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The impact of scope-of-practice restrictions on access to medical care 执业范围限制对获得医疗服务的影响
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2024-01-05 DOI: 10.1016/j.jhealeco.2023.102844
Jiapei Guo , Angela E. Kilby , Mindy S. Marks
{"title":"The impact of scope-of-practice restrictions on access to medical care","authors":"Jiapei Guo ,&nbsp;Angela E. Kilby ,&nbsp;Mindy S. Marks","doi":"10.1016/j.jhealeco.2023.102844","DOIUrl":"10.1016/j.jhealeco.2023.102844","url":null,"abstract":"<div><p><span>We study the impact of scope-of-practice laws in a highly regulated and important policy setting, the provision of medication-assisted treatment<span> for opioid use disorder. We consider two natural experiments generated by policy changes at the state and federal level that allow nurse practitioners more practice autonomy. Both experiments show that liberalizations of prescribing authority lead to large improvements in access to care. Further, we use rich address-level data to answer key policy questions. Expanding nurse practitioner prescribing authority reduces urban–rural </span></span>disparities<span> in health care access. Additionally, expanded autonomy increases access to care provided by physicians, driven by complementarities between providers.</span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"94 ","pages":"Article 102844"},"PeriodicalIF":3.5,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139374303","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 responses to news matter? Evidence from interventional cardiology 对新闻的反应重要吗？介入心脏病学的证据
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2024-01-05 DOI: 10.1016/j.jhealeco.2023.102846
Daniel Avdic , Stephanie von Hinke , Bo Lagerqvist , Carol Propper , Johan Vikström
{"title":"Do responses to news matter? Evidence from interventional cardiology","authors":"Daniel Avdic ,&nbsp;Stephanie von Hinke ,&nbsp;Bo Lagerqvist ,&nbsp;Carol Propper ,&nbsp;Johan Vikström","doi":"10.1016/j.jhealeco.2023.102846","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2023.102846","url":null,"abstract":"<div><p>We examine physician responses to a global information shock<span> and how these impact their patients. We exploit international news over the safety of an innovation in healthcare, the drug-eluting stent. We use data on interventional cardiologists’ use of stents to define and measure cardiologists’ responsiveness to the initial positive news and link this to their patients’ outcomes. We find substantial heterogeneity in responsiveness to news. Patients treated by cardiologists who respond slowly to the initial positive news have fewer adverse outcomes. This is not due to patient–physician sorting. Instead, our results suggest that the differences are partially driven by slow responders being better at deciding when (not) to use the new technology, which in turn affects their patient outcomes.</span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"94 ","pages":"Article 102846"},"PeriodicalIF":3.5,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139108820","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
Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design 兄弟姐妹的溢出效应和接种疫苗的选择：回归不连续设计的证据
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-12-27 DOI: 10.1016/j.jhealeco.2023.102843
Maria Knoth Humlum , Marius Opstrup Morthorst , Peter Rønø Thingholm
{"title":"Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design","authors":"Maria Knoth Humlum ,&nbsp;Marius Opstrup Morthorst ,&nbsp;Peter Rønø Thingholm","doi":"10.1016/j.jhealeco.2023.102843","DOIUrl":"10.1016/j.jhealeco.2023.102843","url":null,"abstract":"<div><p><span><span><span>We investigate the effects of introducing population-wide free-of-charge Human Papillomavirus (HPV) vaccination programs on the targeted adolescent cohorts and their siblings. For identification, we rely on </span>regression discontinuity designs<span> and high-quality Danish administrative data to exploit that date of birth determines program eligibility. We find that the programs increased the </span></span>HPV vaccine take-up of both the targeted children (53.2 percentage points for girls and 36.0 percentage points for boys) </span><em>and</em><span><span> their older same-sex siblings (4.5 percentage points for sisters and 3.5 percentage points for brothers). We show that while the direct effects of the programs reduced HPV vaccine take-up inequality<span>, the spillover effects, in contrast, contributed to an increase in vaccine take-up inequality highlighting the potential importance of spillover effects in the determination of distributional consequences of </span></span>public health programs. Finally, we find some evidence of cross-vaccine spillovers.</span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"94 ","pages":"Article 102843"},"PeriodicalIF":3.5,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139064213","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
Distributionally sensitive measurement and valuation of population health 对分布敏感的人口健康测量和估值
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-12-15 DOI: 10.1016/j.jhealeco.2023.102847
Shaun Da Costa , Owen O’Donnell , Raf Van Gestel
