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Income receipt, economic activities, and health: Evidence from ambulance transport patterns 收入、经济活动和健康：来自救护车运输模式的证据
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-02-06 DOI: 10.1016/j.jhealeco.2025.102970
Yoko Ibuka , Junya Hamaaki
{"title":"Income receipt, economic activities, and health: Evidence from ambulance transport patterns","authors":"Yoko Ibuka ,&nbsp;Junya Hamaaki","doi":"10.1016/j.jhealeco.2025.102970","DOIUrl":"10.1016/j.jhealeco.2025.102970","url":null,"abstract":"<div><div>Studies indicate that mortality increases after income receipt. To explore whether this is due to increased economic activity around the period of receiving income, we examine within-month patterns in ambulance transport incidents, focusing on location and timing. Using Japan’s National Pension payments made every two months, we compare the number of ambulance transport incidents on the day of pension payment and on surrounding days in payment months with those in non-payment months. The results show a 4.5% increase in ambulance transport incidents on the day of pension payment, linked to increased activities such as gambling, shopping, and dining out. We show suggestive evidence that income receipt boosts economic activities by the mechanism of easing liquidity constraints. These findings have implications for healthcare system preparedness and the optimal design of public benefit payment.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"Article 102970"},"PeriodicalIF":3.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379275","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
Implications of the decline in LGBT rights for population mental health: Evidence from Polish “LGBT-free zones” LGBT权利下降对人口心理健康的影响：来自波兰“无LGBT区”的证据
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-02-06 DOI: 10.1016/j.jhealeco.2025.102973
Chad D. Meyerhoefer , Bingjin Xue , Anna Poznańska
{"title":"Implications of the decline in LGBT rights for population mental health: Evidence from Polish “LGBT-free zones”","authors":"Chad D. Meyerhoefer ,&nbsp;Bingjin Xue ,&nbsp;Anna Poznańska","doi":"10.1016/j.jhealeco.2025.102973","DOIUrl":"10.1016/j.jhealeco.2025.102973","url":null,"abstract":"<div><div>Theories of minority stress suggest recent legislation limiting LGBT rights can reduce the health of LGBT individuals and their families. We investigate how the creation of LGBT-free zones across Poland during 2019 and 2020 affected mental health and mortality. We find that annual suicide attempts increased by 16.5 %, or 5 attempts per 100k, deaths from external causes, including automobile accidents, suicides and other accidents and injuries increased 10.6 %, or 5.6 deaths per 100k, and suicide deaths increased 17.0 % (<em>p</em> = 0.108), or 1.9 deaths per 100k, in LGBT-free zones. The rise in suicide attempts was concentrated among individuals aged 13–18 and 45–49 and coincided with an 8.8 % increase in sales of prescription drugs for addictive disorders. However, there was no change in the use of psychotropic medications used to treat mental health conditions, indicative of limited access to mental health care.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"Article 102973"},"PeriodicalIF":3.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420210","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 incentive to treat: Physician agency and the expansion of the 340B drug pricing program 治疗的激励：医生代理和340B药品定价计划的扩大
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-02-03 DOI: 10.1016/j.jhealeco.2025.102971
Danea Horn
{"title":"The incentive to treat: Physician agency and the expansion of the 340B drug pricing program","authors":"Danea Horn","doi":"10.1016/j.jhealeco.2025.102971","DOIUrl":"10.1016/j.jhealeco.2025.102971","url":null,"abstract":"<div><div>The 340B Drug Pricing Program incentivizes healthcare providers to increase medication use. It does this by allowing certain safety-net hospitals and clinics to purchase outpatient drugs at considerable discounts from manufacturers but be reimbursed at full price by payers. Yet, previous literature has left largely unstudied how the 340B program influences physician prescribing behavior. In this paper, I provide evidence of physician agency among 340B providers in the treatment of breast cancer. I leverage the staggered diffusion of the program to identify the impact of 340B participation on prescribing behavior and patient outcomes. Physicians who join the 340B program increase the share of patients who receive pharmaceutical treatments and increase the intensity of per-patient prescribing. I also find significant increases in prescribing medications that are not included in clinical treatment recommendations and medications to treat side effects. Despite more intensive treatment use, I find no statistically significant change in survival.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102971"},"PeriodicalIF":3.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510889","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
