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The effects of becoming a physician on prescription drug use and mental health treatment 成为一名医生对处方药使用和心理健康治疗的影响。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-09-01 DOI: 10.1016/j.jhealeco.2023.102774
D. Mark Anderson , Ron Diris , Raymond Montizaan , Daniel I. Rees
{"title":"The effects of becoming a physician on prescription drug use and mental health treatment","authors":"D. Mark Anderson ,&nbsp;Ron Diris ,&nbsp;Raymond Montizaan ,&nbsp;Daniel I. Rees","doi":"10.1016/j.jhealeco.2023.102774","DOIUrl":"10.1016/j.jhealeco.2023.102774","url":null,"abstract":"<div><p>There is evidence that physicians disproportionately suffer from substance use disorder and mental health problems<span>. It is not clear, however, whether these phenomena are causal. We use data on Dutch medical school applicants to examine the effects of becoming a physician on prescription drug use and the receipt of treatment from a mental health facility. Leveraging variation from lottery outcomes that determine admission into medical schools, we find that becoming a physician increases the use of antidepressants, anxiolytics, opioids, and sedatives. Increases in the use of antidepressants, anxiolytics, and sedatives are larger among female physicians than among their male counterparts.</span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10283061","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
Effects of organized screening programs on breast cancer screening, incidence, and mortality in Europe 有组织的筛查项目对欧洲乳腺癌筛查、发病率和死亡率的影响
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-08-20 DOI: 10.1016/j.jhealeco.2023.102803
Sophie Guthmuller , Vincenzo Carrieri , Ansgar Wübker
{"title":"Effects of organized screening programs on breast cancer screening, incidence, and mortality in Europe","authors":"Sophie Guthmuller ,&nbsp;Vincenzo Carrieri ,&nbsp;Ansgar Wübker","doi":"10.1016/j.jhealeco.2023.102803","DOIUrl":"10.1016/j.jhealeco.2023.102803","url":null,"abstract":"<div><p>We link data on regional Organized Screening Programs (OSPs) throughout Europe with survey data and population-based cancer registries to estimate effects of OSPs on breast cancer screening (mammography), incidence, and mortality. Identification is from regional variation in the existence and timing of OSPs, and in their age-eligibility criteria. We estimate that OSPs, on average, increase mammography by 25 percentage points, increase breast cancer incidence by 16% five years after the OSPs implementation, and reduce breast cancer mortality by about 10% ten years after.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10561281","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 rise and fall of SES gradients in heights around the world. 世界各地高度的SES梯度的上升和下降。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-08-05 DOI: 10.2139/ssrn.4127021
A. Lleras-Muney, Alessandro Tarozzi, E. Aurino, Brendan Tinoco
{"title":"The rise and fall of SES gradients in heights around the world.","authors":"A. Lleras-Muney, Alessandro Tarozzi, E. Aurino, Brendan Tinoco","doi":"10.2139/ssrn.4127021","DOIUrl":"https://doi.org/10.2139/ssrn.4127021","url":null,"abstract":"We use data from a large sample of low- and middle-income countries to study the association (or \"gradient\") between child height and maternal education. We show that the gap in height between high- and low-SES children is small at birth, rises throughout childhood, and declines in adolescence as girls and boys go through puberty. This inverted U-shaped pattern is consistent with a degree of catch-up in linear height among children of low- relative to high-SES families, in partial contrast to the argument that height deficits cannot be overcome after the early years of life. This finding appears to be explained by the association between SES and the timing of puberty and therefore of the adolescent growth spurt: low-SES children start their adolescent growth spurt later and stop growing at later ages as well.","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43537053","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: 2
On the bright side of market concentration in a mixed-oligopoly healthcare industry 在混合寡头垄断的医疗保健行业中，市场集中度的光明一面
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-07-01 DOI: 10.1016/j.jhealeco.2023.102771
Michele Bisceglia , Jorge Padilla , Salvatore Piccolo , Pekka Sääskilahti