{"title":"Distributionally sensitive measurement and valuation of population health","authors":"Shaun Da Costa ,&nbsp;Owen O’Donnell ,&nbsp;Raf Van Gestel","doi":"10.1016/j.jhealeco.2023.102847","DOIUrl":"10.1016/j.jhealeco.2023.102847","url":null,"abstract":"<div><p><span>We introduce a measure of population health that is sensitive to inequality in both age-specific health and lifespan and can be calculated from a health-extended period life table. By allowing for inequality </span>aversion<span>, the measure generalises health-adjusted life expectancy without requiring more data. A transformation of change in the (life-years) measure gives a distributionally sensitive monetary valuation of change in population health and disease burden. Application to Sub-Saharan Africa between 1990 and 2019 reveals that the change in population health is sensitive to allowing for lifespan inequality but is less sensitive to age-specific health inequality. Allowing for distributional sensitivity changes relative burdens of diseases, reduces convergence between the burdens of communicable and non-communicable diseases, and so could influence disease prioritisation. It increases the value of health improvements relative to GDP.</span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"93 ","pages":"Article 102847"},"PeriodicalIF":3.5,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138684471","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
Socioeconomic status and access to mental health care: The case of psychiatric medications for children in Ontario Canada 社会经济地位与获得心理保健的机会：加拿大安大略省儿童精神科用药案例
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-12-12 DOI: 10.1016/j.jhealeco.2023.102841
Janet Currie , Paul Kurdyak , Jonathan Zhang
{"title":"Socioeconomic status and access to mental health care: The case of psychiatric medications for children in Ontario Canada","authors":"Janet Currie ,&nbsp;Paul Kurdyak ,&nbsp;Jonathan Zhang","doi":"10.1016/j.jhealeco.2023.102841","DOIUrl":"10.1016/j.jhealeco.2023.102841","url":null,"abstract":"<div><p>We examine differences in the prescribing of psychiatric medications to lower-income and higher-income children in the Canadian province of Ontario using rich administrative data that includes diagnosis codes and physician identifiers. Our most striking finding is that conditional on diagnosis and medical history, low-income children are more likely to be prescribed antipsychotics and benzodiazepines than higher-income children who see the same doctors. These are drugs with potentially dangerous side effects that ideally should be prescribed to children only under narrowly proscribed circumstances. Lower-income children are also less likely to be prescribed SSRIs, the first-line treatment for depression and anxiety conditional on diagnosis. Hence, socioeconomic differences in the prescribing of psychotropic medications to children persist even in the context of universal public health insurance and universal drug coverage.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"93 ","pages":"Article 102841"},"PeriodicalIF":3.5,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167629623001182/pdfft?md5=4aa0c83a30fbb49d2efae89508c3aacc&pid=1-s2.0-S0167629623001182-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138579005","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
Do risk, time and prosocial preferences predict risky sexual behaviour of youths in a low-income, high-risk setting? 在低收入、高风险的环境中，风险、时间和亲社会偏好能否预测青少年的危险性行为？
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-12-11 DOI: 10.1016/j.jhealeco.2023.102845
Ranjeeta Thomas , Matteo M. Galizzi , Louisa Moorhouse , Constance Nyamukapa , Timothy B. Hallett
{"title":"Do risk, time and prosocial preferences predict risky sexual behaviour of youths in a low-income, high-risk setting?","authors":"Ranjeeta Thomas ,&nbsp;Matteo M. Galizzi ,&nbsp;Louisa Moorhouse ,&nbsp;Constance Nyamukapa ,&nbsp;Timothy B. Hallett","doi":"10.1016/j.jhealeco.2023.102845","DOIUrl":"10.1016/j.jhealeco.2023.102845","url":null,"abstract":"<div><p>Young people in sub-Saharan Africa are particularly at high risk of sexually transmitted infections. Little is known about their preferences and even less about their association with risky sexual behaviour. We conducted incentivized economic experiments to measure risk, time and prosocial preferences in Zimbabwe. Preferences measured at baseline predict biomarker and self-reported measures of risky sexual behaviour gathered 12 months later. We find robust evidence that individuals more altruistic at baseline are more likely to be Herpes Simplex Virus Type-2 (HSV-2) positive 12 months later. Analysis by sex shows this association is driven by our sample of women. Having more sexual partners is associated with greater risk tolerance amongst men and greater impatience amongst women. Results highlight heterogeneity in the association between preferences and risky sexual behaviour.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"93 ","pages":"Article 102845"},"PeriodicalIF":3.5,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167629623001224/pdfft?md5=7523a2c01579bbf0a1d52f01b09a6832&pid=1-s2.0-S0167629623001224-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138568670","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
Valuing life over the life cycle 重视生命甚于生命周期。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-12-01 DOI: 10.1016/j.jhealeco.2023.102842
Pascal St-Amour
