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Health Professional Shortage Area Bonus Payments and Access to Care Under Medicare 医疗专业人员短缺地区的奖金支付和医疗保险下的医疗服务。
IF 2 3区 医学
Health economics Pub Date : 2024-12-23 DOI: 10.1002/hec.4924
Christopher S. Brunt
{"title":"Health Professional Shortage Area Bonus Payments and Access to Care Under Medicare","authors":"Christopher S. Brunt","doi":"10.1002/hec.4924","DOIUrl":"10.1002/hec.4924","url":null,"abstract":"<div>\u0000 \u0000 <p>For over 3 decades, the Centers for Medicare &amp; Medicaid Services (CMS) has provided a bonus payment for outpatient physician services provided to beneficiaries under Medicare Part B in areas designated as Primary Care Health Professional Shortage Areas (HPSAs) during the previous calendar year. Despite the longstanding existence of the program, no studies have explicitly evaluated how previously established physicians practicing in areas subject to an HPSA designation respond to the bonus payments. Using 2012–2019 physician-level data with stacked event study models that control for several characteristics, including the underlying criteria used to construct HPSA scores, I find little to no statistically significant changes in access to care (as measured through total annual beneficiaries treated or services delivered to Medicare beneficiaries) in the years leading up to HPSA designation. However, once physicians become eligible for a 10% bonus payment, their annual number of beneficiaries treated and volume of services decline, consistent with recent empirical work and CMS's actuarial assumptions about how physicians respond to changes in reimbursement.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 4","pages":"601-630"},"PeriodicalIF":2.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881928","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}
引用次数: 0
Incentives, Health, and Retirement: Evidence From a Finnish Pension Reform 激励、健康和退休：来自芬兰养老金改革的证据。
IF 2 3区 医学
Health economics Pub Date : 2024-12-23 DOI: 10.1002/hec.4917
Joonas Ollonqvist, Kaisa Kotakorpi, Mikko Laaksonen, Pekka Martikainen, Jukka Pirttilä, Lasse Tarkiainen
{"title":"Incentives, Health, and Retirement: Evidence From a Finnish Pension Reform","authors":"Joonas Ollonqvist,&nbsp;Kaisa Kotakorpi,&nbsp;Mikko Laaksonen,&nbsp;Pekka Martikainen,&nbsp;Jukka Pirttilä,&nbsp;Lasse Tarkiainen","doi":"10.1002/hec.4917","DOIUrl":"10.1002/hec.4917","url":null,"abstract":"<p>This paper examines, using exogenous variation generated by a Finnish pension reform implemented in 2005, the interplay between health and financial incentives to postpone retirement. Based on detailed administrative data on individual health and retirement behavior, we focus on whether individual reactions to incentives vary according to health status and analyze whether individuals with ill health are also able to take advantage of the potential monetary benefits of delayed retirement created by the reform. We find that on average, individuals react to the financial incentives created by the reform as expected. This result holds for most of the health-related subgroups we analyze. However, those with a long period of sickness absence are less likely to respond to changes in the financial incentives to postpone retirement.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"537-572"},"PeriodicalIF":2.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881929","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}
引用次数: 0
The Dynamic and Heterogeneous Effects of COVID-19 Vaccination Mandates in the USA 美国COVID-19疫苗接种任务的动态和异质性效应
IF 2 3区 医学
Health economics Pub Date : 2024-12-18 DOI: 10.1002/hec.4923
Manh-Hung Nguyen, Viet-Ngu Hoang, Son Nghiem, Lan Anh Nguyen
{"title":"The Dynamic and Heterogeneous Effects of COVID-19 Vaccination Mandates in the USA","authors":"Manh-Hung Nguyen,&nbsp;Viet-Ngu Hoang,&nbsp;Son Nghiem,&nbsp;Lan Anh Nguyen","doi":"10.1002/hec.4923","DOIUrl":"10.1002/hec.4923","url":null,"abstract":"<div>\u0000 \u0000 <p>Mandatory vaccination for COVID-19 has received intense political and ethical debates, while the literature on the causal effects of vaccination mandates on vaccination outcomes is very limited. In this study, we examine the effects of the announcement of vaccine mandates (VMs) for workers working in three sectors, including health, education, and state governments, on the uptake of first-dose and second-dose vaccination across 50 states