European Journal of Health Economics最新文献

{"title":"Life-cycle health effects of compulsory schooling.","authors":"Johannes Hollenbach, Hendrik Schmitz, Beatrice Baaba Tawiah","doi":"10.1007/s10198-025-01884-2","DOIUrl":"10.1007/s10198-025-01884-2","url":null,"abstract":"<p><p>We study the effect of education on health (hospital stays, number of diagnosed conditions, poor or bad self-rated health, and body mass index) over the life cycle, using German compulsory schooling reforms as a source of exogenous variation. Our results show clear correlations between educational attainment and better health across all age groups (30 to 74). However, we do not find causal relationships between additional schooling and health or health care utilization, neither earlier nor later in life. A simulated ex-post power analysis shows that this is not due to a lack of statistical power. One reason for the absence of effects may be that the studied compulsory schooling reforms succeeded in raising the educational attainment of the target group - individuals at the lowest educational margin - but did not lead to healthier employment opportunities.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1293-1322"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Broadening sources of finance for health promotion and disease prevention: Smart capacitating investment.","authors":"Maureen Rutten-van Mölken, Holly Whiteley, Balázs Babarczy, Jacob Davies, Lucas Goossens, Lina Papartyte, Alison Maassen, Balázs Nagy, Stephen Wright, Rhiannon Tudor-Edwards","doi":"10.1007/s10198-025-01874-4","DOIUrl":"10.1007/s10198-025-01874-4","url":null,"abstract":"","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1171-1190"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental risk preferences and children's vaccination coverage.","authors":"Flavia Coda Moscarola, Sarah Zaccagni","doi":"10.1007/s10198-025-01880-6","DOIUrl":"10.1007/s10198-025-01880-6","url":null,"abstract":"<p><p>This paper examines vaccine hesitancy from a behavioral economics perspective, focusing on how parental risk preferences, altruism, and vaccine distrust affect children's vaccination rates. A model of parental investment in children's health is developed and expanded using empirical data from WHO, UNICEF, the World Bank, and the Global Preferences Survey. The study utilizes a fractional response probit model to analyze data from 69 countries, accounting for both stringent and non-stringent vaccination policies. Results show that risk aversion, altruism, and trust are positively associated with vaccination coverage, with the impact varying by policy stringency. In countries with stringent policies, risk aversion is the most significant factor, while altruism and distrust are more influential in countries with less strict policies. However, the effects of these factors are modest, with income levels accounting for most cross-country differences. The study calls for further research using more recent, individual-level data. Highlights We develop a theoretical framework suggesting that parents with higher risk aversion and altruism are more likely to invest in their children's health, particularly in vaccination decisions, extending current literature insights. Our model is empirically tested using macro-level data on parental risk preferences and altruism from the Global Preferences Survey (GPS), combined with WHO and UNICEF vaccination coverage data for ten diseases in one-year-old children. The analysis reveals a positive association between parental risk aversion, altruism, and vaccination coverage across 69 countries, moderated by the stringency of national vaccination policies. In countries with stringent vaccination policies, risk aversion predominantly drives vaccination coverage, whereas in less stringent environments, altruism and vaccine distrust play a more significant role. Vaccination coverage is notably lower in low-income countries.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1233-1249"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health expenditure in Africa: examining the synergistic impact of economic policy uncertainty and governance quality.","authors":"Ekene ThankGod Emeka, Simplice Asongu","doi":"10.1007/s10198-025-01879-z","DOIUrl":"10.1007/s10198-025-01879-z","url":null,"abstract":"<p><p>This study examines the relevance of governance quality in shaping the effect of economic policy uncertainty on several health expenditure indicators, including external health expenditure, national health expenditure, public health expenditure, and private health expenditure. The analysis is based on a sample of fifty-three African countries spanning 2005 to 2022. The adopted empirical strategy comprises the interactive dynamic two-step System Generalized Method of Moments (SGMM). The analysis is structured such that various governance dimensions-economic, political, and institutional governance moderate economic policy uncertainty to reduce health expenditure. Overall, governance dynamics do not effectively moderate economic policy uncertainty to negatively influence health expenditure dynamics. Specifically, a corresponding aggregated governance threshold of 2.2264, is needed to completely mitigate the positive effect of economic policy uncertainty on external health expenditure. Furthermore, improved infrastructure, employment, and foreign direct investment are potent channels for reducing some health expenditure dynamics within the continent. The associated policy implications of this study are discussed within the framework of the African Union's Agenda 2063 and the United Nations Sustainable Development Goals (SDGs).