{"title":"Valuing life over the life cycle","authors":"Pascal St-Amour","doi":"10.1016/j.jhealeco.2023.102842","DOIUrl":"10.1016/j.jhealeco.2023.102842","url":null,"abstract":"<div><p>Adjusting the valuation of life along the (i) person-specific (age, health, wealth) and (ii) mortality risk-specific (beneficial or detrimental, temporary or permanent changes) dimensions is relevant in prioritizing healthcare interventions. These adjustments are provided by solving a life cycle model of consumption, leisure and health choices and the associated Hicksian variations for mortality changes. The calibrated model yields plausible Values of Life Year between 154K$ and 200K$ and Values of Statistical Life close to 6.0M$. The willingness to pay (WTP) and to accept (WTA) compensation are equal and symmetric for one-shot beneficial and detrimental changes in mortality risk. However, permanent, and expected longevity changes are both associated with larger willingness for gains, relative to losses, and larger WTA than WTP. Ageing lowers both variations via falling resources and health, lower marginal continuation utility of living and decreasing longevity returns of changes in mortality.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"93 ","pages":"Article 102842"},"PeriodicalIF":3.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167629623001194/pdfft?md5=76346da878dca6b702901f2f7a5ca2df&pid=1-s2.0-S0167629623001194-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500040","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 labour market returns to sleep 劳动力市场重新进入睡眠状态。
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-11-20 DOI: 10.1016/j.jhealeco.2023.102840
Joan Costa-Font , Sarah Fleche , Ricardo Pagan
{"title":"The labour market returns to sleep","authors":"Joan Costa-Font ,&nbsp;Sarah Fleche ,&nbsp;Ricardo Pagan","doi":"10.1016/j.jhealeco.2023.102840","DOIUrl":"10.1016/j.jhealeco.2023.102840","url":null,"abstract":"<div><p>Despite the growing prevalence of insufficient sleep among individuals, we still know little about the labour market return to sleep. To address this gap, we use longitudinal data from Germany and leverage exogenous fluctuations in sleep duration caused by variations in time and local sunset times. Our findings reveal that a one-hour increase in weekly sleep is associated with a 1.6 percentage point rise in employment and a 3.4% increase in weekly earnings. Such effect on earnings stems from productivity improvements given that the number of working hours decreases with longer sleep duration. We also identify a key mechanism driving these effects, namely the enhanced mental well-being experienced by individuals who sleep longer hours.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"93 ","pages":"Article 102840"},"PeriodicalIF":3.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167629623001170/pdfft?md5=acfcaa5d9495a1c7147301d06b441654&pid=1-s2.0-S0167629623001170-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300498","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
Reminder design and childhood vaccination coverage 提醒设计和儿童疫苗接种覆盖率
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-11-14 DOI: 10.1016/j.jhealeco.2023.102832
Jonas Cuzulan Hirani , Miriam Wüst
{"title":"Reminder design and childhood vaccination coverage","authors":"Jonas Cuzulan Hirani ,&nbsp;Miriam Wüst","doi":"10.1016/j.jhealeco.2023.102832","DOIUrl":"10.1016/j.jhealeco.2023.102832","url":null,"abstract":"<div><p><span>A major policy concern across public vaccination programs is non-compliance. Exploiting Danish population data and three national reforms in regression discontinuity designs, we document the effects of reminders for childhood </span>vaccination coverage<span><span>. Retrospective reminders are primarily effective for families with small children and when sent out close to the recommended vaccination age. Digital and postal reminders are equally effective. Prospective reminders increase timely vaccinations in later childhood and help reaching high coverage for new vaccines in increasingly complex vaccination programs. While reminders prompt additional preventive care for focal children, we find no </span>spillovers to other health behaviors or relatives.</span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"93 ","pages":"Article 102832"},"PeriodicalIF":3.5,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135763736","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 primary healthcare on mortality: Evidence from Costa Rica 初级保健对死亡率的影响:来自哥斯达黎加的证据
IF 3.5 2区 经济学
Journal of Health Economics Pub Date : 2023-11-08 DOI: 10.1016/j.jhealeco.2023.102833
Claudio A. Mora-García , Madeline Pesec , Andrea M. Prado
{"title":"The effect of primary healthcare on mortality: Evidence from Costa Rica","authors":"Claudio A. Mora-García ,&nbsp;Madeline Pesec ,&nbsp;Andrea M. Prado","doi":"10.1016/j.jhealeco.2023.102833","DOIUrl":"10.1016/j.jhealeco.2023.102833","url":null,"abstract":"<div><p><span>This paper uses the gradual implementation of a primary healthcare (PHC) intervention in Costa Rica to examine the long-term effect of PHC on mortality. Nine years after opening a primary care center, known as a Health Area, there was an associated 13% reduction in age-adjusted mortality rate in the assigned patient population. The effect was highest among adults over 65 years of age and for those with </span>noncommunicable diseases, such as cardiovascular-related causes of death. We also show that as Health Areas opened, more individuals sought care at primary care clinics, while fewer sought care at emergency rooms; these changes may have partially mediated the effect of the intervention on mortality.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"93 ","pages":"Article 102833"},"PeriodicalIF":3.5,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135516533","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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