in the United States of America. We show that VM announcements have heterogeneous effects; hence, standard two-way fixed effects and difference-in-differences estimators are biased. We present evidence for the heterogeneous treatment effects in single and two-treatment settings. In the setting of a single treatment, when treating all VM announcements equally, our results show that VM announcement was associated with an increase of 20.6% first-dose uptake from 1 July to 31 August 2021. In two-treatment settings, our results suggest that VM announcements for workers in health or state government sectors have significant causal effects on first-dose vaccination. Additionally, VM announcements do not have significant causal effects on second-dose uptake. Our results are robust to the choice of differing outcome variables and periods after controlling for state-level covariates, including COVID-19 death, unemployment, and cumulative two-dose vaccination.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"518-536"},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853633","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}
引用次数: 0
Public Health Insurance and Healthcare Utilisation Decisions of Young Adults 年轻人的公共健康保险和医疗保健利用决策。
IF 2 3区 医学
Health economics Pub Date : 2024-12-11 DOI: 10.1002/hec.4922
Muhammad Fikru Rizal
{"title":"Public Health Insurance and Healthcare Utilisation Decisions of Young Adults","authors":"Muhammad Fikru Rizal","doi":"10.1002/hec.4922","DOIUrl":"10.1002/hec.4922","url":null,"abstract":"<div>\u0000 \u0000 <p>This paper investigates the impact of a dependent coverage age-eligibility rule on young adults' health and healthcare utilisation under Indonesia's National Health Insurance (NHI) program. Employing a regression discontinuity design, analysis of the NHI administrative data documents a significant 14.6 to 20.9 percentage points drop in coverage among young adults at age 21, the age cut-off imposed by the rule. Using a large nationally representative household survey, this paper shows that the loss of insurance coverage does not change young adults' health status but markedly decreases the utilisation of outpatient care among those who are ill. Specifically, there is an abrupt 5.3 to 8.4 percentage points reduction in the probability of young adults having any outpatient visit in the past month, primarily driven by lower utilisation of primary care services. The study also finds an increased likelihood of self-treatment and the use of traditional healers, indicating a substitution effect. Further analysis shows a larger impact on those who are poor, less educated, and live in regions with higher healthcare costs.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"500-517"},"PeriodicalIF":2.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812904","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}
引用次数: 0
Diagnosis Related Payment for Inpatient Mental Health Care: Hospital Selection and Effects on Length of Stay 精神卫生住院病人诊断相关支付：医院选择及对住院时间的影响
IF 2 3区 医学
Health economics Pub Date : 2024-12-08 DOI: 10.1002/hec.4920
Franziska Valder, Simon Reif, Harald Tauchmann
{"title":"Diagnosis Related Payment for Inpatient Mental Health Care: Hospital Selection and Effects on Length of Stay","authors":"Franziska Valder,&nbsp;Simon Reif,&nbsp;Harald Tauchmann","doi":"10.1002/hec.4920","DOIUrl":"10.1002/hec.4920","url":null,"abstract":"<div>\u0000 \u0000 <p>We study a policy introducing diagnosis related payment for inpatient mental health care in Germany with rates decreasing over length of stay. Using data on all hospital cases, we first examine which hospitals voluntarily opt into the new scheme. We show that specialized hospitals that treat more complicated cases and are reimbursed more highly under the new scheme select into it. Second, we study the effect of diagnosis related payment on length of stay. We find that diagnosis related payment is associated with large reductions in length of stay but has no effect on mortality, post-acute care, or the ambulatory sector. We argue that the reductions in length of stay are driven by the fact that diagnoses related reimbursement is higher for more complex cases and by payment decreasing over length of stay. This novel evidence contributes to a scarce literature on the role of payment systems for inpatient mental health care and provides important insights for policymakers.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"472-499"},"PeriodicalIF":2.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794646","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}
