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The effects of wealth shocks on public and private long-term care insurance 财富冲击对公共和私人长期护理保险的影响
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2025-11-26 DOI: 10.1016/j.jhealeco.2025.103086
Joan Costa-Font , Richard G Frank , Nilesh Raut
{"title":"The effects of wealth shocks on public and private long-term care insurance","authors":"Joan Costa-Font ,&nbsp;Richard G Frank ,&nbsp;Nilesh Raut","doi":"10.1016/j.jhealeco.2025.103086","DOIUrl":"10.1016/j.jhealeco.2025.103086","url":null,"abstract":"<div><div>The financing of long-term care services and supports (LTSS) relies heavily on self-insurance in the form of housing or financial wealth. Exploiting both <em>local market variation</em> in housing prices and individual-level variation in stock market wealth from 1996 to 2016, we show that exogenous wealth shocks significantly reduce the probability of LTCI coverage, without altering Medicaid eligibility among people with housing and financial assets. The effect of shocks to liquid wealth strongly dominates the effect of housing wealth changes. A $100 K increase in housing (financial) wealth reduces the likelihood of LTCI coverage by 1.24 (3.22) percentage points.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103086"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980791","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
Reform-induced competition: Evaluating the impact on Swiss pharmacies and total drug costs 改革引发的竞争：评估对瑞士药房和药品总成本的影响
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1016/j.jhealeco.2026.103111
Marc Anderes
{"title":"Reform-induced competition: Evaluating the impact on Swiss pharmacies and total drug costs","authors":"Marc Anderes","doi":"10.1016/j.jhealeco.2026.103111","DOIUrl":"10.1016/j.jhealeco.2026.103111","url":null,"abstract":"<div><div>This paper explores the effect of increased competition on pharmacies induced by a regime change in two Swiss cities allowing physicians to self-dispense drugs. By merging detailed sales and survey data at the pharmacy level, a difference-in-differences estimation shows a significant and permanent loss of market share in prescribed drug revenue and profits. The decline is driven by drugs used for acute illnesses and is less pronounced for larger pharmacies. While generic drug sales decrease significantly, the more expensive brand-name drugs remain largely unaffected. I find evidence that pharmacies respond to increased competition by diversifying toward health services. Adding administrative physician data shows that the reform caused approximately CHF 19.5M in additional drug costs per year. My results demonstrate that more competition can result in higher drug costs for society.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103111"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038700","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
Shared Stakes in English General Practice: The Impact of Practice Managers as Partners on Outcomes 英语全科实践中的共同利益：实践管理者作为合作伙伴对结果的影响。
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2026-02-26 DOI: 10.1016/j.jhealeco.2026.103122
Sean Urwin , Ben Walker , Michael Anderson
{"title":"Shared Stakes in English General Practice: The Impact of Practice Managers as Partners on Outcomes","authors":"Sean Urwin ,&nbsp;Ben Walker ,&nbsp;Michael Anderson","doi":"10.1016/j.jhealeco.2026.103122","DOIUrl":"10.1016/j.jhealeco.2026.103122","url":null,"abstract":"<div><div>Ownership of English general practices by physicians has been declining for many years and concentrated among fewer physicians. Non-clinical ownership may provide a sustainable alternative structure for general practice. In this study, we provide the first formal evaluation of non-clinical ownership in an English general practice setting. We compile a comprehensive dataset of general practices across eight years between 2015/16 and 2022/23 from a range of sources to investigate the impact of non-clinical ownership stakes on key primary care outcomes, including staffing levels and turnover, patient satisfaction, access, quality of care, reimbursement for non-core services and total patient list size. Employing a dynamic event study design combined with propensity-score weighting, we find practice manager partners increase direct patient care (excluding physicians and nurses), administrative staff numbers, reimbursement for non-core services and total patient list size. However, we find no statistically significant effect on any other outcome. Offering equity stakes to non-physician staff may support practice sustainability by allowing alternative ownership structures.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103122"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312057","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
What happens to population health when the doctors leave? Evidence from the exit of Cuban doctors in Brazil 当医生离开后，人们的健康会发生什么？来自古巴医生离开巴西的证据
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2026-01-05 DOI: 10.1016/j.jhealeco.2025.103099
Stefan Sliwa Ruiz , Malte Becker , Thomas Hone , Rudi Rocha