{"title":"On the bright side of market concentration in a mixed-oligopoly healthcare industry","authors":"Michele Bisceglia ,&nbsp;Jorge Padilla ,&nbsp;Salvatore Piccolo ,&nbsp;Pekka Sääskilahti","doi":"10.1016/j.jhealeco.2023.102771","DOIUrl":"10.1016/j.jhealeco.2023.102771","url":null,"abstract":"<div><p>We describe the healthcare industry<span> as a mixed oligopoly<span>, where a public and two private providers compete, and examine the effects of a merger<span> between the two private healthcare providers on prices, quality, and welfare. When the price and (eventually) quality of the public provider are regulated, the cost synergies required for the merger to increase consumer welfare are less significant than in a setting with only profit-maximizing providers. When, instead, the public provider can adjust its policy to the rivals’ behavior and maximizes a weighted sum of profits and consumer surplus (i.e., it has ‘semi-altruistic’ preferences), the merger is consumer surplus increasing if the public provider is sufficiently altruist, in some cases even absent efficiencies. These results suggest that ignoring the role and objectives of the public sector in the healthcare industry may lead agencies to reject mergers that, while would decrease consumer welfare in fully privatized industries, would increase it in mixed oligopolies.</span></span></span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9851757","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
On resource allocation in health care: The case of concierge medicine 论卫生保健中的资源配置:以礼宾医疗为例
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-07-01 DOI: 10.1016/j.jhealeco.2023.102776
Adam Leive , Guy David , Molly Candon
{"title":"On resource allocation in health care: The case of concierge medicine","authors":"Adam Leive ,&nbsp;Guy David ,&nbsp;Molly Candon","doi":"10.1016/j.jhealeco.2023.102776","DOIUrl":"10.1016/j.jhealeco.2023.102776","url":null,"abstract":"<div><p>Resource allocation generally involves a tension between efficiency and equity, particularly in health care. The growth in exclusive physician arrangements using non-linear prices is leading to consumer segmentation with theoretically ambiguous welfare implications. We study concierge medicine, in which physicians only provide care to patients paying a retainer fee. We find limited evidence of selection based on health and stronger evidence of selection based on income. Using a matching strategy that leverages the staggered adoption of concierge medicine, we find large spending increases and no average mortality effects for patients impacted by the switch to concierge medicine.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9854306","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
Adoption and utilization of device-assisted telemedicine 设备辅助远程医疗的采用和利用
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-07-01 DOI: 10.1016/j.jhealeco.2023.102780
Dan Zeltzer , Liran Einav , Joseph Rashba , Yehezkel Waisman , Motti Haimi , Ran D. Balicer
{"title":"Adoption and utilization of device-assisted telemedicine","authors":"Dan Zeltzer ,&nbsp;Liran Einav ,&nbsp;Joseph Rashba ,&nbsp;Yehezkel Waisman ,&nbsp;Motti Haimi ,&nbsp;Ran D. Balicer","doi":"10.1016/j.jhealeco.2023.102780","DOIUrl":"10.1016/j.jhealeco.2023.102780","url":null,"abstract":"<div><p><span>We estimate the effect of adopting a digital device for performing medical exams at home during telehealth<span> visits. We match visits of adopters and non-adopters who used the same virtual care clinic but without the device and compare healthcare utilization after the matched visits. We find that device adoption, partially offset by decreased use of other primary care modalities, results in a 12% higher utilization rate of primary care and increased use of antibiotics. But – particularly among adults – adoption lowers the use of </span></span>urgent care, the emergency room, and hospital care, resulting in no increase in total cost.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9854321","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
Decomposing social risk preferences for health and wealth 分解健康和财富的社会风险偏好
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-07-01 DOI: 10.1016/j.jhealeco.2023.102757
Arthur E. Attema , Olivier L'Haridon , Gijs van de Kuilen
