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Medicare Part D and Hospital Admissions due to Antimicrobial Resistance. 医疗保险D部分和抗菌素耐药性导致的住院。
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2026-01-19 DOI: 10.1002/hec.70080
Ricardo B Ang

Antimicrobial resistance (AMR) has been increasing rapidly in the United States despite government efforts to contain its spread. Both under-utilization and overuse of prescribed antimicrobials contribute to rising resistance. The introduction of Medicare Part D in 2006 expanded prescription drug coverage for the elderly, including coverage for antimicrobial medications. If cost barriers had previously led to under-utilization of prescriptions, then Medicare Part D could have mitigated AMR by improving access to antimicrobials. However, if Medicare Part D also encouraged excessive antibiotic use, it may have inadvertently contributed to greater resistance. Using data from the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality for January 2001 to September 2008, I estimate the causal impact of Medicare Part D on AMR-related hospital discharges using a difference-in-differences identification strategy. My findings suggest that Medicare Part D led to a slower increase in AMR-related inpatient discharges among the Medicare-eligible population.

尽管政府努力控制其传播,但抗菌素耐药性(AMR)在美国迅速增加。处方抗菌素的利用不足和过度使用都会导致耐药性上升。2006年引入的医疗保险D部分扩大了老年人处方药的覆盖范围,包括抗菌药物的覆盖范围。如果成本障碍以前导致处方利用不足,那么医疗保险D部分可以通过改善获得抗微生物药物来减轻抗菌素耐药性。然而,如果医疗保险D部分也鼓励过度使用抗生素,它可能会无意中导致更大的耐药性。利用2001年1月至2008年9月的全国住院病人样本(NIS)、医疗保健成本和利用项目(HCUP)、医疗保健研究和质量机构的数据,我使用差异中差异识别策略估计了医疗保险D部分对amr相关医院出院的因果影响。我的研究结果表明,在符合医疗保险条件的人群中,医疗保险D部分导致与amr相关的住院病人出院率增长较慢。
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引用次数: 0
The Effect of Voluntary Staying at Home on Japanese Female Suicide During the COVID-19 Pandemic. COVID-19大流行期间自愿居家对日本女性自杀的影响
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2026-01-11 DOI: 10.1002/hec.70078
Yoko Ibuka, Haruo Kakehi, Ryuki Kobayashi, Ryo Nakajima

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.

在日本,女性自杀率在COVID-19大流行期间有所上升。这项研究评估了与大流行相关的居家隔离如何影响女性自杀。我们采用偏移-份额工具变量设计来评估不同的大流行暴露是否会导致自杀发生率的变化。我们发现,随着越来越多的人呆在家里,20岁以下的女性自杀率上升。反事实分析表明,这些自杀中至少有35%归因于在家监禁。我们的研究结果表明,年轻女性自杀增加的很大一部分是由疫情期间生活方式的改变造成的。
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引用次数: 0
Return on Returns: Building Scientific Capacity in AIDS Endemic Countries. 回报回报:在艾滋病流行国家建设科学能力。
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2026-01-11 DOI: 10.1002/hec.70079
Caroline Fry, Ina Ganguli

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.

我们通过美国国立卫生研究院福格蒂国际中心的艾滋病国际培训和研究项目检查卫生研究的公共资金,该项目旨在通过向非洲研究人员提供在美国接受培训的机会来加强艾滋病流行国家的科学能力。我们使用了一个差异中差异的框架,其中包含参与该项目的科学家的信息,以及在本国机构工作的非洲科学家在被忽视的热带病相关主题上的研究活动。与同类科学家相比,那些在有回国学员的机构工作的科学家随后发表了更多关于艾滋病相关主题的文章,获得了更多的资助,参与了更多的临床试验,他们的工作为更多的政策文件做出了贡献。这些模式表明,在福格蒂方案之后,非洲国家与艾滋病流行有关的研究、创新和卫生政策变得更加活跃。
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引用次数: 0
Asymmetric Information With Multiple Risks: The Case of the Chilean Private Health Insurance Market. 多重风险下的信息不对称:以智利私人医疗保险市场为例
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2026-01-06 DOI: 10.1002/hec.70075
Dolores de la Mata, Matilde P Machado, Pau Olivella, Nieves Valdés

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.