{"title":"What happens to population health when the doctors leave? Evidence from the exit of Cuban doctors in Brazil","authors":"Stefan Sliwa Ruiz ,&nbsp;Malte Becker ,&nbsp;Thomas Hone ,&nbsp;Rudi Rocha","doi":"10.1016/j.jhealeco.2025.103099","DOIUrl":"10.1016/j.jhealeco.2025.103099","url":null,"abstract":"<div><div>This paper studies the effects of a large-scale exit of doctors on population health outcomes, health production inputs, outputs, and health system adaptation in Brazil. Identification exploits the exogenous timing of the Cuban exit from municipalities that relied more <em>versus</em> less on Cuban doctors within the More Doctors Program. We find persistent reductions in the care of chronic diseases, while service utilization for conditions requiring immediate care, such as maternal-related services and infections, quickly recovered. Reductions in utilization did not translate into changes in health outcomes. Supply-side response and demand diversion helped mitigate major adverse repercussions for population health at the market level.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103099"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915101","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
Learner driving experience and motor vehicle accidents 学习驾驶经验及机动车辆事故。
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2026-02-03 DOI: 10.1016/j.jhealeco.2026.103113
Nathan Kettlewell, Peter Siminski
{"title":"Learner driving experience and motor vehicle accidents","authors":"Nathan Kettlewell,&nbsp;Peter Siminski","doi":"10.1016/j.jhealeco.2026.103113","DOIUrl":"10.1016/j.jhealeco.2026.103113","url":null,"abstract":"<div><div>Minimum supervised driving hours (MSDH) are a key component of Graduated Driver Licensing (GDL) policy. GDL has been shown to reduce motor vehicle accidents, but its optimal design is far from clear. Exploiting two discrete MSDH changes in New South Wales (the largest state in Australia), we estimate causal effects of various MSDH options, providing evidence on driver safety under different regimes. Increasing MSDH from zero to 50 h lowered the risk of a motor vehicle accident in the first year of unsupervised driving by around 23%. Further increasing the mandate to 120 h had no additional benefit.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103113"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144636","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 mining-induced earthquakes on mental health: Evidence from the Dutch Lifelines Cohort Study and Biobank 采矿引起的地震对心理健康的影响：来自荷兰生命线队列研究和生物银行的证据。
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2026-02-04 DOI: 10.1016/j.jhealeco.2026.103118
Ailun Shui , Gerard J. van den Berg , Jochen O. Mierau , Laura Viluma
{"title":"The impact of mining-induced earthquakes on mental health: Evidence from the Dutch Lifelines Cohort Study and Biobank","authors":"Ailun Shui ,&nbsp;Gerard J. van den Berg ,&nbsp;Jochen O. Mierau ,&nbsp;Laura Viluma","doi":"10.1016/j.jhealeco.2026.103118","DOIUrl":"10.1016/j.jhealeco.2026.103118","url":null,"abstract":"<div><div>A large body of literature demonstrates that exposure to major adverse events such as natural disasters affects physical and mental health. Less is known about health consequences of long-term exposure to smaller, recurring shocks such as mining-induced earthquakes. Leveraging data from the Dutch Lifelines Cohort Study and Biobank and the Royal Netherlands Meteorological Institute, we examine mental health effects of frequent earthquakes generated by the extraction of natural gas, which was a major source of economic revenue for the Netherlands. Long-term exposure is captured by the accumulated peak ground acceleration. We employ individual-level fixed effects models to deal with selective exposure. We find that exposure increases depression and anxiety symptoms. Our results are robust to selective migration and to varying the exposure indicator. The results support a reassessment of the societal costs of the mining of natural gas.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103118"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137990","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
Corrigendum to “Religious proximity and misinformation: Experimental evidence from a mobile phone-based campaign in India” [Journal of Health Economics Volume 96, June 2024, 102883] 对“宗教接近和错误信息：来自印度移动电话运动的实验证据”的更正[卫生经济学杂志第96卷，2024年6月，102883]。
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.jhealeco.2026.103117
Alex Armand , Britta Augsburg , Antonella Bancalari , Kalyan Kumar Kameshwara
{"title":"Corrigendum to “Religious proximity and misinformation: Experimental evidence from a mobile phone-based campaign in India” [Journal of Health Economics Volume 96, June 2024, 102883]","authors":"Alex Armand ,&nbsp;Britta Augsburg ,&nbsp;Antonella Bancalari ,&nbsp;Kalyan Kumar Kameshwara","doi":"10.1016/j.jhealeco.2026.103117","DOIUrl":"10.1016/j.jhealeco.2026.103117","url":null,"abstract":"","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103117"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127419","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
Nurse practitioner training and local medical provider supply 护士执业培训和当地医疗提供者供应。
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2026-02-15 DOI: 10.1016/j.jhealeco.2026.103121
Anja F. Gruber , Anders Van Sandt , Craig W. Carpenter , Scott Loveridge
