American Journal of Health Economics最新文献

Immigration, the Long-Term Care Workforce, and Elder Outcomes in the US. 美国的移民、长期护理劳动力和老年结局。

IF 1.9 2区经济学

American Journal of Health Economics Pub Date : 2026-06-18 DOI: 10.1086/737645

David C Grabowski, Jonathan Gruber, Brian E McGarry

{"title":"Immigration, the Long-Term Care Workforce, and Elder Outcomes in the US.","authors":"David C Grabowski, Jonathan Gruber, Brian E McGarry","doi":"10.1086/737645","DOIUrl":"10.1086/737645","url":null,"abstract":"The U.S. nursing home industry faces severe labor shortages that have worsened following the Covid-19 pandemic. Because nursing homes are highly reliant on immigrant labor, a frequently proposed policy lever to address shortages is to increase national immigration flows. Although debates over immigration remain contentious, existing evidence using geographic-level data indicates that greater immigration increases the supply of nurses and nurse aides with some improvements in nursing home quality. This paper extends earlier work using nursing home- and patient-level data and shift-share analyses to assess the impact of increased immigration on nursing home staffing and care quality. Additionally, we explore heterogeneity in observed treatment effects and potential mechanisms through which changes in patient outcomes occur. In our preferred specifications, we show that increased immigration significantly raises the direct care staffing ratios of nursing homes, with effects concentrated among full-time workers. We then show that this has a robust and very positive effect on a variety of patient outcomes. Effects were strongest from increases in Hispanic immigrants. We find suggestive evidence that immigrants increase both the supply and quality of the nursing home workforce, supporting the critical role that immigration may play in addressing long-standing staffing and quality issues in this industry.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

E-CIGARETTE FLAVOR RESTRICTIONS' EFFECTS ON TOBACCO PRODUCT SALES. 电子烟口味限制对烟草产品销售的影响。

IF 1.9 2区经济学

American Journal of Health Economics Pub Date : 2026-03-23 DOI: 10.1086/734689

Abigail S Friedman, Alex C Liber, Alyssa Crippen, Michael F Pesko

{"title":"E-CIGARETTE FLAVOR RESTRICTIONS' EFFECTS ON TOBACCO PRODUCT SALES.","authors":"Abigail S Friedman, Alex C Liber, Alyssa Crippen, Michael F Pesko","doi":"10.1086/734689","DOIUrl":"10.1086/734689","url":null,"abstract":"More than 385 US localities and 7 states have implemented restrictions on sales of flavored electronic nicotine delivery systems (ENDS), yet these policies' effects remain unclear. Utilizing comprehensive data on tobacco product flavor policies linked to retail sales data from January 2018 through March 2023, we estimate the effects of these restrictions. Our findings reveal that ENDS flavor restrictions yield substantial decreases in total ENDS sales, primarily owing to significant declines in flavored ENDS sales alongside nonsignificant increases in unflavored ENDS sales. Further analyses find that ENDS flavor restrictions increase sales of combustible cigarettes, a more harmful product: 11 to 15 additional cigarettes are purchased for every 1 less 0.7 mL ENDS pod sold because of these policies. This uptick in cigarette sales stems primarily from non-menthol cigarettes and includes brands disproportionately used by underage youth. These findings suggest that the public health benefits from reducing ENDS sales via flavor restrictions may be offset by the public health costs of consequent increases in cigarette consumption.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How Benchmark Changes Affect Participation in Accountable Care Organizations: Prospects for Voluntary Payment Models. 基准如何影响问责制医疗组织的参与:自愿支付模式的前景

IF 2 2区经济学

American Journal of Health Economics Pub Date : 2025-01-01 Epub Date: 2024-12-17 DOI: 10.1086/726748

Alice J Chen, J Michael McWilliams

{"title":"How Benchmark Changes Affect Participation in Accountable Care Organizations: Prospects for Voluntary Payment Models.","authors":"Alice J Chen, J Michael McWilliams","doi":"10.1086/726748","DOIUrl":"10.1086/726748","url":null,"abstract":"In voluntary alternative payment models, participation is essential for model viability and the progression of provider payment reform. We study participation decisions of accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP). We leverage a natural experiment in which a 2017 rule change introduced differential shocks to an ACO's baseline spending and performance-year spending. The net effect was an effective change in benchmarks that varied across ACOs. Dropout was 7 percentage points more likely among ACOs with effective benchmark decreases. While small reductions in the effective benchmark did not affect program participation, larger reductions increased dropout by 11 percentage points. ACOs with spending already above their benchmarks were particularly sensitive to effective benchmark reductions, consistent with the program's weak long-term incentives to reduce spending. Our results highlight the causal role benchmarks play in determining ACO participation and the need to consider the consequences of participation effects in the design of new payment models.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":" ","pages":"38-62"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41519318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","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 Effects of Post-Acute Care Payment Reform on Caregiving 急性期后护理付款改革对护理工作的影响