Investigator racial diversity and clinical trial participation 研究者种族多样性和临床试验参与
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-31 DOI: 10.1016/j.jhealeco.2025.102968
Marcella Alsan , Romaine A. Campbell , Lukas Leister , Ayotomiwa Ojo
{"title":"Investigator racial diversity and clinical trial participation","authors":"Marcella Alsan ,&nbsp;Romaine A. Campbell ,&nbsp;Lukas Leister ,&nbsp;Ayotomiwa Ojo","doi":"10.1016/j.jhealeco.2025.102968","DOIUrl":"10.1016/j.jhealeco.2025.102968","url":null,"abstract":"<div><div>We investigate whether increased racial diversity of clinical trial principal investigators could increase the enrollment of Black patients, which currently lags population and disease-burden. We conducted a survey experiment in which respondents were shown a photo of a current NIH investigator in which race (Black/White) was randomized. Sex was also randomized as a relevant benchmark. Black respondents reported 0.35 standard deviation units higher interest in participating in a clinical study led by a race concordant investigator (a 12.6% increase). Sex concordance had no effect. Further analyses indicate that perceived trustworthiness and attractiveness are the most important factors explaining these results.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"Article 102968"},"PeriodicalIF":3.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143336543","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 effect of smoking cessation on mental health: Evidence from a randomized trial 戒烟对心理健康的影响：来自随机试验的证据
IF 3.4 2区 经济学
Journal of Health Economics Pub Date : 2025-01-25 DOI: 10.1016/j.jhealeco.2025.102969
Katherine Meckel , Katherine Rittenhouse
{"title":"The effect of smoking cessation on mental health: Evidence from a randomized trial","authors":"Katherine Meckel ,&nbsp;Katherine Rittenhouse","doi":"10.1016/j.jhealeco.2025.102969","DOIUrl":"10.1016/j.jhealeco.2025.102969","url":null,"abstract":"<div><div>One in nine Americans smokes cigarettes, and a disproportionate share of smokers suffer from mental illness. Despite this correlation, there exists little rigorous evidence on the effects of smoking cessation on mental health. We re-use data from a randomized trial of a smoking cessation treatment to estimate short and long-term impacts on previously un-analyzed measures of mental distress. We find that smoking cessation increases short-run mental distress, while reducing milder forms of long-run distress. We provide suggestive evidence on mechanisms including physical health, marriage, employment and substance use. Our results suggest that cessation efforts and mental health supports are complementary interventions in the short run and provide new evidence of welfare gains from cessation in the long run.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"Article 102969"},"PeriodicalIF":3.4,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103840","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
Intensive care supply and admission decisions 重症监护供应和住院决定。
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 ,&nbsp;Lauren Hoehn-Velasco ,&nbsp;Diana R. Jolles","doi":"10.1016/j.jhealeco.2025.102967","DOIUrl":"10.1016/j.jhealeco.2025.102967","url":null,"abstract":"<div><div>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 (<span><math><mo>&lt;</mo></math></span>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 (<span><math><mo>&lt;</mo></math></span>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.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"Article 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 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 ,&nbsp;Monica Deza","doi":"10.1016/j.jhealeco.2024.102945","DOIUrl":"10.1016/j.jhealeco.2024.102945","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"Article 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 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":"<div><div>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.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"Article 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":"OA","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 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 ,&nbsp;Chiara Serra","doi":"10.1016/j.jhealeco.2024.102944","DOIUrl":"10.1016/j.jhealeco.2024.102944","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"Article 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":"OA","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 DOI: 10.1016/j.jhealeco.2024.102941
Conor Lennon , Johanna Catherine Maclean , Keith Teltser
{"title":"Ridesharing and substance use disorder treatment","authors":"Conor Lennon ,&nbsp;Johanna Catherine Maclean ,&nbsp;Keith Teltser","doi":"10.1016/j.jhealeco.2024.102941","DOIUrl":"10.1016/j.jhealeco.2024.102941","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"99 ","pages":"Article 102941"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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