{"title":"Nurse practitioner training and local medical provider supply","authors":"Anja F. Gruber ,&nbsp;Anders Van Sandt ,&nbsp;Craig W. Carpenter ,&nbsp;Scott Loveridge","doi":"10.1016/j.jhealeco.2026.103121","DOIUrl":"10.1016/j.jhealeco.2026.103121","url":null,"abstract":"<div><div>The Nurse Practitioner (NP) workforce expanded rapidly from 2010-2023, especially in rural counties, where patients today are nearly as likely to receive care from an NP as from a physician. At the same time, rural health outcomes and access to health care continue to worsen relative to urban areas. Empirical research on how NPs interact with or substitute for physicians remains limited. This paper exploits county-level openings of graduate nursing programs to test how they impact the local supply of NPs and primary care physicians. Using data from the Integrated Postsecondary Education Data System and Area Health Resource Files, we estimate staggered difference-in-differences frameworks. We show that new graduate programs lead to large increases in the local NP supply and find positive spillover effects for nearby rural counties and counties with low provider to population ratios. We find that over the decade after a program first graduates students, up to 30% of students become licensed NPs in the same county, and for rural programs, the majority of graduates add to the regional supply of NPs. We find no adverse impact of local NP increases on the number of primary care physicians, suggesting that broader access to NP education boosts the local supply of providers overall. This paper illustrates the importance of rural medical education in increasing local access to primary care providers and in addressing existing inequities in access to care.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103121"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272673","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
Obesity, sedentary behavior and lifestyle: A lifecycle model of eating and physical activity 肥胖、久坐行为和生活方式：饮食和身体活动的生命周期模型。
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI: 10.1016/j.jhealeco.2026.103114
Davide Dragone , Gustav Feichtinger , Dieter Grass , Richard F. Hartl , Peter M. Kort , Andrea Seidl , Stefan Wrzaczek
{"title":"Obesity, sedentary behavior and lifestyle: A lifecycle model of eating and physical activity","authors":"Davide Dragone ,&nbsp;Gustav Feichtinger ,&nbsp;Dieter Grass ,&nbsp;Richard F. Hartl ,&nbsp;Peter M. Kort ,&nbsp;Andrea Seidl ,&nbsp;Stefan Wrzaczek","doi":"10.1016/j.jhealeco.2026.103114","DOIUrl":"10.1016/j.jhealeco.2026.103114","url":null,"abstract":"<div><div>We propose a theoretical model to study individual lifestyle choices related to calorie intake and physical activity, depending on personal fitness and body weight. The model builds on the rational eating literature and can generate a variety of behaviors that are consistent with the empirical evidence. In particular, we show that engaging in periods of a sedentary lifestyle can be a rational, utility-maximizing decision—a finding that is not present in the existing literature but is empirically widespread. Additionally, we show the possible existence of multiple equilibria and multiple indifferent lifestyles. The former justifies policy interventions to help individuals exit a self-reinforcing, but unhealthy equilibrium; the latter provides a theoretical basis for remediation plans that compensate for earlier unhealthy behaviors.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"106 ","pages":"Article 103114"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120904","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
Has the shortened drug distribution chain cut drug prices? Evidence from the Two-Invoice System in China 药品分销链的缩短是否降低了药品价格？来自中国两票制的证据
IF 3.6 2区 经济学
Journal of Health Economics Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI: 10.1016/j.jhealeco.2025.103097
Xiaoxi Li , Fanyu Liu , Jianye Yan , Nina Yin
{"title":"Has the shortened drug distribution chain cut drug prices? Evidence from the Two-Invoice System in China","authors":"Xiaoxi Li ,&nbsp;Fanyu Liu ,&nbsp;Jianye Yan ,&nbsp;Nina Yin","doi":"10.1016/j.jhealeco.2025.103097","DOIUrl":"10.1016/j.jhealeco.2025.103097","url":null,"abstract":"<div><div>Global concerns over rising drug prices have led to regulatory efforts in the pharmaceutical industry targeting price transparency and distribution efficiency. This study examines the impact of China’s Two-Invoice System (TIS), a 2016 reform aimed at reducing drug costs by streamlining the pharmaceutical distribution chain and enhancing price transparency. With a theoretical model, we examine the decision-making for pharmaceutical manufacturers and distributors on pricing and promotion activities. We predict competing effects on drug prices: while intermediary markups inflated by double marginalization are reduced, the removal of efficient distributors may elevate supply chain expenses. Using a staggered difference-in-differences approach with procurement data from 2015 to 2019, we find that the implementation of TIS led to a 1.9% increase in average drug prices, contrary to policy expectations. Price increases were more pronounced for lower-priced drugs and in wealthier regions, for which the supply chain markups are limited and the effect of efficiency disruption might dominate. We also document a significant increase in sales and marketing expenses of the manufacturers, who are supposed to have absorbed a considerable amount of promotional costs previously borne by distributors. These findings underscore the unintended inefficiencies of regulatory reforms, highlighting the need for a balanced policy design that considers both cost control and market dynamics in healthcare.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"105 ","pages":"Article 103097"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884628","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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