{"title":"Decomposing social risk preferences for health and wealth","authors":"Arthur E. Attema ,&nbsp;Olivier L'Haridon ,&nbsp;Gijs van de Kuilen","doi":"10.1016/j.jhealeco.2023.102757","DOIUrl":"10.1016/j.jhealeco.2023.102757","url":null,"abstract":"<div><p>This study reports the results of the first artefactual field experiment designed to measure the prevalence of aversion toward different components of social risks in a large and demographically representative sample. We identify social risk preferences for health and wealth for losses and gains, and decompose these attitudes into four different dimensions: individual risk, collective risk, ex-post inequality, and ex-ante inequality. The results of a non-parametric analysis suggest that aversion to risk and inequality is the mean preference for outcomes in health and wealth in the domain of gains and losses. A parametric decomposition of aversion to risk and inequality shows that respondents are averse to ex-post and ex-ante inequality in health and wealth for gains and losses. Likewise, respondents are averse to collective risk, but neutral to individual risk, which highlights the importance of considering different components of social risk preferences when managing social health and wealth risks.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9793421","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
Universal cash transfers and prescription utilization: Evidence from the Alaska permanent fund dividend 普遍现金转移和处方使用:来自阿拉斯加永久基金红利的证据
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-07-01 DOI: 10.1016/j.jhealeco.2023.102758
Mouhcine Guettabi, Allison Witman
{"title":"Universal cash transfers and prescription utilization: Evidence from the Alaska permanent fund dividend","authors":"Mouhcine Guettabi,&nbsp;Allison Witman","doi":"10.1016/j.jhealeco.2023.102758","DOIUrl":"10.1016/j.jhealeco.2023.102758","url":null,"abstract":"<div><p>We investigate the impact of a large cash transfer on prescription utilization. Our identification strategy leverages the Alaksa Permanent Fund Dividend (PFD), which is distributed annually in October and comprises 6% of the average household's annual income. We study the impact of the PFD on the use of prescription medications<span> using a within-Alaska comparison group and difference-in-differences design. Using the IBM MarketScan Commercial Claims and Encounters Prescription Drug Database, we observe prescriptions for 50,866 commercially-insured individuals who filled prescriptions between 2013 and 2019. We find no changes in prescription use overall and are able to rule out changes larger than 0.5% in the week of the PFD and 1.4% the week after. Subgroup analyses find no changes by patient characteristics<span>, degree of cost sharing, or prescription type. We also conduct a synthetic control analysis using a non-Alaska comparison group and find no effects of the PFD on prescriptions. These findings are useful for understanding liquidity sensitivity for prescription medication and the effects of cash distributions among individuals with employer-based health insurance.</span></span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10150680","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
Consequences of a Shortage and Rationing: Evidence from a Pediatric Vaccine 短缺和配给的后果:来自儿科疫苗的证据
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-07-01 DOI: 10.3386/w31479
E. Liebman, Emily C. Lawler, Abe Dunn, D. Ridley
{"title":"Consequences of a Shortage and Rationing: Evidence from a Pediatric Vaccine","authors":"E. Liebman, Emily C. Lawler, Abe Dunn, D. Ridley","doi":"10.3386/w31479","DOIUrl":"https://doi.org/10.3386/w31479","url":null,"abstract":"Shortages and rationing are common in health care, yet we know little about the consequences. We examine an 18-month shortage of the pediatric 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 spillovers to other care.","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44348317","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 effect of RCTs on drug demand: Evidence from off-label cancer drugs 随机对照试验对药物需求的影响:来自标签外抗癌药物的证据
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-07-01 DOI: 10.1016/j.jhealeco.2023.102779
Rebecca McKibbin
{"title":"The effect of RCTs on drug demand: Evidence from off-label cancer drugs","authors":"Rebecca McKibbin","doi":"10.1016/j.jhealeco.2023.102779","DOIUrl":"10.1016/j.jhealeco.2023.102779","url":null,"abstract":"<div><p>This paper investigates the effect of scientific information from randomized controlled clinical trials<span> (RCTs) on the demand for off-label uses of cancer drugs. This is a unique setting where demand for a drug for a specific use is observable both before and after the first RCT results are released. Using variation in the timing of RCTs across off-label uses of drugs, I find that demand responds asymmetrically to the trial results based on the statistical significance of the clinically relevant endpoint. When this endpoint is statistically significant, there is a large and immediate increase in demand. When this end point is not statistically significant, physicians are relatively slow to abandon use of the drug.</span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10176021","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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