</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1213-1231"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the costs and benefits of non-pharmaceutical pandemic measures using the economic values of social contacts.","authors":"Mortaza Baky Haskuee, Ali Asgary, Zachary McCarthy, Sperydon Koumarianos, Callista Wu, Ali Parsa, Andrew Fallone, Jianhong Wu","doi":"10.1007/s10198-025-01886-0","DOIUrl":"10.1007/s10198-025-01886-0","url":null,"abstract":"<p><p>We develop and calibrate a two-layer macroeconomic model of a pandemic to examine the macroeconomic costs and benefits of COVID-19 public health interventions. By integrating policies into a stratified epidemic compartmental model (Susceptible-Infected-Recovered, or SIR), we analyze the impact of non-pharmaceutical interventions (NPIs) on disease transmission. We then apply a dynamic stochastic general equilibrium (DSGE) model to simulate the effects of containment policy shocks on consumption, labor supply, and production, and their implications for macroeconomic variables. The model is calibrated and simulated for the province of Ontario, Canada. Our findings highlight the significant reduction in infections due to NPIs, quantify the negative economic consequences of policy shocks, and acknowledge that labor market flexibility and business adaptations played a key role in mitigating these adverse effects. This study provides a qualitative framework for evaluating the delicate balance between public health and economic considerations in policymaking during a public health emergency.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1359-1378"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the economic burden of complicated urinary tract infection: A systematic literature review.","authors":"Edward Broughton, Ann Colosia, Meryem Bektas, Kristi Kuper, Ramy Kotb","doi":"10.1007/s10198-025-01846-8","DOIUrl":"10.1007/s10198-025-01846-8","url":null,"abstract":"<p><strong>Background: </strong>Complicated urinary tract infections (cUTIs) arise in patients with structural or functional abnormalities of the genitourinary tract or those with nonurogenital comorbidities. cUTIs can be associated with high healthcare resource utilization (HCRU). We conducted a systematic literature review (SLR) to understand the economic burden of cUTI in a selection of countries likely to have early adoption of innovative antibiotic combination regimens.</p><p><strong>Methods: </strong>The SLR was conducted to identify observational studies evaluating the burden of cUTI in France, Italy, Germany, Spain, the United Kingdom, China, Japan, and the United States (US) for 2013-2023 (PROSPERO-CRD42023454794) using PubMed, Embase, Cochrane, and EconLit databases, with no language limitations.</p><p><strong>Results: </strong>Of 1,041 studies identified, 154 from databases were selected for full-text review; of these, 53 met the economic inclusion criteria, reporting direct costs and/or healthcare utilization. Mean hospitalization costs per cUTI varied from $2,747 in China to $32,790 for catheter-associated UTI (CAUTI) acquired in the hospital among US children. Length of stay (LOS) was the most common HCRU outcome reported. Across 3 multicountry studies, LOS for cUTI hospitalization was similar, with a median length of 7 days. Patients with CAUTI had longer LOS than did controls.</p><p><strong>Conclusions: </strong>Available evidence from the US studies indicates that economic burden associated with cUTI is substantial. However, except for the US, direct costs were missing or reported in only 1 or 2 studies for each of the other countries examined. Similarly, HCRU outcomes were missing or reported in only a few studies, except for the US and Spain.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1149-1169"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of age-specific stay-at-home recommendation on healthcare utilization: Evidence from Finland's COVID-19 policy.","authors":"Jukka Laaksonen, Mika Kortelainen, Henri Salokangas","doi":"10.1007/s10198-025-01887-z","DOIUrl":"10.1007/s10198-025-01887-z","url":null,"abstract":"<p><p>Postponements of non-acute care during the COVID-19 pandemic commonly raised concerns about harmful health consequences and increased healthcare costs, particularly among older individuals. Using nationwide register data from Finland, we employ a regression discontinuity design to examine the effect of an age-specific stay-at-home recommendation on healthcare utilization during the first wave of the pandemic. We find that the recommendation reduced non-acute visits, such as dental care, physiotherapy, and specialized care visits, but had no effect on acute care use, including emergency department visits or inpatient stays. The reductions in dental care use were partly compensated for after the lockdown was lifted, but not in other non-acute services. Additionally, we find indicative evidence of a slight increase in mortality during the three-months post-period after the lockdown. Our findings suggest that a Scandinavian-type social distancing recommendation targeting the elderly may reduce non-acute healthcare use in the short term, thereby temporarily alleviating pressure on healthcare resources during a pandemic. However, the absence of rebound in some non-acute services highlight potential unmet needs, which may imply longer-term risks of functional decline, preventable hospitalizations, and associated healthcare costs. These findings point to the importance of policies that ensure continued access to essential non-acute care for older populations.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1323-1349"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting health state preferences after 20 years: A new EQ-5D-3L value set for the Netherlands.","authors":"Bram Roudijk, Marcel F Jonker","doi":"10.1007/s10198-025-01892-2","DOIUrl":"10.1007/s10198-025-01892-2","url":null,"abstract":"<p><strong>Introduction: </strong>Value sets for the EQ-5D-3L have been developed since the 1990's, using methods that are now considered outdated. The Dutch EQ-5D-3L value set was developed using data collected in 2003, and population's preferences may have shifted over time. Consequently, the existing value set may no longer accurately represent the preferences of the Dutch general population. This study aims to develop a new EQ-5D-3L value set using state-of-the-art methods and compare it with the existing value set.</p><p><strong>Methods: </strong>A nationally representative sample of 417 Dutch adults, stratified by age and sex, completed 12 composite time trade-off (cTTO) tasks via online EuroQol Valuation Technology interviews. The data were modelled using a Tobit model that accounts for heteroskedasticity and the censored nature of cTTO data. Agreement between the new and existing value set was assessed using Bland-Altman and scatter plots.