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Intensive care supply and admission decisions.
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-10 DOI: 10.1016/j.jhealeco.2025.102967
Seth Freedman, Lauren Hoehn-Velasco, Diana R Jolles
{"title":"Intensive care supply and admission decisions.","authors":"Seth Freedman, Lauren Hoehn-Velasco, Diana R Jolles","doi":"10.1016/j.jhealeco.2025.102967","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2025.102967","url":null,"abstract":"<p><p>Over 2005-2019, the number of neonatal intensive care units (NICUs) grew by 10%, and the number of NICU beds increased by 30%. This expansion in intensive care has raised concerns over unwarranted intensive care admissions. In this study, we examine whether the greater supply of NICUs causally raises admission rates. Our event-study results show that an additional NICU opening in a county raises the share of newborns admitted to the NICU by 8%. The majority of new NICU admissions come from healthier newborns (2,500 grams and over) rather than very premature newborns (<1,500 grams). Admission for the smallest newborns (those under 1,500 grams) only increases in counties with limited NICU access. In these areas, greater NICU supply also reduces mortality, but only for very small newborns (<1,500 grams). Together, our findings suggest a tradeoff, where higher NICU supply reduces neonatal mortality for the most vulnerable infants while also raising admission for healthier newborns.</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"102967"},"PeriodicalIF":3.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034036","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
Driving under the influence of allergies: the effect of seasonal pollen on traffic fatalities. 过敏影响下的驾驶：季节性花粉对交通事故死亡的影响。
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-01 Epub Date: 2024-11-24 DOI: 10.1016/j.jhealeco.2024.102945
Shooshan Danagoulian, Monica Deza
{"title":"Driving under the influence of allergies: the effect of seasonal pollen on traffic fatalities.","authors":"Shooshan Danagoulian, Monica Deza","doi":"10.1016/j.jhealeco.2024.102945","DOIUrl":"10.1016/j.jhealeco.2024.102945","url":null,"abstract":"<p><p>Traffic fatalities are the leading cause of mortality in the United States despite being preventable. While several policies have been introduced to improve traffic safety and their effects have been well documented, the role of transitory health shocks or situational factors at explaining variations in fatal traffic accidents has been understudied. Exploring daily variation in city-specific pollen counts, this study finds novel evidence that traffic fatalities increase on days in which the local pollen count is particularly high. We find that the effects are present in accidents involving private vehicles and occur most frequently on the weekends, suggesting potentially the missed opportunity to avoid these fatalities. We do not find similar effects for fleet vehicles. These findings remain robust to alternative specifications and alternative definitions of high pollen count. Taken together, this study finds evidence that a prevalent and transitory exogenous health-shock, namely pollen allergies, increases traffic fatalities. Given our lack of evidence of avoidance, these effects are not mechanical and are likely driven by cognitive impairments that arise as a result of seasonal allergies.</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"102945"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808393","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
Moral hazard and risk adjustment. 道德风险和风险调整。
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-01 Epub Date: 2024-12-11 DOI: 10.1016/j.jhealeco.2024.102955
Gijsbert Zwart
{"title":"Moral hazard and risk adjustment.","authors":"Gijsbert Zwart","doi":"10.1016/j.jhealeco.2024.102955","DOIUrl":"10.1016/j.jhealeco.2024.102955","url":null,"abstract":"<p><p>We analyse a model of optimal risk adjustment in competitive health-insurance markets which suffer from both ex-ante adverse selection and ex-post moral hazard. We find, firstly, that, unlike in an adverse-selection-only market, in an environment where also moral hazard is important, removing insurers' selection incentives requires risk-adjustment payments that do not fully equalize costs among consumer types. Current practice of attempting to correct for all predictable cost differences among consumers is then misguided. Secondly, if the sponsor of the risk-adjustment system is not only concerned with eliminating selection distortions, but also wants to redistribute towards high-risk consumers, the required higher risk-adjustment payments will introduce selection distortions in high-risk consumers' contracts. This leads to excessive equilibrium provision of care for those suffering severe health shocks. Finally, insurer market power creates countervailing incentives, helping the risk adjuster to combat selection distortions but working against a risk-adjustment regulation that also cares about redistribution.</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"102955"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824669","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
Triage at shift changes and distortions in the perception and treatment of emergency patients. 分诊在轮班变化和扭曲的感知和治疗的紧急病人。
