect Of The Dependent Coverage Provision Of The Affordable Care Act On Opioid Use And Abuse, Christian Carrillo Feb 2019

The Effect Of The Dependent Coverage Provision Of The Affordable Care Act On Opioid Use And Abuse, Christian Carrillo

School of Arts & Sciences Theses

The non-medical use of prescription opioids has become the fastest growing drug problem in the United States. This paper examines the effect of the ACA's dependent coverage provision on the prevalence of prescription opioid misuse and abuse along with the mechanism driving the results.


The Impact Of Legalization Of Marijuana On Opioid Overdose Deaths, Radhika N. Bharadwaj Feb 2019

The Impact Of Legalization Of Marijuana On Opioid Overdose Deaths, Radhika N. Bharadwaj

School of Arts & Sciences Theses

This masters’ thesis aims to examine the impact of the legalization of marijuana for recreational use on the death toll from opioid misuse in the state of Colorado. This investigation was done using the Synthetic Controls Method via data collected primarily from the CDC and IPUMS databases. The results indicate that the 2012 legalization policy in Colorado appears to reduce the number of deaths due to opioid overdoses.


Refusal Bias In Hiv Data From The Demographic And Health Surveys: Evaluation, Critique And Recommendations, Oyelola A. Adegboye, Tomoki Fujii, Denis H. Y. Leung Feb 2019

Refusal Bias In Hiv Data From The Demographic And Health Surveys: Evaluation, Critique And Recommendations, Oyelola A. Adegboye, Tomoki Fujii, Denis H. Y. Leung

Research Collection School Of Economics

Non-response is a commonly encountered problem in many population-based surveys. Broadly speaking, non-response can be due to refusal or failure to contact the sample units. Although both types of non-response may lead to bias, there is much evidence to indicate that it is much easier to reduce the proportion of non-contacts than to do the same with refusals. In this article, we use data collected from a nationally-representative survey under the Demographic and Health Surveys program to study non-response due to refusals to HIV testing in Malawi. We review existing estimation methods and propose novel approaches to the estimation of ...


Lowering Out Of Pocket Drug Costs For Consumers, Mylissa K. Price Jan 2019

Lowering Out Of Pocket Drug Costs For Consumers, Mylissa K. Price

Commonwealth Medicine Publications

Prohibiting gag clauses could help lower consumer out-of-pocket pharmacy costs - if Pharmacy Benefits Managers don't raise prices to make-up the difference. Mylissa Price closes our blog series on President Trump's Blueprint to Lower Drug Costs in this final entry.


Maintaining Stability In A Changing Climate: A Comparative Analysis Of Public Health Systems And Migration Policies In The U.S. And Canada, Laura Cutlip Jan 2019

Maintaining Stability In A Changing Climate: A Comparative Analysis Of Public Health Systems And Migration Policies In The U.S. And Canada, Laura Cutlip

Climate and Society

This paper examines the relation between climate change, migration, and public health to better understand how the United States health system is positioned to deal with likely challenges to human health posed by environmental changes. The author reviews probable impacts of climate change on population displacement and disease before considering how the current structure of the health system of the United States will render it unable to adapt to these changes and challenges. The Canadian health care system and refugee policies are then reviewed to provide a counterpoint to this analysis. These findings are then considered in tandem as the ...


Deciphering State Medicaid Programs, Rachel Gershon Jan 2019

Deciphering State Medicaid Programs, Rachel Gershon

Commonwealth Medicine Publications

State Medicaid programs vary substantially from one another. For members, researchers, policymakers, and advocates trying to decipher a state’s Medicaid program, this variation can be a source of frustration, because the details of this variation can be hard to locate.


Short-Run Health Consequences Of Retirement And Pension Benefits: Evidence From China, Plamen Nikolov, Alan Adelman Jan 2019

Short-Run Health Consequences Of Retirement And Pension Benefits: Evidence From China, Plamen Nikolov, Alan Adelman

Justice & Well-Being Studies Faculty Scholarship

This paper examines the impact of the New Rural Pension Scheme (NRPS) in China. Exploiting the staggered implementation of an NRPS policy expansion that began in 2009, we used a difference-in-difference approach to study the effects of the introduction of pension benefits on the health status, health behaviors, and healthcare utilization of rural Chinese adults age 60 and above. The results point to three main conclusions. First, in addition to improvements in self-reported health, older adults with access to the pension program experienced significant improvements in several important measures of health, including mobility, self-care, usual activities, and vision. Second, regarding ...


Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker Jan 2019

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.1 However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic ...


Unlocking Access To Health Care: A Federalist Approach To Reforming Occupational Licensing, Gabriel Scheffler Jan 2019

Unlocking Access To Health Care: A Federalist Approach To Reforming Occupational Licensing, Gabriel Scheffler

Faculty Scholarship at Penn Law

Several features of the existing occupational licensing system impede access to health care without providing appreciable protections for patients. Licensing restrictions prevent health care providers from offering services to the full extent of their competency, obstruct the adoption of telehealth, and deter foreign-trained providers from practicing in the United States. Scholars and policymakers have proposed a number of reforms to this system over the years, but these proposals have had a limited impact for political and institutional reasons.

Still, there are grounds for optimism. In recent years, the federal government has taken a range of initial steps to reform licensing ...