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The Effect of a Free Family Planning Program on Fertility 免费计划生育计划对生育率的影响
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2022-09-19 DOI: 10.1086/722557
Aaron M. Gamino
{"title":"The Effect of a Free Family Planning Program on Fertility","authors":"Aaron M. Gamino","doi":"10.1086/722557","DOIUrl":"https://doi.org/10.1086/722557","url":null,"abstract":"In this paper, I estimate the effect of access to family planning clinics on birth rates. The Louisiana Family Planning Program opened more than 140 clinics between 1965 and 1970. By 1971, a family planning clinic was operating in each Louisiana county. Exploiting the variation in dates when clinics began operating in each county, I employ two-way fixed effects and staggered difference-in-differences designs to assess the impact of family planning access on birth rates. I find that clinic openings led to a 5 to 7 percent decrease in birth rates.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"9 1","pages":"127 - 147"},"PeriodicalIF":3.7,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46089218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do Class Size Reductions Protect Students from Infectious Diseases? 缩减班级规模能保护学生免受传染病的侵害吗？
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2022-09-01 DOI: 10.1086/719354
M. Oikawa, Ryuichi Tanaka, S. Bessho, H. Noguchi
{"title":"Do Class Size Reductions Protect Students from Infectious Diseases?","authors":"M. Oikawa, Ryuichi Tanaka, S. Bessho, H. Noguchi","doi":"10.1086/719354","DOIUrl":"https://doi.org/10.1086/719354","url":null,"abstract":"We evaluate the causal effect of class size (number of students in a classroom) on incidence of class closure due to the flu, as an outcome of an infectious disease epidemic. For identification of causal effects, we apply a regression discontinuity design using discontinuous variation of class sizes, around the class size cap set by regulation, to administrative data of public primary and middle school students in one of the largest municipalities within the Tokyo metropolitan area from 2015 to 2017. Most classrooms in Japan are constructed in accordance with a standard of classroom area, 63 square meters; class size reduction improves social distancing among students in a classroom. We find that class size reduction is effective in reducing class closures due to the flu: a one-unit reduction of class size decreases class closure by about 5 percent. Additionally, forming small classes with 27 students at most, satisfying the social distancing of 1.5 meters recommended to prevent droplet infection including influenza and COVID-19, reduces class closure by about 90 percent. Moreover, we find that the older the students, the larger the effects of class size reduction. Our findings provide evidence for the effectiveness of social distancing policy in primary and middle schools to protect students from droplet infectious disease spread, including COVID-19.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"8 1","pages":"449 - 476"},"PeriodicalIF":3.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44034411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Value of an Additional Day of Post-acute Care in a Skilled Nursing Facility 在专业护理机构额外进行一天急性期后护理的价值
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2022-07-22 DOI: 10.1086/721706
R. Werner, Norma B. Coe, Mingyu Qi, R. Konetzka
{"title":"The Value of an Additional Day of Post-acute Care in a Skilled Nursing Facility","authors":"R. Werner, Norma B. Coe, Mingyu Qi, R. Konetzka","doi":"10.1086/721706","DOIUrl":"https://doi.org/10.1086/721706","url":null,"abstract":"With ongoing efforts to improve the value of health care in the United States and reduce wasteful spending, we examine empirically the value trade-offs involved in an additional day in a skilled nursing facility (SNF) after hospital discharge. To control for potential endogeneity, we use the percentage of Medicare beneficiaries enrolled in Medicare Advantage in each county-year as an instrument for individuals’ SNF length of stay among Traditional Medicare beneficiaries, as local Medicare Advantage penetration puts downward pressure on SNF length of stay for all SNF patients but does not directly affect utilization management of those enrolled in Traditional Medicare. We also test for heterogeneity in treatment effect across patients by clinical complexity and two non-health-related factors, marital status and nursing home profit status. We find that one additional day in a SNF lowers short-term readmission rates, but this effect is small and heterogeneous across patient types. The most clinically complex patients (those with the longest predicted SNF stays) benefit the most from an additional SNF day, as do patients whose stays are shorter because of non-health-related factors. The cost savings from reduced readmission rates are small and do not offset the additional SNF costs.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"9 1","pages":"1 - 21"},"PeriodicalIF":3.7,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46147551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Childhood Health Conditions and Lifetime Labor Market Outcomes 儿童健康状况与终身劳动力市场结果
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2022-06-29 DOI: 10.1086/721573
M. Flores, B. Wolfe