引用次数: 0
Aggregation Bias and Socioeconomic Gradients in Waiting Time for Hospital Admissions 住院候诊时间的聚集偏差与社会经济梯度。
IF 2 3区 医学
Health economics Pub Date : 2024-12-05 DOI: 10.1002/hec.4913
Fredrik Carlsen, Tor Helge Holmås, Oddvar Kaarboe
{"title":"Aggregation Bias and Socioeconomic Gradients in Waiting Time for Hospital Admissions","authors":"Fredrik Carlsen,&nbsp;Tor Helge Holmås,&nbsp;Oddvar Kaarboe","doi":"10.1002/hec.4913","DOIUrl":"10.1002/hec.4913","url":null,"abstract":"<p>Waiting time is a rationing mechanism that is used in publicly funded healthcare systems as a mean to ensure equal access for equal need. However, several studies suggest that individuals with higher socioeconomic status wait less. These studies typically measure patients' socioeconomic status as an aggregate measure from patients' residential area and the results are hence vulnerable for aggregation biases. We shed light on the magnitude of the aggregation bias by analyzing socioeconomic gradients in waiting times when education and income are measured on three different levels: the individual level, the population cell level, and the municipal level. Our individual level socioeconomic gradient is modest compared with the literature. When socioeconomic status is measured on an aggregate level, we observe stronger associations with socioeconomic variables and less accurate estimates. A researcher who only has access to the aggregate data runs the risk of overstating the magnitude of the socioeconomic gradients.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"371-375"},"PeriodicalIF":2.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784681","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}
引用次数: 0
The Growth of Illicit Drug Use and Its Effects on Murder Rates 非法药物使用的增长及其对谋杀率的影响。
IF 2 3区 医学
Health economics Pub Date : 2024-12-04 DOI: 10.1002/hec.4919
Sujeong Park
{"title":"The Growth of Illicit Drug Use and Its Effects on Murder Rates","authors":"Sujeong Park","doi":"10.1002/hec.4919","DOIUrl":"10.1002/hec.4919","url":null,"abstract":"<p>After years of reductions in the rate of murder in the United States, the national murder rate has increased since 2015. The causes of this trend are generally unknown, though there is some evidence related to narcotic drugs. Arrests related to heroin and cocaine had been stable between 2010 and 2014 before a sudden increase in 2015. Likewise, the number of murders related to narcotic drugs has increased since 2013, with a jump in 2015. Increased rates of these crimes parallel recent dramatic growth in overdoses involving heroin. However, the causal relationship between the recent opioid crisis and the rise in murder rates is missing from the literature. I used OxyContin reformulation as an exogenous shock to illicit markets. OxyContin reformulation led some people who misused OxyContin to switch to illicit opioids. Previous work has shown that areas with higher rates of OxyContin misuse experienced faster growth in heroin overdoses post-reformulation. I tested whether this growth in illicit drug use caused an increase in crime. After reformulation, I find significantly greater relative increases in murder rates in states with high pre-reformulation rates of OxyContin misuse. The results support a causal link between the opioid epidemic and crime.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"456-471"},"PeriodicalIF":2.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779990","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}
引用次数: 0
Willingness to Care—Financial Incentives and Caregiving Decisions 护理意愿--经济激励与护理决定。
IF 2 3区 医学
Health economics Pub Date : 2024-11-24 DOI: 10.1002/hec.4918
Mara Rebaudo, Lena Calahorrano, Kathrin Hausmann
