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How do hospitals respond to input regulation? Evidence from the California nurse staffing mandate 医院如何应对输入监管？来自加利福尼亚州护士配置授权的证据。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-11-06 DOI: 10.1016/j.jhealeco.2023.102826
Chandni Raja
{"title":"How do hospitals respond to input regulation? Evidence from the California nurse staffing mandate","authors":"Chandni Raja","doi":"10.1016/j.jhealeco.2023.102826","DOIUrl":"10.1016/j.jhealeco.2023.102826","url":null,"abstract":"<div><p>Mandated minimum nurse-to-patient ratios have been the subject of active debate in the U.S. for over twenty years and are under legislative consideration today in several states and at the federal level. This paper uses the 1999 California nurse staffing mandate as an empirical setting to estimate the causal effects of minimum ratios on hospitals. Minimum ratios led to a 58 min increase in nursing time per patient day and 9 percent increase in the wage bill per patient day in the general medical/surgical acute care unit among treated hospitals. Hospitals responded on several margins: increased use of lower-licensed and younger nurses, reduced capacity by 16 beds (14 percent), and increased bed utilization rates by 0.045 points (8 percent). Using administrative data on discharges for acute myocardial infarction (AMI), I find a significant reduction in length of stay (5 percent) and no effect on the 30-day all-cause readmission rate. The null effect on readmissions suggests that length of stay declined not because hospitals were discharging AMI patients “quicker and sicker”, rather, AMI patients recovered more quickly due to an improvement in care quality per day.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102826"},"PeriodicalIF":3.5,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523164","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 minimum wage laws affect employer-sponsored insurance provision? 最低工资法是否影响雇主赞助的保险条款？
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-10-27 DOI: 10.1016/j.jhealeco.2023.102825
Mark K. Meiselbach , Jean M. Abraham
{"title":"Do minimum wage laws affect employer-sponsored insurance provision?","authors":"Mark K. Meiselbach ,&nbsp;Jean M. Abraham","doi":"10.1016/j.jhealeco.2023.102825","DOIUrl":"10.1016/j.jhealeco.2023.102825","url":null,"abstract":"<div><p>Employers may respond to minimum wage increases by adjusting their health benefits. We examine the impact of state minimum wage increases on employer health benefit offerings using the 2002–2020 Medical Expenditure Panel Survey – Insurance/Employer Component data. Our primary regression specifications are difference-in-differences models that estimate the relationship between within-state changes in employer-sponsored insurance and minimum wage laws over time. We find that a $1 increase in minimum wages is associated with a 0.92 percentage point (p.p.) decrease in the percentage of employers offering health insurance, largely driven by small employers and employers with a greater share of low-wage employees. A $1 increase is also associated with a 1.83 p.p. increase in the prevalence of plans with a deductible requirement, but we do not find consistent evidence that other benefit characteristics are affected. We find no consequent change in uninsurance, likely explained by an increase in Medicaid enrollment.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102825"},"PeriodicalIF":3.5,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784537","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
Physician responses to Medicare reimbursement rates 医生对医疗保险报销率的反应
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-10-24 DOI: 10.1016/j.jhealeco.2023.102816
Aileen M. Devlin , Grace McCormack
{"title":"Physician responses to Medicare reimbursement rates","authors":"Aileen M. Devlin ,&nbsp;Grace McCormack","doi":"10.1016/j.jhealeco.2023.102816","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2023.102816","url":null,"abstract":"<div><p>This paper investigates how office-based physicians respond to Medicare reimbursement changes. Using variation from an Affordable Care Act policy that increased reimbursements for office-based care in four states, we use a triple difference analysis, comparing physicians with higher and lower reimbursement changes in treated states to similar physicians in untreated states. We find two mechanisms through which physicians respond. First, the reimbursement change affected integration—physicians with larger increases in office-based reimbursement were less likely to vertically integrate with hospitals and more likely to continue providing office-based care than physicians with smaller reimbursement increases. Second, we find some evidence that physicians who continued practicing in an office setting increased the volume of services provided.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102816"},"PeriodicalIF":3.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49818513","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
Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data 非正式护理会延迟进入疗养院吗？荷兰相关调查和行政数据的证据。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-10-20 DOI: 10.1016/j.jhealeco.2023.102831
Julien Bergeot , Marianne Tenand
{"title":"Does informal care delay nursing home entry? Evidence from Dutch linked survey and administrative data","authors":"Julien Bergeot ,&nbsp;Marianne Tenand","doi":"10.1016/j.jhealeco.2023.102831","DOIUrl":"10.1016/j.jhealeco.2023.102831","url":null,"abstract":"<div><p>We assess whether informal care receipt affects the probability of transitioning to a nursing home. Available evidence derives from the US, where nursing home stays are often temporary. Exploiting linked survey and administrative data from the Netherlands, we use the gender mix of children to retrieve exogenous variation in informal care receipt. We find that informal care increases the chance of an admission within a three-year period for individuals with severe functional limitations, and increases the costs incurred on formal home care. For individuals with mild limitations, informal care substantially decreases total care costs, whereas its effect on nursing home admission is unclear. Further, informal care results in lower post-acute care use and hospital care costs, and does not increase mortality. Promoting informal care cannot be expected to systematically result in lower institutionalization rate and care costs, but it may nonetheless induce health benefits for its recipients.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102831"},"PeriodicalIF":3.5,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S016762962300108X/pdfft?md5=c7df85a62ec2bc3b237c22718e788523&pid=1-s2.0-S016762962300108X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428602","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 effects of early-life pollution exposure: Evidence from the London smog 早期接触污染的长期影响：来自伦敦烟雾的证据。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-10-16 DOI: 10.1016/j.jhealeco.2023.102827
Stephanie von Hinke , Emil N. Sørensen
{"title":"The long-term effects of early-life pollution exposure: Evidence from the London smog","authors":"Stephanie von Hinke ,&nbsp;Emil N. Sørensen","doi":"10.1016/j.jhealeco.2023.102827","DOIUrl":"10.1016/j.jhealeco.2023.102827","url":null,"abstract":"<div><p>This paper uses a large UK cohort to investigate the impact of early-life pollution exposure on individuals’ human capital and health outcomes in older age. We compare individuals who were exposed to the London smog in December 1952 whilst <em>in utero</em> or in infancy to those born after the smog and those born at the same time but in unaffected areas. We find that those exposed to the smog have substantially lower fluid intelligence and worse respiratory health, with some evidence of a reduction in years of schooling.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102827"},"PeriodicalIF":3.5,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693506","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: 6
Mass vaccination and educational attainment: Evidence from the 1967–68 Measles Eradication Campaign 大规模疫苗接种和教育程度:来自1967-68年消灭麻疹运动的证据
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-10-10 DOI: 10.1016/j.jhealeco.2023.102828
Philipp Barteska , Sonja Dobkowitz , Maarit Olkkola , Michael Rieser
{"title":"Mass vaccination and educational attainment: Evidence from the 1967–68 Measles Eradication Campaign","authors":"Philipp Barteska ,&nbsp;Sonja Dobkowitz ,&nbsp;Maarit Olkkola ,&nbsp;Michael Rieser","doi":"10.1016/j.jhealeco.2023.102828","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2023.102828","url":null,"abstract":"<div><p>We show that the first nationwide mass vaccination campaign against measles increased educational attainment in the United States. Our empirical strategy exploits variation in exposure to the childhood disease across states right before the Measles Eradication Campaign of 1967–68, which reduced reported measles incidence by 90 percent within two years. Our results suggest that mass vaccination against measles increased the years of education on average by about 0.1 years in the affected cohorts. We also find tentative evidence that the college graduation rate of men increased.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102828"},"PeriodicalIF":3.5,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167629623001054/pdfft?md5=cd5849e5547d5aeb208abaabbfef4791&pid=1-s2.0-S0167629623001054-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92099222","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
Tax incidence for menthol cigarettes by race: Evidence from Nielsen Homescan data 按种族划分的薄荷醇香烟的纳税率：尼尔森家庭调查数据的证据。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-10-06 DOI: 10.1016/j.jhealeco.2023.102829
Hyunchul Kim, Dongwon Lee