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1016/j.jhealeco.2024.102944
Simone Ferro, Chiara Serra
{"title":"Triage at shift changes and distortions in the perception and treatment of emergency patients.","authors":"Simone Ferro, Chiara Serra","doi":"10.1016/j.jhealeco.2024.102944","DOIUrl":"10.1016/j.jhealeco.2024.102944","url":null,"abstract":"<p><p>Employing more than 2 million emergency department (ED) records, we combine machine learning and regression discontinuity to document novel distortions in triage nurses' assessments of patients' conditions and investigate the short- and medium-term consequences for patients. We show that triage nurses progressively become more lenient during their shifts, and identical ED patients arriving just after a shift change are thus assigned a lower priority. We show that these patients receive lower levels of care and require additional emergency care afterward. We conclude that distortions in nurses' initial assessments of urgency bias' medical staff's perceptions.</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"102944"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808394","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
Ridesharing and substance use disorder treatment. 拼车和药物使用障碍治疗。
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-01 Epub Date: 2024-11-23 DOI: 10.1016/j.jhealeco.2024.102941
Conor Lennon, Johanna Catherine Maclean, Keith Teltser
{"title":"Ridesharing and substance use disorder treatment.","authors":"Conor Lennon, Johanna Catherine Maclean, Keith Teltser","doi":"10.1016/j.jhealeco.2024.102941","DOIUrl":"10.1016/j.jhealeco.2024.102941","url":null,"abstract":"<p><p>We examine whether ridesharing provides a meaningful transportation alternative for those who require ongoing healthcare. Specifically, we combine variation in UberX entry across the U.S. with the Treatment Episode Data Set to estimate the effect of ridesharing on admissions to substance use disorder treatment. People needing such treatment report transportation as a barrier to receiving care. We find that UberX entry into a Core Based Statistical Area has no effect on the overall number of treatment admissions. However, we find a decline in non-intensive outpatient treatment which is fully offset by an increase in intensive outpatient treatment. Given the required relative frequency of non-intensive and intensive outpatient treatment in terms of visits per week, our findings indicate that UberX helps to reduce transportation barriers to accessing healthcare. Event-studies show parallel trends in outcomes before UberX entry and results are robust to numerous sensitivity checks.</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"102941"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787547","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
Biological age and predicting future health care utilisation. 生物年龄和预测未来的医疗保健利用。
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-01 Epub Date: 2024-12-06 DOI: 10.1016/j.jhealeco.2024.102956
Apostolos Davillas, Andrew M Jones
{"title":"Biological age and predicting future health care utilisation.","authors":"Apostolos Davillas, Andrew M Jones","doi":"10.1016/j.jhealeco.2024.102956","DOIUrl":"10.1016/j.jhealeco.2024.102956","url":null,"abstract":"<p><p>We explore the role of epigenetic biological age in predicting subsequent health care utilisation. We use longitudinal data from the UK Understanding Society panel, capitalising on the availability of baseline epigenetic biological age measures along with data on general practitioner (GP) consultations, outpatient (OP) visits, and hospital inpatient (IP) care collected 5-12 years from baseline. Using least absolute shrinkage and selection operator (LASSO) regression analyses and accounting for participants' pre-existing health conditions, baseline biological underlying health, and socio-economic predictors we find that biological age is selected as a predictor of future GP consultations and IP care, while chronological rather than biological age is selected for future OP visits. Post-selection prediction analysis and Shapley-Shorrocks decompositions, comparing our preferred prediction models to models that replace biological age with chronological age, suggest that biological ageing has a stronger role in the models predicting future IP care as opposed to \"gatekeeping\" GP consultations.</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"102956"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822825","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 light of life: The effects of sunlight on suicide. 生命之光：阳光对自杀的影响。
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-01 Epub Date: 2024-12-03 DOI: 10.1016/j.jhealeco.2024.102947
Shinsuke Tanaka, Tetsuya Matsubayashi