</p><p><strong>Results: </strong>Pain/discomfort and mobility were the most important dimensions in the new value set, whereas pain/discomfort and anxiety/depression were most important in the existing value set. The lowest health state value was - 0.723, considerably lower than the - 0.329 of the existing value set. The Bland-Altman and scatter plots indicated limited agreement between the two value sets.</p><p><strong>Conclusion: </strong>The new Dutch EQ-5D-3L value set differs substantially from the existing value set. We recommend its adoption and replacement of the previous value set. Our findings suggest that other countries with older value sets should consider similar updates to ensure accurate representation of contemporary societal preferences.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1351-1357"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Productivity costs associated with premature deaths due to acute myocardial infarction in Spain: analysis from 2013 to 2022.","authors":"Josep Darbà, Meritxell Ascanio, Antonio Rodríguez","doi":"10.1007/s10198-025-01881-5","DOIUrl":"10.1007/s10198-025-01881-5","url":null,"abstract":"<p><strong>Introduction: </strong>Acute myocardial infarction is one of the leading causes of death in Spain and a contributor to productivity loss. This condition represents an economic burden, involving significant indirect costs. Our objective here is to estimate premature deaths and productivity losses due to acute myocardial infarction in Spain during the period 2013-2022.</p><p><strong>Methods: </strong>Productivity costs were estimated using a simulation model based on the human capital method. Mortality rates, average salaries, and employment rates were collected for the entire study period.</p><p><strong>Results: </strong>After the analysis, acute myocardial infarction was identified as the leading cause of premature deaths related to cardiovascular diseases, accounting for 24% over the 10-year period. Additionally, an annual average of 26,935 YPLPLL was determined, with total productivity losses estimated at €5574.31 million, showing an upward trend over the reference period 2013-2022.</p><p><strong>Conclusions: </strong>The study concludes by emphasizing the economic burden associated with acute myocardial infarction, which can assist decision-makers in allocating resources more efficiently.</p>","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1251-1259"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How tax structures for retail cannabis shape cannabis use among youth and young adults: evidence from a volumetric choice experiment.","authors":"Lei Xu, Yanyun He, Hojin Park, Shiqi Zhang, Shaoying Ma, Ce Shang","doi":"10.1007/s10198-025-01875-3","DOIUrl":"10.1007/s10198-025-01875-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite ongoing debates about cannabis regulation, little is known about how tax policy design influences cannabis use among U.S. adolescents and young adults (AYAs). With states adopting diverse taxation schemes based on weight, price, or product potency, evaluating how these approaches affect consumption is critical for evidence-based policymaking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study uses a split sample volumetric choice experiment (VCE) to examine how variations in pretax prices, tax bases, tax rates, and THC levels influence both the amount of cannabis consumed and the overall intake of THC among US AYAs aged 15-20. We also estimate the own-price elasticities for four cannabis forms (legal flower, illegal flower, edibles, and cartridges) and cross-price elasticities between these products.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We use a nationally representative sample of 1,100 AYA who reported current use or susceptibility to use and completed a set of hypothetical purchase tasks featuring choices among four product forms (legal flower, illegal flower, edibles, cartridges). Respondents were randomized to three tax bases: weight-, price-, or potency-based taxation, where pre-tax price levels, tax rates, and THC levels additionally vary. We estimated own- and cross-price elasticities and assessed how AYA current and susceptible users adjusted cannabis consumption in response to the varying attributes using zero-inflated negative binomial and fixed effects models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Higher pre-tax prices and elevated tax rates significantly reduce both purchase quantities and total THC intake among current and susceptible AYA users. Products with higher THC levels increased THC intake but did not affect quantity consumption, suggesting that these users continue to purchase similar quantities but opt for more potent products. Compared to weight-based taxation, potency-based taxes (i.e., THC) were associated with a 30%-32% increase in cannabis quantity consumption. The price elasticities of cannabis demand were -0.3, with edibles being complements to other forms and illegal flowers being substitutes for legal flowers and cartridges. Compared to weight-based taxes, THC-based taxes significantly reduce the impact of THCs in increasing THC consumption. Finally, the impact of taxes on reducing THC consumption from legal products may be completely offset by shifting from legal to illegal products.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;For AYAs who are using or susceptible to using cannabis, tax increases can effectively reduce the quantity and THC consumption, albeit a tax rate beyond 60% of pretax prices or equivalent generating no additional reductions. Compared to weight-based taxes, potency-based and price-based taxes reduce the consumption of high THC products, but potency-based taxes may also increase the consumption of low THC products. Given that higher prices on cartridges and edibles do not drive AYAs' ","PeriodicalId":51416,"journal":{"name":"European Journal of Health Economics","volume":" ","pages":"1191-1212"},"PeriodicalIF":3.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}