IF 3.7 2区经济学

American Journal of Health Economics Pub Date : 2024-01-04 DOI: 10.1086/729337

Rachel M. Werner, Norma B. Coe, Seiyoun Kim, R. Konetzka

引用次数: 0

Gender Identity-, Race-, and Ethnicity-Based Discrimination in Access to Mental Health Care. 基于性别认同、种族和民族的精神卫生保健歧视

IF 2 2区经济学

American Journal of Health Economics Pub Date : 2024-01-01 Epub Date: 2024-04-09 DOI: 10.1086/728931

Luca Fumarco, Benjamin J Harrell, Patrick Button, David J Schwegman, E Dils

{"title":"Gender Identity-, Race-, and Ethnicity-Based Discrimination in Access to Mental Health Care.","authors":"Luca Fumarco, Benjamin J Harrell, Patrick Button, David J Schwegman, E Dils","doi":"10.1086/728931","DOIUrl":"10.1086/728931","url":null,"abstract":"Racial, ethnic, and gender minorities face mental health disparities. While mental health care can help, minorities could face discriminatory barriers in accessing it. Discrimination may be particularly pronounced in mental health care because providers have more discretion over accepting patients. Research documents discrimination, including in access to health care, but there is limited empirical research on discrimination in access to mental health care. We provide the first experimental evidence, from an audit (\"simulated patients\") study, of the extent to which transgender and non-binary people, African Americans, and Hispanics face discrimination in access to mental health care appointments. We find significant discrimination against transgender or non-binary African Americans and Hispanics. We do not find evidence of discrimination against White transgender and non-binary prospective patients. We are mostly inconclusive as to if cisgender African Americans or Hispanics face discrimination, except we find evidence of discrimination against cisgender African American women. Our study occurred before and during the initial onset of the COVID-19 pandemic and we study if COVID-19 affected access to (or discrimination in access to) appointments. We find some suggestive evidence that increased COVID-19 intensity may have reduced access, and discrimination in access, to appointments.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"10 2","pages":"182-214"},"PeriodicalIF":2.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12547971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","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 Long-Term Impacts of Cigarette Taxes on Smoking. 香烟税对吸烟的长期影响。

IF 2 2区经济学

American Journal of Health Economics Pub Date : 2024-01-01 Epub Date: 2024-10-01 DOI: 10.1086/726584

Julia M Dennett

引用次数: 0

From Lawn Care to Home Care: Undocumented Immigration and Aging in Place 从草坪护理到家庭护理：无证移民与居家养老

IF 3.7 2区经济学

American Journal of Health Economics Pub Date : 2023-11-21 DOI: 10.1086/728717

Youngjoo Jung, Domininkas Mockus

引用次数: 0

Heterogeneous Effects of the Affordable Care Act on Emergency Department Visits and Payer Composition among Older Adults by Race and Ethnicity 平价医疗法案》对不同种族和族裔老年人急诊就诊和付款人构成的不同影响

IF 3.7 2区经济学

American Journal of Health Economics Pub Date : 2023-11-21 DOI: 10.1086/728787

Y. A. Antwi, Giacomo Meille, Asako Moriya

引用次数: 0

Financial Risk and the Decision of Small Employers to Self-Fund Health Insurance: Evidence from Stop Loss Regulation in California 财务风险与小雇主自筹医疗保险决策:来自加州止损规定的证据

2区经济学

American Journal of Health Economics Pub Date : 2023-11-06 DOI: 10.1086/728588

Mark Meiselbach, Matthew Eisenberg

引用次数: 0

Increased Schooling Reduces Hospitalization Later in Life: New Evidence with Optimal Instruments from the United States 增加学校教育减少晚年住院治疗:来自美国的最佳仪器的新证据

2区经济学

American Journal of Health Economics Pub Date : 2023-11-06 DOI: 10.1086/728403

Dahai Yue, Ninez A. Ponce, Jack Needleman, Susan L. Ettner, Adriana Lleras-Muney

引用次数: 0