{"title":"Childhood Health Conditions and Lifetime Labor Market Outcomes","authors":"M. Flores, B. Wolfe","doi":"10.1086/721573","DOIUrl":"https://doi.org/10.1086/721573","url":null,"abstract":"We explore the influence that different dimensions of early life health, such as the experience of epilepsy or a significant mental, physical, or general health problem, have on numerous lifetime labor market outcomes and patterns of life cycle employment. The data we use include over 81,000 males and females from the 29 countries in the Survey of Health, Ageing, and Retirement in Europe. Our results show that for men, all four dimensions of early life health impose a penalty for nearly all the lifetime labor market outcomes we consider, but those with childhood mental health problems tend to do worst. These penalties are often only somewhat larger than those of men with epilepsy but more than twice and five times larger than those with, respectively, poor general or adverse physical health during childhood. Women appear less affected by adverse early life health, although we find evidence of similar employment penalties for those with epilepsy and poor general health during childhood. Our life cycle analysis is consistent but provides more insight into the timing of reduced employment and full-time employment, thereby extending earlier studies in this literature. Overall, our results highlight the potential lifetime work gains for public health policies that help to prevent or comprehensively treat poor general health, mental health problems, or epilepsy during childhood.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"8 1","pages":"506 - 533"},"PeriodicalIF":3.7,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49578315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Student Aid, Higher Education, and Long-Run Health 学生资助、高等教育与长期健康
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2022-06-29 DOI: 10.1086/721567
Barton Willage
{"title":"Student Aid, Higher Education, and Long-Run Health","authors":"Barton Willage","doi":"10.1086/721567","DOIUrl":"https://doi.org/10.1086/721567","url":null,"abstract":"Financial aid lowers the cost of higher education and improves educational attainment. Based on the correlation between education and health, one might expect aid to improve health, but little evidence exists. I use a shock in Social Security benefits that occurred in 1981 to test the relationship between aid, education, and health. Minor children of retired, disabled, or deceased parents are eligible for their own Social Security benefits, and until 1981 college-aged recipients could continue to receive these benefits conditional on college enrollment. Using difference-in-differences, I show that aid reduced women’s long-run body mass index and general health, but had no effect on men. I find that financial aid improved educational attainment for beneficiaries, which is the plausible mechanism between aid and health. Consistent with the effects on health, the educational effects are concentrated in women. Finally, I use Social Security benefits as an instrument for attending college to estimate the effect of education on long-run weight and general health.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"8 1","pages":"549 - 579"},"PeriodicalIF":3.7,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44529855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paying Adolescents for Health Screenings Works 支付青少年健康检查费用
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2022-06-29 DOI: 10.1086/721571
M. Halla, G. Pruckner, T. Schober
{"title":"Paying Adolescents for Health Screenings Works","authors":"M. Halla, G. Pruckner, T. Schober","doi":"10.1086/721571","DOIUrl":"https://doi.org/10.1086/721571","url":null,"abstract":"With regard to their future health, adolescents are at a critical stage. Previous evaluations have shown that health screenings, counseling, and other intervention programs during this phase of life are important, particularly for those with a low socioeconomic background. Unfortunately, adolescents tend to have little interest in preventive programs. We designed a field experiment to evaluate the effectiveness of financial incentives to promote participation in health screenings. Our study comprises more than 10,000 participants, observed via high-quality administrative data from Austria. The treatment group received a €40 shopping voucher if they participated in an age-specific health screening. On average, the financial incentive increased the likelihood of participation by 280 percent. Treatment effects are comparably larger for children in families with a higher socioeconomic status, and of parents with a revealed preference for secondary health prevention.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"8 1","pages":"534 - 548"},"PeriodicalIF":3.7,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43615501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
INFORMATION GAPS AND HEALTH INSURANCE ENROLLMENT: Evidence from the Affordable Care Act Navigator Programs. 信息差距和健康保险登记
IF 2 2区 经济学
American Journal of Health Economics Pub Date : 2022-01-01 Epub Date: 2022-09-22 DOI: 10.1086/721569
Rebecca Myerson, Honglin Li
{"title":"INFORMATION GAPS AND HEALTH INSURANCE ENROLLMENT: Evidence from the Affordable Care Act Navigator Programs.","authors":"Rebecca Myerson, Honglin Li","doi":"10.1086/721569","DOIUrl":"10.1086/721569","url":null,"abstract":"<p><p>We studied the impact of Affordable Care Act navigator programs on health insurance coverage, using the 80 percent cut in program funding under the Trump administration as a natural experiment. Our study design exploited county-level differences in the program prior to funding cuts. We did not find that cuts to the program significantly decreased rates of marketplace coverage or any health insurance coverage by 2019; however, our estimates could not rule out marketplace coverage declines of up to 2.7 percent (point estimate -1.3 percent, 95 percent CI: 2.7 percent to 0.1 percent), or total coverage declines of up to 1.8 percentage points (point estimate -0.8 percentage points or -1.2 percent, 95 percent CI: -1.8 to 0.2). Cuts to the navigator program significantly decreased marketplace coverage and total coverage among lower-income adults, and significantly decreased total coverage among adults under age 45, Hispanic adults, and adults who speak a language other than English at home. We found no significant impact of the cuts on Medicaid enrollment (95 percent CI: -1.9 percentage points to 0.5 percentage points); most uninsured people in the states we studied lived in locations that had not implemented Medicaid eligibility expansions. These findings suggest that before the funding cuts, navigators were helping underserved consumers obtain coverage.</p>","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"8 1","pages":"477-505"},"PeriodicalIF":2.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41758392","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
Do opioid prescriptions lead to fatal car crashes? 阿片类药物处方会导致致命车祸吗?
