Health economics最新文献

{"title":"Patient Information and Surgery Decisions: A Discrete Choice Experiment","authors":"Francesca Cornaglia,&nbsp;Alessandro Iaria,&nbsp;Eugenio Felipe Merlano,&nbsp;John R. Prowle","doi":"10.1002/hec.70135","DOIUrl":"10.1002/hec.70135","url":null,"abstract":"<p>Surgical treatments are offered more widely than ever before, increasingly to older and high-risk patients. However, it is unclear whether patients making surgical decisions are fully informed about the risks of surgery and the available non-surgical treatments. Especially for high-risk patients, unrecognized elevated post-surgery risks may make non-surgical treatments particularly relevant. In this paper, we study the role of information provision and the availability of non-surgical treatments for high-risk patients considering hip replacement surgery in the UK. We develop a discrete choice model of incorrect beliefs about post-surgery outcomes and limited availability of non-surgical treatments, which we estimate using an online choice experiment. In the experiment, participants take the perspective of a hypothetical high-risk patient; we elicit their beliefs about post-surgery outcomes and randomize additional information about these outcomes and the availability of physiotherapy. We find that beliefs differ systematically from predicted post-surgery outcomes and that the provision of additional information has heterogeneous effects on belief accuracy. We show that excluding physiotherapy from the available treatments accounts for four-fifths of the participants' total welfare loss, while incorrect beliefs about post-surgery outcomes account for the remainder. We find evidence that education is a strong predictor of welfare loss from incorrect beliefs.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1571-1596"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring Flexibly? Working Conditions and the Supply of Adult Care","authors":"Joan Costa-Font,&nbsp;Wanying Wang","doi":"10.1002/hec.70133","DOIUrl":"10.1002/hec.70133","url":null,"abstract":"<p>Although flexible employment policies can help employed individuals balance caregiving and paid work, limited evidence has been devoted to examining the effect of working flexibly on the supply of care to older adults. In this paper, we study the impact of flexible working conditions on the supply of informal adult care and mental health. We exploit variation from the 2014 expansion of the <i>Right to Request Flexible Work</i> (RRFW) to employees in the UK. Our findings point to a gendered response to increased employment flexibility. We document a 1.3-percentage-point increase in the likelihood that men provide informal care within the household, alongside less regular daytime work, greater control over working hours, and higher engagement in home production. In contrast, among potential female caregivers, we find that the reform reduced the probability of high-intensity caregiving, which is typically incompatible with employment or related activities. We document that the increased workplace flexibility not only encourages caregiving but also helps reduce gender disparities in unpaid care. We additionally find suggestive evidence of improved mental health outcomes, particularly among men.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1548-1570"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health on the Move: The Impact of Poverty Alleviation Relocation on Healthcare Utilization in China","authors":"Yao Tang,&nbsp;Weiyi Shi,&nbsp;Lin Zhang,&nbsp;Qing Huang,&nbsp;Huanguang Qiu","doi":"10.1002/hec.70124","DOIUrl":"10.1002/hec.70124","url":null,"abstract":"<div>\u0000 \u0000 <p>Limited utilization of healthcare services remains a persistent challenge for poor populations in many countries. This study examines the impact of China's Poverty Alleviation Relocation Program (PARP) on healthcare utilization, utilizing panel data from rural households in 16 counties across eight provinces. Employing a difference-in-differences (DID) framework, we find that relocation leads to a 24.6% increase in clinic visits and a 36.9% increase in hospital visits per household, helping prevent minor illnesses from escalating. Despite higher utilization, relocation does not significantly raise total medical expenditure, out-of-pocket medical costs, or reimbursement levels, due to reduced per-visit costs. Mechanism analysis suggests that relocation improves access to healthcare facilities and boosts household income. Our findings highlight the critical role of combining housing mobility with healthcare system improvements to promote healthcare equity, offering important insights for the design of poverty alleviation strategies in other developing country contexts where access to healthcare remains a critical constraint.