我们将罗斯柴尔德和斯蒂格利茨(1976)模型扩展到两个风险来源-住院和门诊风险-以更好地代理现实世界的健康保险市场。我们发现了一个有趣的理论可能性:以个体A和个体B为例,他们在住院方面风险较低,但A在门诊方面风险较高。那么,A在住院维度上的覆盖率可能低于B(覆盖率反转)。这一现象表明,当测试一个特定维度的逆向选择时,必须分别对待在另一个维度上存在差异的个体。考虑到这一点,我们将Chiappori和salani(2000)的正相关检验适用于这个多维度,并使用它来测试智利私人保险的个人层面索赔数据的逆向选择。这一实证分析表明,忽视上述分离样品的需要可能会导致有偏见的结论。
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引用次数: 0
Exploring Population Heterogeneities in Health Dynamics. 探索健康动力学中的种群异质性。
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2026-01-01 DOI: 10.1002/hec.70076
Flaviana Palmisano

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.

个人的健康状况是如何随时间演变的?这种演变是否具有任何社会经济梯度的特征?为了回答这些问题,本文提出了一种新的直观和规范的标准,用于评估和比较考虑人口异质性的健康动态随时间的变化。本文将这一标准应用于欧洲数据,提供了2005年至2019年健康动态和相关异质性的首个泛欧洲证据。它表明,社会经济梯度在形成欧洲人口所经历的健康动态方面发挥了重要作用。相对于由收入水平决定的个人的纯粹经济地位,这些动态似乎是渐进的。当个人的经济条件扩大到包括非纯粹的货币方面,如职业条件和父母背景时,这一特征就会恢复。
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引用次数: 0
The Generational Gift: The Effects of Grandparental Care on the Next Generations' Health and Well-Being 代际礼物:祖父母关怀对下一代健康和幸福的影响。
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2025-12-17 DOI: 10.1002/hec.70054
Mara Barschkett, C. Katharina Spiess, Elena Ziege

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.

家庭中的健康和福祉可能受到照料安排的影响。在许多西方社会,祖父母是继父母照顾和日托之后第三重要的照顾者。尽管祖父母的照顾有相关性,但很少有证据表明这种照顾模式对下一代的健康和福祉有因果影响。在本文中,我们通过调查定期祖父母照顾对父母和子女自我报告的健康和(特定领域)满意度的因果影响来填补这一空白。为此,我们利用与祖父母的地理距离作为外生变异的来源,并使用具有代表性的德国面板数据,用于有11岁以下儿童的家庭。研究结果显示,家长对幼儿保育状况的满意度和母亲对闲暇时间的满意度均有正向影响。然而,我们也发现了对儿童健康的负面影响,特别是对小学学龄儿童和男孩。
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引用次数: 0
Long-Term Health Effects of Early Childhood Exposure to the Child and Dependent Care Tax Credit 儿童早期接触儿童和受抚养人照顾税收抵免的长期健康影响。
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2025-12-17 DOI: 10.1002/hec.70058
Susan Averett, Yating Gong, Yang Wang

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.

本研究调查了儿童早期接触美国儿童和受抚养人护理税收抵免(CDCTC)的长期健康影响。利用收入动态小组研究的儿童发展补充的纵向数据,我们研究了6-18岁儿童早期接触CDCTC与健康结果之间的联系。研究结果显示,受教育程度的不同会产生不同的影响:受过高中以上教育的母亲所生的孩子身体和心理健康都会出现不良后果。相比之下,受过高中或更低教育的母亲所生的孩子在心理健康方面有所改善。这些结果表明,尽管CDCTC旨在帮助工薪家庭,但受社会经济因素的影响,它可能对儿童健康产生复杂的影响。这项研究强调需要仔细设计政策,考虑到具有不同社会经济地位的家庭的不同需要。
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引用次数: 0
Cover 封面
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2025-12-05 DOI: 10.1002/hec.70069
Chantal Schouwenaar, Pierre Koning, Yvonne Krabbe-Alkemade, Maarten Lindeboom, France Portrait

The cover image is based on the article Long-Term Care at Advanced Ages: The Effect of Spousal Bereavement on Institutional Care Needs by Chantal Schouwenaar et al., https://doi.org/10.1002/hec.70043.

