Health economics最新文献

We analyze the short- and long-term impacts of maternity ward closures using registry data on every delivery in Norway from 1981 through 2019. Among those directly experiencing a closure, we find a small decline in 5-minute Apgar score and increased probability of birth outside institution. Since this drop in Apgar is not reflected across the other indicators, we hypothesize it reflects different institutional scoring standards as opposed to a health effect. For long-term outcomes, we find treatment as an infant increases the likelihood of beginning high school by 1 percentage point, but has no effect on graduating. Furthermore, for infants assigned female at birth, we find early-life treatment does not change the probability of giving birth as an adult or experiencing negative health conditions during pregnancy. We hypothesize robust prenatal care and health and social services may mitigate the impact of closures and thus account for a limited treatment effect.

Patient cost-sharing can lead to delays in necessary care, especially among low-income populations. In this study, we examine the impact of health insurance coverage for chronic disease treatments in outpatient care, using recent administrative insurance claims dataset from a low-income population in an underdeveloped city in China. Employing a propensity score matching and difference-in-differences approach, we find that outpatient coverage for certain chronic diseases increased outpatient utilization and expenses among patients with these conditions. Interestingly, these patients also increased their use of inpatient services, despite no changes in the cost-sharing for inpatient care. Our findings suggest the presence of delayed care, where outpatient visits helped patients recognize the severity of their diseases and increased the demand for inpatient care. These results have important implications for the implementation of universal health coverage and the dynamics of healthcare costs in low- and middle-income countries.

This paper examines the impacts of the Nitrogen Oxide Budget Program (NBP), a program that created a cap-and-trade market to regulate ozone pollution, on infant health outcomes. I employ the universe of birth records in the US from 1995 to 2008 and estimate how in-utero exposure to the NBP affected infant health using a triple-differences strategy. I find that exposure to the NBP improved infant health. Full exposure to the NBP reduces the incidence of low birth weight and very preterm birth by about 5.5% and 13%, respectively. Heterogeneity analyses suggest larger effects among Black mothers, low-educated mothers, and single mothers. I provide empirical evidence suggesting that endogenous changes in fertility behavior are unlikely to confound the estimates. A series of event studies do not support concerns that the effects reflect pre-existing trends in birth outcomes. Finally, I discuss the economic significance of the results in light of other exposures and their later-life impacts.

This paper examines the effects of increased trade between Japan and the U.S. on mortality rates in the U.S. using a shift-share instrumental variables approach. Overall, we find that an increase in Japanese imports is associated with higher rates of cardiovascular disease (CVD) mortality and lower rates of mortality from accidents. Effects of Japanese imports on deaths of despair are inconsistent, but there is a positive association between imports and drug-related deaths. These effects exhibit significant racial disparities. Specifically, a $1000 increase in import competition is associated with a 3.0% increase in CVD deaths per 100,000 Black individuals aged 20–64 years old, while there is no statistically significant effect among whites. Additionally, a $1000 increase in import competition is associated with a 13.5% increase in drug-related deaths per 100,000 Black individuals aged 20–64 years old compared to a 7.8% increase among white individuals. Effects on mortality rates from accidents are driven by deaths among whites. Our findings also indicate that the rise in CVD and drug-related mortality is concentrated among males and in regions with relatively high shares of employment in the automobile or computer industries.

This study examines the impact of enhanced social care provided through the Australian National Disability Insurance Scheme (NDIS) on subsidized healthcare utilisation for people with disability. Using linked administrative datasets from 2011 to 2020, we employed a Difference-in-Difference model and the staggered rollout of the NDIS to assess its effects on healthcare services, focusing on visits to general practitioners (GP), mental healthcare providers, allied health professionals, specialists, and mental health prescriptions. The results show that the NDIS reduced subsidized mental health services and allied health services in the six quarters after enrollment. However, it did not significantly affect visits to GP, specialists, or mental health prescriptions. These effects were most pronounced among individuals aged 0–24 years, males, and those living in major cities. The findings suggest that services available from NDIS may substitute for subsidized healthcare services by providing non-clinical care through social care channels. Further research is needed to investigate the long-term effects and health outcomes of the NDIS.