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1435-1449"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unintended Consequences of Installing Platform Screen Doors: Displacement and Substitution for Suicide Attempts","authors":"Minsung Park,&nbsp;Youngju Lee,&nbsp;Nobuhiko Nakazawa","doi":"10.1002/hec.70131","DOIUrl":"10.1002/hec.70131","url":null,"abstract":"<div>\u0000 \u0000 <p>This research investigates the displacement and substitution effects of installing physical barriers in metro stations for suicide prevention. Although physical barriers are considered effective at reducing suicides at a given metro station, it remains unexplored whether their installation actually decreases suicide attempts at the macro level. Exploiting the timing of the installation and using platform-level novel data on suicide attempts, we find new evidence showing that installing physical barriers at metro stations causes (1) displacement to other lines without barriers in the same station, (2) displacement to other single-line stations, and (3) substitution to other suicide methods.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1532-1547"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Costs Following Medical Gender-Affirmation: Evidence From Whole-of-Population Australian Administrative Data","authors":"Karinna Saxby,&nbsp;Dennis Petrie,&nbsp;Brendan J. Nolan","doi":"10.1002/hec.70127","DOIUrl":"10.1002/hec.70127","url":null,"abstract":"<p>Gender incongruence in trans and nonbinary (“trans”) populations is often associated with psychological distress and increased demand for mental healthcare. Gender-affirming hormone therapy (GAHT) is a key component of care for many trans people, yet long-term evidence around its cost implications remains limited despite increasing uptake and policy attention worldwide. We provide the first population-based evidence on the healthcare costs of GAHT initiation using longitudinal administrative data from 32,313 trans Australians who initiated testosterone-based GAHT (tGAHT) or estradiol-based GAHT (eGAHT) between 2013 and 2024. Employing a dynamic difference-in-differences design, we estimate the impacts on government expenditure and patient out-of-pocket costs in the 6 years after initiation, using future initiators as controls. We find that initiating tGAHT leads to an additional AUD$3119 (USD$2246) in government expenditure and AUD$143 (USD$103) in out-of-pocket costs over 6 years; corresponding estimates were AUD$8348 (USD$6011) and AUD$1269 (USD$914) for eGAHT recipients. For tGAHT recipients, both government and out-of-pocket costs declined after initiation, with mental healthcare reductions exceeding ongoing hormone therapy expenditure after 6 years. For eGAHT recipients, costs also fell but remained above baseline, driven by sustained prescription spending. Taken together with quality-of-life benefits, our results suggest GAHT is likely to be cost-effective.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1468-1481"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lead in Drinking Water and Child Health: Evidence From Jackson, Mississippi","authors":"Eunsik Chang,&nbsp;Kendall Kennedy,&nbsp;Justine Mallatt","doi":"10.1002/hec.70121","DOIUrl":"10.1002/hec.70121","url":null,"abstract":"<div>\u0000 \u0000 <p>This paper quantifies the impact of prenatal exposure to lead in drinking water on infant health at birth by exploiting a quasi-experiment in Jackson, Mississippi. This setting provides a unique context where behavioral changes to avoid lead-contaminated water are limited due to delayed water testing and dissemination of information about lead contamination. We apply synthetic control using other US cities and Mississippi counties as donors to identify the effect of lead exposure on birth outcomes. We find that prenatal lead exposure in Jackson increased the incidence of low birth weight by approximately 1.5 percentage points, relative to a synthetic Jackson.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1450-1467"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air Pollution Control and Residents' Weight: Empirical Evidence From China's Action Plan","authors":"Nianyu Du,&nbsp;Lele Liu,&nbsp;Liangqiang Jiang,&nbsp;Shijiu Yin","doi":"10.1002/hec.70130","DOIUrl":"10.1002/hec.70130","url":null,"abstract":"<div>\u0000 \u0000 <p>Air pollution is a significant environmental issue with widespread impacts on public health. Evidence on the causal effect of air pollution control policies on weight-related outcomes remains limited. This study fills this gap by leveraging the Air Pollution Prevention and Control Action Plan as a quasi-natural experiment, combining four waves (2010, 2012, 2014, 2016) of panel data from the China Family Panel Studies (CFPS). Employing a difference-in-differences framework, we find that implementing this policy significantly reduces overweight risk among residents. Mechanism analyses indicate that the policy primarily lowers overweight risk by increasing physical exercise frequency and alleviating depressive symptoms. Further heterogeneity analyses show this impact is particularly pronounced among urban residents, young adults, females, and individuals with lower educational attainment. Our findings clarify the causal link between environmental regulation and population health, and provide actionable insights for policymakers to design coordinated interventions that leverage air quality improvements to advance public health goals.