封面图片基于Chantal Schouwenaar等人的文章《高龄长期护理:配偶丧亲对机构护理需求的影响》(https://doi.org/10.1002/hec.70043)。
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引用次数: 0
Effects of Long-Term Exposure to the Earned Income Tax Credit on Work Disability in Later Life 长期接触劳动所得税抵免对晚年工作残疾的影响。
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2025-12-05 DOI: 10.1002/hec.70068
Katie Jajtner, Keisha T. Solomon, Yang Wang

This study investigates the impact of the Earned Income Tax Credit (EITC) on work disability and Social Security Disability Insurance (DI) claims among Americans. Utilizing the Panel Study of Income Dynamics, we examine the effects of EITC exposure from birth to mid-adulthood on work disability risk before retirement. Our analysis reveals that EITC exposure during adulthood significantly reduces the likelihood of work disability, potentially influencing DI trends. Specifically, a $10,000 increase in cumulative EITC exposure is associated with about a 1.25 percentage-point lower probability of any work limitation at ages 50–61 (a 0.94 percentage-point reduction in the likelihood of chronic/severe limitations) and a 0.84 percentage-point reduction in DI receipt, highlighting the EITC's potential role in reducing DI dependency and its broader implications for public policy and social welfare.

本研究调查了劳动所得税抵免(EITC)对美国人工作残疾和社会保障残疾保险(DI)索赔的影响。利用收入动态面板研究,我们研究了从出生到成年中期的EITC暴露对退休前工作残疾风险的影响。我们的分析表明,成年期的EITC暴露显著降低了工作残疾的可能性,潜在地影响了DI趋势。具体而言,每增加1万美元的累积EITC敞口,50-61岁的任何工作限制的可能性降低约1.25个百分点(慢性/严重限制的可能性降低0.94个百分点),残障补贴收入减少0.84个百分点,突出了EITC在减少残障补贴依赖方面的潜在作用及其对公共政策和社会福利的更广泛影响。
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引用次数: 0
Pandemic Babies: Medical Care Delays in Utero and Infant Birth Outcomes 流行病婴儿:子宫内医疗护理延迟和婴儿出生结局。
IF 2.4 3区 医学 Q2 ECONOMICS Pub Date : 2025-12-05 DOI: 10.1002/hec.70060
Xuechao Qian

This paper investigates the impact of medical care delays on infant and maternal health by leveraging Medical Procedure Delay Orders (MPDOs) issued by over 30 U.S. states at the onset of the COVID-19 pandemic and analyzing a large national claims dataset. I find that in utero exposure to MPDOs increases the likelihood of being diagnosed with newborn disorders related to adverse birth outcomes by 13%. Women exposed to MPDOs during pregnancy—particularly in the first and second trimesters—experience delays in critical prenatal care, such as ultrasounds and the detection of gestational health conditions. These disruptions likely contribute to the observed increase in adverse birth outcomes. The findings highlight the intergenerational and long-term consequences of interrupted maternal care.

本文通过利用美国30多个州在COVID-19大流行开始时发布的医疗程序延迟令(mpdo)并分析大型国家索赔数据集,调查了医疗保健延迟对婴儿和孕产妇健康的影响。我发现,在子宫内暴露于mpdo会使被诊断患有与不良出生结果相关的新生儿疾病的可能性增加13%。在怀孕期间暴露于mpdo的妇女,特别是在妊娠早期和中期,在关键的产前护理(如超声波检查和妊娠健康状况检测)方面会出现延误。这些干扰可能导致观察到的不良出生结局的增加。研究结果强调了中断产妇护理的代际和长期后果。
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引用次数: 0
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Health economics
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