{"title":"The light of life: The effects of sunlight on suicide.","authors":"Shinsuke Tanaka, Tetsuya Matsubayashi","doi":"10.1016/j.jhealeco.2024.102947","DOIUrl":"10.1016/j.jhealeco.2024.102947","url":null,"abstract":"<p><p>This study examines the causal effects of sunlight exposure on suicide rates. Leveraging county-month-year data on solar insolation and suicide rates in the U.S. from 1979 to 2004, we provide first robust evidence that insufficient sunlight increases suicide rates. We also find that insufficient sunlight increases Google searches containing depressive language, suggesting a potential adverse impact on mental well-being. Importantly, our findings favor a biological pathway over alternative mechanisms. The estimated effect of sunlight on suicide, often exceeding other interventions in magnitude, sheds new light on sunlight as a significant risk factor in suicide incidence.</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"102947"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822794","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
Is supported employment effective for Disability Insurance recipients with mental health conditions? Evidence from a randomized experiment in Belgium. 支持就业对有精神健康问题的残疾保险受助人有效吗？来自比利时随机实验的证据。
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2024-12-26 DOI: 10.1016/j.jhealeco.2024.102958
Sébastien Fontenay, Ilan Tojerow
{"title":"Is supported employment effective for Disability Insurance recipients with mental health conditions? Evidence from a randomized experiment in Belgium.","authors":"Sébastien Fontenay, Ilan Tojerow","doi":"10.1016/j.jhealeco.2024.102958","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2024.102958","url":null,"abstract":"<p><p>We conduct a randomized experiment (n = 600) to evaluate a Supported Employment (SE) program that, through intensive job coaching and follow-along support, aims to increase work activity of Belgian Disability Insurance (DI) recipients with mental health conditions. The control group gets regular vocational rehabilitation. After a 30-month follow-up period, we find that SE increases the probability of working while claiming DI by 7.5 percentage points and reduces the amount of DI benefit received by 110 euros per month (-9.5 percent).</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"102958"},"PeriodicalIF":3.4,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903843","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 pharmacist will see you now: Pharmacist prescribed contraceptives and fertility rates. 药剂师现在要见你了：药剂师开了避孕药具和生育率。
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2024-12-18 DOI: 10.1016/j.jhealeco.2024.102942
Daniel Grossman, Arijit Ray, Allyssa Wadsworth
{"title":"The pharmacist will see you now: Pharmacist prescribed contraceptives and fertility rates.","authors":"Daniel Grossman, Arijit Ray, Allyssa Wadsworth","doi":"10.1016/j.jhealeco.2024.102942","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2024.102942","url":null,"abstract":"<p><p>Policies that increase contraceptive access for young women and their partners are a potentially low-cost way of reducing unintended pregnancies and improving later life outcomes. Several states have recently implemented laws that allow pharmacists to prescribe contraceptives to women without the need to see a physician. We study the effect of these state laws on fertility rates. Using US Natality files for 2014-2020, we employ a difference-in-differences strategy using the 13 states that had enacted a law until the first quarter of 2020 as the treated group, and the 15 policy-implementing states post-2020 quarter 1 as the control group. We find approximately 0.5 fewer births per 1000 women aged 15-49 per quarter occur post law implementation, compared to control states. The effect of the policy appears to be focused among women aged 25-34 and 40-44 and women with a high school education or less.</p>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"102942"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899834","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
How does undervaluation in medical savings accounts (MSAs) affect healthcare utilization? Evidence from administrative data in China 医疗储蓄账户（msa）的低估如何影响医疗保健利用？来自中国行政数据的证据
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2024-12-01 DOI: 10.1016/j.jhealeco.2024.102946
Wei Huang , Xiaoyan Lei , Yuqi Ta
{"title":"How does undervaluation in medical savings accounts (MSAs) affect healthcare utilization? Evidence from administrative data in China","authors":"Wei Huang ,&nbsp;Xiaoyan Lei ,&nbsp;Yuqi Ta","doi":"10.1016/j.jhealeco.2024.102946","DOIUrl":"10.1016/j.jhealeco.2024.102946","url":null,"abstract":"<div><div>This study examines how the undervaluation of funds in Medical Savings Accounts (MSAs) influences healthcare utilization in China. Given that MSA funds are restricted to healthcare expenses, individuals may undervalue these funds relative to cash, leading to potential overuse of health care. Through an event study approach using administrative data, we find significant reductions in healthcare utilization after MSA balances are depleted—outpatient care expenses drop by 49 percent, and drugstore purchases decrease by 41 percent. These effects persist across socioeconomic groups, indicating that liquidity constraints are not a major factor. Our back-of-the-envelope calculations suggest that insured individuals undervalue MSA funds by 40–70 %. This research sheds light on the behavioral impacts of MSAs and the broader implications of perceived price distortions in health insurance.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"98 ","pages":"Article 102946"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748179","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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