{"title":"Willingness to Care—Financial Incentives and Caregiving Decisions","authors":"Mara Rebaudo,&nbsp;Lena Calahorrano,&nbsp;Kathrin Hausmann","doi":"10.1002/hec.4918","DOIUrl":"10.1002/hec.4918","url":null,"abstract":"<p>As population aging will likely lead to an increasing number of people in need of care, the demand for informal care is expected to rise. In this context, it is often discussed whether financial incentives can motivate more individuals to assume caregiving responsibilities. We analyze the potential effect of financial incentives on the provision of informal care by estimating a structural model with endogenous labor supply and caregiving decisions. This allows us to investigate how both individual wages and financial compensations for caregiving affect the caregiving decision, while accounting for heterogeneous preferences. We find that wage increases are associated with a decreased willingness to care. Financially compensating potential carers for the opportunity costs from caregiving significantly increases the probability of providing care. However, across different subgroups, a large share of about 50% of potential carers remains unwilling to provide care despite the financial incentive. For these individuals, factors such as preferences and social norms outweigh financial considerations in their caregiving decision.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"442-455"},"PeriodicalIF":2.0,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709779","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}
引用次数: 0
Cesarean Section, Childhood Health, and Schooling: Quasi-Experimental Evidence From Denmark, Norway and Sweden 剖腹产、儿童健康和入学：来自丹麦、挪威和瑞典的准实验证据。
IF 2 3区 医学
Health economics Pub Date : 2024-11-22 DOI: 10.1002/hec.4914
Jessica á Rogvi, Aline Bütikofer, Lone Krebs, Hanna Mühlrad, Miriam Wüst
{"title":"Cesarean Section, Childhood Health, and Schooling: Quasi-Experimental Evidence From Denmark, Norway and Sweden","authors":"Jessica á Rogvi,&nbsp;Aline Bütikofer,&nbsp;Lone Krebs,&nbsp;Hanna Mühlrad,&nbsp;Miriam Wüst","doi":"10.1002/hec.4914","DOIUrl":"10.1002/hec.4914","url":null,"abstract":"<p>Despite being one of the most common surgical procedures in industrialized countries, there is limited causal evidence on the long-term consequences of Cesarean section (CS). We study the impacts of CS on health during ages 1–12 years and human capital outcomes at age 16 years, using exogenous variation in the probability of receiving a CS for breech births at term—a group with high CS risk. We use administrative data from Denmark, Norway, and Sweden to show that preventing complicated vaginal births benefits health at birth and reduces the number of all-cause hospital nights during childhood. Our findings for childhood diagnoses for asthma, allergies, diabetes mellitus type 1, and school outcomes are imprecise and do thus not lend strong support for prominent hypotheses on CS causing long-term immune dysfunction disorders and, thereby, worse human capital outcomes.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"431-441"},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692899","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}
引用次数: 0
Health Insurance Coverage Changes Under the Affordable Care Act Among High Housing Cost Households, 2010–18 2010-18 年高住房成本家庭在《平价医疗法案》下的医疗保险覆盖变化。
IF 2 3区 医学
Health economics Pub Date : 2024-11-13 DOI: 10.1002/hec.4912
Yu Cao, Yuxin Su, Guan Wang, Chengcheng Zhang
{"title":"Health Insurance Coverage Changes Under the Affordable Care Act Among High Housing Cost Households, 2010–18","authors":"Yu Cao,&nbsp;Yuxin Su,&nbsp;Guan Wang,&nbsp;Chengcheng Zhang","doi":"10.1002/hec.4912","DOIUrl":"10.1002/hec.4912","url":null,"abstract":"<p>This study examines the impact of the Affordable Care Act (ACA) on health insurance coverage among rent-burdened households—those spending more than 30% of their income on rent—and non-rent-burdened households. Using data from American Community Survey, we find that Medicaid take-up rate increased 8.88 percentage points (pp) among rent-burdened households and 7.54 pp among non-rent-burdened households in expansion states. Conditional on household income and demographic characteristics, rent-burdened households exhibit a 1.5 pp higher likelihood of Medicaid enrollment, with an additional decline of 0.7 pp in employer-sponsored insurance and 1.0 pp in directly purchased insurance enrollment. These effects were more pronounced among individuals aged over 26 and those in states without state-run exchanges. The findings show the importance of tailored Medicaid policies to assist households facing housing burdens, especially for those ineligible for housing vouchers.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 3","pages":"415-430"},"PeriodicalIF":2.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618747","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}
引用次数: 0
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