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2022-01-01 DOI: 10.1086/718511
Michael R Betz, Lauren E Jones
{"title":"Do opioid prescriptions lead to fatal car crashes?","authors":"Michael R Betz,&nbsp;Lauren E Jones","doi":"10.1086/718511","DOIUrl":"https://doi.org/10.1086/718511","url":null,"abstract":"<p><p>Widespread opioid misuse suggests a potential for increased fatal car crashes. However, opioid use may not necessarily lead to additional crashes if drivers respond to opioid prevalence by substituting away from more inebriating intoxicants like alcohol. Combining data on local opioid prescription rates and car crashes from the Fatality Analysis and Reporting System, we use two-way fixed effects models to test the direction of the association between prescribing intensity and crash fatalities between 2007 and 2016. We estimate that a 10 percent increase in the local prescription rate is associated with a 1 percent increase in the number of driver deaths in motor vehicle accidents. The association is robust to several model specifications, and isolated to drivers most affected by the opioid crisis: males and 25 to 34 year-olds.</p>","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"8 3","pages":"359-386"},"PeriodicalIF":3.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997667/pdf/nihms-1856121.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9106040","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: 3
Physician Competition And Low-Value Health Care 医师竞争和低价值医疗保健
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2021-12-13 DOI: 10.1086/718509
Anthony Scott, Jinhu Li, H. Gravelle, M. McGrail
{"title":"Physician Competition And Low-Value Health Care","authors":"Anthony Scott, Jinhu Li, H. Gravelle, M. McGrail","doi":"10.1086/718509","DOIUrl":"https://doi.org/10.1086/718509","url":null,"abstract":"Although countries have implemented pro-competitive reforms in health care to reduce costs and improve quality, there is limited evidence on the effect of competition on quality of care provided by physicians. We study the effect of competition on the provision of low-value—ineffective or harmful—health care by general practitioners (GPs). We use rich patient-level data on GP consultations in Australia and measure competition as distance to other GPs. Our study found that GPs facing more competition provide lower quality of care by ordering more imaging for low back pain and uncomplicated acute bronchitis. We find similar but smaller and insignificant effects of competition on prescribing antibiotics for coughs and colds. Competition can have mixed effects across different conditions because of differences in GPs’ beliefs and patient expectations about the effectiveness of care, as well as differences in demand, costs, and profit.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"8 1","pages":"252 - 274"},"PeriodicalIF":3.7,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45773279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
The Demand for Individual Insurance 个人保险需求
IF 3.7 2区 经济学
American Journal of Health Economics Pub Date : 2021-11-11 DOI: 10.1086/718161
Conor Ryan, R. Feldman, Stephen L. Parente
{"title":"The Demand for Individual Insurance","authors":"Conor Ryan, R. Feldman, Stephen L. Parente","doi":"10.1086/718161","DOIUrl":"https://doi.org/10.1086/718161","url":null,"abstract":"We use a novel data set from a private online marketplace to estimate the demand for individual health insurance among a set comprising many high-income households across 18 states. Households earning more than four times the federal poverty level (FPL) are willing to pay $30 to $135 per month to increase the actuarial value of their insurance by 10 percentage points, much less than households earning less than 2.5 times FPL. Higher-income households are also less likely to forgo insurance because of a premium increase. These results are important for understanding the effect of health reform proposals targeting higher-income populations.","PeriodicalId":45056,"journal":{"name":"American Journal of Health Economics","volume":"8 1","pages":"275 - 299"},"PeriodicalIF":3.7,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49248579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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