Health economics最新文献

In Japan, female suicide increased during the COVID-19 pandemic. This study evaluated how pandemic-related home confinement affected female suicide. We employed a shift-share instrumental variable design to assess whether differential exposure to the pandemic caused changes in suicide incidence. We found that suicide increased among females under 20 years of age as more people stayed at home. Counterfactual analyses showed that at least 35% of these suicides were attributed to home confinement. Our results suggest that a substantial part of the suicide increase among young females was driven by lifestyle changes during the pandemic.

We examine public funding for health research through the United States National Institutes of Health Fogarty International Center's AIDS International Training and Research Program, which sought to strengthen scientific capacity in AIDS-endemic countries by providing African researchers with training opportunities in the U.S. We use a difference-in-differences framework with information on scientists who participated in the program and the research activities of African scientists working at their home institutions in adjacent topics of neglected tropical diseases. Relative to comparable scientists, those at institutions with returning trainees subsequently publish more on HIV-related topics, receive more grant funding, engage in more clinical trials, and their work contributes to a greater number of policy documents. These patterns suggest that following the Fogarty program, research, innovation, and health policy related to the AIDS epidemic in African countries became more active.

We extend the Rothshild and Stiglitz (1976) model to two sources of risk -inpatient and outpatient risk- to better proxy real-world health insurance markets. We uncover an interesting theoretical possibility: Take individuals A and B, who are low risks in, say, the inpatient dimension but A is riskier in the outpatient dimension. Then, A may enjoy less coverage than B in the inpatient dimension (coverage reversal). This phenomenon indicates that when testing for adverse selection in a given dimension, one has to treat individuals who differ in the other dimension separately. With this insight in mind, we adapt the Chiappori and Salanié (2000) positive correlation test to this multi-dimensionality and use it to test for adverse selection using individual-level claims data for the privately insured in Chile. This empirical analysis indicates that overlooking the aforementioned need of separating samples can potentially lead to biased conclusions.

How does individuals' health status evolve over time? Is this evolution characterized by any socio-economic gradient? To answer these questions, this paper proposes a new intuitive and normatively grounded criterion to assess and compare health dynamics over time accounting for population heterogeneities. Implementing this criterion to European data, this paper provides the first pan-European evidence on health dynamics and related heterogeneities from 2005 to 2019. It shows that socio-economic gradients have played an important role in shaping the health dynamics experienced by the European population. These dynamics appear progressive with respect to the pure economic status of individuals determined by their level of income. This feature is reverted when the economic conditions of individuals are widened to include non-pure monetary aspects such as professional condition and parental background.

Annually, countries allocate hundreds of millions of dollars to subsidize fossil fuels, often at the expense of public health and environmental sustainability. This undermines progress toward Sustainable Development Goals (SDG) 3 (Good Health and Well-Being) and 13 (Climate Action). Despite this, the impact of fossil fuel subsidies (FFS) on social protection expenditure, including health, remains poorly quantified. This study aimed to determine whether FFS crowd out health expenditure globally, using panel data from 126 countries covering the period 2015-2019. An instrumental variable approach, relying on countries' exposure to international energy trade and fluctuations in crude oil price, was employed to capture exogenous variation in FFS and estimate a causal relationship. The analyses revealed that in 2019, 17 countries spent more than five percent of GDP on FFS, with FFS expenditure exceeding health expenditure in 15 of those countries. Specifically, a 1% increase in FFS per capita, driven by rising international oil prices and weighted by countries' exposure to international energy trade, led to a 0.05% (95% CI -0.08% to -0.02%) decrease in domestic health expenditure per capita. These findings underscore the detrimental impact of FFS on health expenditure, presenting another reason to eliminate FFS to achieve SDG3 in addition to avoiding further dangerous climate heating.

Health and well-being in the family context can be affected by care giving arrangements. Following parental care and daycare, grandparents are the third most important care givers for children in many Western societies. Despite the relevance of grandparental care, there is little evidence on the causal effects of this care mode on the next generations' health and well-being. In this paper, we fill this gap by investigating the causal impact of regular grandparental care on the self-reported health and (domain-specific) satisfaction of both parents and children. To do so, we exploit geographic distance to grandparents as a source of arguably exogenous variation and use representative German panel data for families with children under the age of 11. Our results suggest positive effects on parental satisfaction with the child care situation, as well as mothers' satisfaction with their leisure time. However, we also find negative effects on children's health, particularly for elementary school aged children and for boys.

This study investigates the long-term health effects of early childhood exposure to the U.S. Child and Dependent Care Tax Credit (CDCTC). Using longitudinal data from the Child Development Supplement of the Panel Study of Income Dynamics, we examine the connection between early-life CDCTC exposure and health outcomes for children aged 6-18. The findings reveal varied effects depending on maternal education: children of mothers with more than a high school education experience adverse physical and mental health outcomes. In contrast, children of mothers who have a high school education or less show improvements in their mental health. These results indicate that, despite its intention to aid working families, the CDCTC may have complex effects on children's health, influenced by socio-economic factors. This study highlights the need for careful policy designs that consider the varying needs of families with different socio-economic statuses.

We investigate how disability insurance (DI) generosity affects DI take-up and labor market participation in a setting where benefits can be cumulated with substantial labor earnings. Using rich administrative data on Italian private-sector workers and a Regression Discontinuity in Time design, we find a large behavioral response to DI generosity, with an elasticity of 1.26 in DI take-up, while employment effects are minor and concentrated among immigrants. Our identification strategy exploits a major social security reform that reduced the expected DI replacement rate and generated a clear income effect. To address unobserved heterogeneity and the unobservability of underlying disability, we focus on individuals affected by acute cardiovascular shocks whose DI eligibility is plausibly exogenous. Overall, our results suggest that when earnings cumulability is extensive, DI is widely perceived as a complement to labor income. This has important implications for the design of labor-inclusive DI schemes.

This paper quantifies physician agency in China's prescription drug market by exploiting the structural shift created by the Zero-Markup Drug Policy. We find that physicians' prescribing decisions are about three times more sensitive to the hospital's profit margin than to the retail price faced by patients. The study provides several key findings. First, government policy exerts a strong influence on drug prices. Second, branded drugs are generally preferred over generics and display lower price elasticity. Third, the policy accounts for more than half of the observed decline in average wholesale prices. Finally, while the policy improves patient welfare, it reduces pharmaceutical firms' sales and profits, and a partial restoration of drug markups could increase overall social welfare.

In France, the Couverture Maladie Universelle Complémentaire (CMU-C) scheme is a means-tested, state-financed, complementary health insurance program that fully covers healthcare. Using administrative claims data and a staggered difference-in-differences approach, we estimate the impact of enrollment in the program on healthcare utilization. To address selection into the program, we use health shocks at the family level to exogenize individual enrollment. The findings indicate that access to free healthcare significantly increases healthcare utilization at both intensive and extensive margins. This effect is driven primarily by individuals who are uninsured before enrolling in the CMU-C. Moreover, individuals with severe or chronic illnesses, who already receive additional public coverage for their conditions, experience significant gains from the CMU-C coverage. Finally, these effects persist throughout the coverage period.