{"title":"Tax incidence for menthol cigarettes by race: Evidence from Nielsen Homescan data","authors":"Hyunchul Kim,&nbsp;Dongwon Lee","doi":"10.1016/j.jhealeco.2023.102829","DOIUrl":"10.1016/j.jhealeco.2023.102829","url":null,"abstract":"<div><p>We use Nielsen Homescan data to examine whether the incidence of cigarette taxes on menthol products varies with race. We find that taxes are shifted at significantly lower rates to Black smokers of menthol cigarettes than any other smokers. One possible explanation is that the industry targets price promotions to Black menthol smokers because they tend to be more responsive to cigarette prices relative to other smokers. We find evidence that Black smokers receive significantly more price discounts for menthol products than white menthol smokers. Our findings indicate that increasing cigarette taxes would effectively reduce menthol smoking among Black Americans because tax pass-through rate for Black menthol smokers is still substantially above zero.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102829"},"PeriodicalIF":3.5,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684399","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
Physician-patient race-match reduces patient mortality 医患种族匹配可降低患者死亡率。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-10-04 DOI: 10.1016/j.jhealeco.2023.102821
Andrew J. Hill , Daniel B. Jones , Lindsey Woodworth
{"title":"Physician-patient race-match reduces patient mortality","authors":"Andrew J. Hill ,&nbsp;Daniel B. Jones ,&nbsp;Lindsey Woodworth","doi":"10.1016/j.jhealeco.2023.102821","DOIUrl":"10.1016/j.jhealeco.2023.102821","url":null,"abstract":"<div><p>This paper assesses the impacts of physician-patient race-match, especially Black patients paired with Black physicians, on patient mortality. We draw on administrative data from Florida, linking hospital encounters from mid-2011 through 2014 to information from the Florida Physician Workforce Survey. Focusing on uninsured patients experiencing unscheduled hospital admissions who are conditionally randomly assigned to physicians, we find that physician-patient race-match for Black patients reduces the likelihood of within-hospital mortality by 0.28 percentage points, a 27 % reduction relative to the overall mortality rate. An alternative identification strategy relying on instrumental variables provides a similar finding.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102821"},"PeriodicalIF":3.5,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693505","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: 11
Consequences of a shortage and rationing: Evidence from a pediatric vaccine 短缺和定量配给的后果：来自儿科疫苗的证据。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-09-29 DOI: 10.1016/j.jhealeco.2023.102819
Eli Liebman , Emily C. Lawler , Abe Dunn , David B. Ridley
{"title":"Consequences of a shortage and rationing: Evidence from a pediatric vaccine","authors":"Eli Liebman ,&nbsp;Emily C. Lawler ,&nbsp;Abe Dunn ,&nbsp;David B. Ridley","doi":"10.1016/j.jhealeco.2023.102819","DOIUrl":"10.1016/j.jhealeco.2023.102819","url":null,"abstract":"<div><p><span>Shortages and rationing are common in health care<span>, yet we know little about the consequences. We examine an 18-month shortage of the pediatric<span> Haemophilus Influenzae Type B (Hib) vaccine. Using insurance claims data and variation in shortage exposure across birth cohorts, we find that the shortage reduced uptake of high-value primary doses by 4 percentage points and low-value booster doses by 26 percentage points. This suggests providers largely complied with rationing recommendations. In the long-run, catch-up vaccination occurred but was incomplete: shortage-exposed cohorts were 4 percentage points less likely to have received the ir booster dose years later. We also find that the shortage and rationing caused provider switches, extra provider visits, and negative </span></span></span>spillovers to other care.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102819"},"PeriodicalIF":3.5,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684397","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 impact of a long-term care information campaign on insurance coverage 长期护理信息宣传活动对保险范围的影响。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-09-26 DOI: 10.1016/j.jhealeco.2023.102822
Jessica H. Brown
{"title":"The impact of a long-term care information campaign on insurance coverage","authors":"Jessica H. Brown","doi":"10.1016/j.jhealeco.2023.102822","DOIUrl":"10.1016/j.jhealeco.2023.102822","url":null,"abstract":"<div><p>I estimate the impact of an information campaign on long-term care planning behaviors. I identify this effect using the staggered timing of the federal-state “Own Your Future” campaign, which urged individuals to plan ahead for long-term care needs and reached 26 states over five years. I find the campaign increased long-term care insurance coverage for individuals in the top quintile of the asset distribution by four percentage points, or seventeen percent. A back-of-the-envelope calculation indicates Medicaid savings of $483 million in present value.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102822"},"PeriodicalIF":3.5,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180397","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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