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1482-1495"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Various Tax Bases and Rates on Cannabis Consumption Among US Adults Who use Recreational Cannabis","authors":"Yanyun He,&nbsp;Lei Xu,&nbsp;Hojin Park,&nbsp;Shaoying Ma,&nbsp;Ce Shang","doi":"10.1002/hec.70129","DOIUrl":"10.1002/hec.70129","url":null,"abstract":"&lt;p&gt;As an increasing number of states legalize recreational cannabis, it is increasingly important to understand the optimal tax design for recreational cannabis. Currently, various tax bases (weight, potency, price) and rates are used. However, the empirical evidence on the impact of tax-related attributes (pre-tax prices, tetrahydrocannabinol [THC] levels, tax bases, and tax rates) and their interactions on consumption is limited. To address this evidence gap, this study utilizes a split-sample volumetric choice experiment to understand the impact of pre-tax prices, tax bases, tax rates, and THC levels on cannabis consumption and THC intake by US adult users. We further estimated the own- and cross-price elasticities for four cannabis forms (legal flower, illegal flower, edibles, and vaping concentrates). We collected a nationally representative sample of &lt;i&gt;N&lt;/i&gt; = 1525 US adults aged 21+ who reported the past 30-day use of recreational cannabis in June and July 2024. Participants were randomized into seeing one of the three different tax bases, and each person answered 9 choice questions where they were given varying combinations of pre-tax prices, tax rates, and THC levels of the four cannabis products. Zero-inflated negative binomial regressions were used to estimate the impacts of varying factors on the cannabis consumption (units and THC) and own- and cross-price elasticities. The interactions between tax bases and their targeted attributes were explored using a linear model accounting for individual fixed effects. Higher pre-tax prices and tax rates significantly reduce consumption, whereas higher THC levels increase consumption. Compared to a tax rate of 60% of pretax prices or equivalent, an 80% rate does not induce further consumption reduction. The overall price elasticities of cannabis demand range from −0.4 to −0.5, with form- or product-specific price elasticities ranging between −0.2 and −0.4. Illegal and legal flowers are substitutes for each other. Edibles and cartridges are complements for each other. In addition, illegal flowers are substitutes for legal cartridges, and edibles are complements to flowers. While increases in the prices of legal products significantly reduce their consumption, 89% of this reduction may be offset by switching to illegal products. While tax bases do not significantly impact consumption, a potency tax base reduces the consumption of higher potency products, and a price tax base reduces the consumption of higher-priced products. If the illegal market is restricted, policymakers can expect increasing cannabis prices using excise taxes to reduce both unit and THC consumption, while generating tax revenues. However, given the sizable illegal market, a large portion of the consumption reduction due to taxes may be offset by switching to illegal products. Tax rates reduce consumption in addition to base prices. There is room to increase cannabis tax rates to 60% of pretax prices or equivalent to counter ","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1519-1531"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Threat Effects and Work Incentives: Evidence From a Danish Sick Leave Reform","authors":"Jeppe Elholm Madsen","doi":"10.1002/hec.70126","DOIUrl":"10.1002/hec.70126","url":null,"abstract":"<p>This paper investigates the effects of a 2014 policy reform on paid sick leave in Denmark. The reform shortened the eligibility period from 56 to 26 weeks for paid sick leave and introduced a mandatory return-to-work activation program for individuals whose benefits were not extended. The reform initially led to a temporary increase in returns to employment, as individuals on sick leave resumed work to avoid entering the mandatory activation program. However, this effect fades in the long run, and no sustained employment improvements were observed.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1496-1518"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-Urban Migration and the Health of Left-Behind Older Adults","authors":"Tess Stafford,&nbsp;Xiaoyun Zhang,&nbsp;Katja Hanewald","doi":"10.1002/hec.70128","DOIUrl":"10.1002/hec.70128","url":null,"abstract":"<div>\u0000 \u0000 <p>We study the effect of rural-urban migration on the well-being of older adults who remain in rural communities in China, a country that is experiencing extensive rural-urban migration and rapid population aging. We exploit China's historic “sent-down youth” program which temporarily relocated millions of urban youth to rural villages and created lasting social ties between sending cities and receiving villages. These ties coupled with present-day variation in urban growth create exogenous variation in present-day rural-urban migration rates, which we use in an instrumental variables framework to identify the causal effects of migration on health. Results suggest that migration negatively affects the physical, cognitive, and emotional health of older adults that remain behind.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"35 10","pages":"1613-1629"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}