Health economics最新文献

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Time to Spare and Too Much Care? Crowding, Medical Intervention and Health Outcomes in the Maternity Ward 多余的时间和太多的关心？产妇病房拥挤、医疗干预和健康结果。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-10-24 DOI: 10.1002/hec.70048

Simon Bensnes

This paper examines the causal effect of crowding in maternity wards on medical treatment and health outcomes. To address endogeneity concerns, I focus on mothers and their newborns in Norwegian maternity wards and use the number of women with the same due date in a local area as an instrument for crowding. Using detailed administrative data covering all births in Norway over multiple years, I find that crowding—measured as a higher admission level— causes fewer unplanned readmissions and improved APGAR scores. On crowded days, mothers receive fewer inductions and other medical interventions, and no corresponding increase in reported complications. The instrumental variable strategy addresses potential endogeneity biases inherent in fixed-effects models and yields qualitatively similar estimates.

本文考察了产科病房拥挤对医疗和健康结果的因果影响。为了解决内生性问题，我将重点放在挪威产科病房的母亲和她们的新生儿上，并使用当地相同预产期的妇女数量作为拥挤的工具。使用涵盖挪威多年来所有出生的详细行政数据，我发现，以更高的入院水平衡量的拥挤导致更少的意外再入院，并提高了APGAR分数。在拥挤的日子里，母亲接受的引产和其他医疗干预较少，报告的并发症也没有相应增加。工具变量策略解决了固定效应模型固有的潜在内生性偏差，并产生了定性相似的估计。

引用次数: 0

Beyond Wealth: The Impact of Robot Adoption on Chronic Diseases 超越财富：采用机器人对慢性病的影响。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-10-18 DOI: 10.1002/hec.70052

Yinan Liu, Zou Wang, Xiaoxuan Jin, Angdi Lu

While the labor market effects of industrial robots have been extensively studied, their broader health implications, particularly on chronic diseases, remain unexplored. This study fills this gap by linking China's national-industry robot adoption data to individual health records from the China Health and Nutrition Survey (CHNS). Employing a city-level Bartik-type instrumental variable strategy, our Two-Stage Least Squares (2SLS) estimates reveal that an increase of one robot per thousand workers in a city reduces local probability of individuals having chronic diseases by 8.67%. The mechanisms driving these health benefits include better working conditions, better physical and mental well-being, and healthier lifestyle choices. A cost-benefit analysis suggests these health benefits are substantial, significantly outweighing the robots' acquisition costs. Our findings from China highlight a crucial, yet overlooked, positive externality of automation on public health in developing economies.

虽然工业机器人对劳动力市场的影响已被广泛研究，但其更广泛的健康影响，特别是对慢性病的影响，仍未得到探索。本研究通过将中国国家工业机器人采用数据与中国健康与营养调查（CHNS）的个人健康记录联系起来，填补了这一空白。采用城市级bartik型工具变量策略，我们的两阶段最小二乘（2SLS）估计显示，一个城市每千名工人增加一个机器人，将使当地个人患慢性病的概率降低8.67%。推动这些健康益处的机制包括更好的工作条件、更好的身心健康以及更健康的生活方式选择。一项成本效益分析表明，这些健康效益是巨大的，远远超过了购买机器人的成本。我们在中国的研究结果强调了自动化对发展中经济体公共卫生的一个至关重要但被忽视的积极外部性。

引用次数: 0

Long-Term Care at Advanced Ages: The Effect of Spousal Bereavement on Institutional Care Needs 高龄长期照护：配偶丧亲对机构照护需求的影响。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-10-13 DOI: 10.1002/hec.70043

Chantal Schouwenaar, Pierre Koning, Yvonne Krabbe-Alkemade, Maarten Lindeboom, France Portrait

With populations aging, long-term care (LTC) needs and costs rise, intensifying the reliance on informal care. Since spouses predominantly provide such care, it is crucial to understand the transition dynamics from widowhood to institutional LTC, which is the main driver of the public LTC costs in most OECD countries. Our study examines the causal effect of widowhood on the onset of needs for institutional LTC. For this we use recently developed event-time models that accommodate for variation in treatment time and dynamic effects of treatment. Our results show that partner loss significantly increases the need for institutional LTC. The average effect of partner loss on the need for institutional LTC peaks at a 1.5 percentage point rise 3 months after widowhood and disappears after 10 months. The effect is strongest for individuals with psycho-geriatric disorders, the oldest old and the frail. Addressing the immediate need for institutional LTC after widowhood remains critical for effective aging-in-place strategies.

随着人口老龄化，长期护理（LTC）需求和成本上升，加剧了对非正式护理的依赖。由于配偶主要提供这种照顾，因此了解从守寡到机构长期护理的过渡动态至关重要，这是大多数经合组织国家公共长期护理成本的主要驱动因素。我们的研究考察了丧偶对机构LTC需求发生的因果影响。为此，我们使用最近开发的事件时间模型，以适应治疗时间和治疗动态效果的变化。我们的研究结果表明，合作伙伴的流失显著增加了机构LTC的需求。失去伴侣对机构LTC需求的平均影响在丧偶3个月后达到峰值，上升1.5个百分点，10个月后消失。这种影响对老年精神疾病患者、老年人和体弱多病者最为明显。解决丧偶后机构LTC的迫切需求对于有效的就地老龄化战略仍然至关重要。

引用次数: 0

Hope and the Life Course: Results From a Longitudinal Study of 25,000 Adults 希望与生命历程：一项对25000名成年人的纵向研究的结果。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-10-07 DOI: 10.1002/hec.70041

Carol Graham, Redzo Mujcic

This paper reports the first large-scale longitudinal links between one of the least known dimensions of wellbeing—hope—and long-term outcomes in a range of life arenas. Hope has agentic properties which are relevant to people's future outcomes. Following 25,000 randomly sampled Australian adults over a period of 14 years from 2007 to 2021 (N > 115,000), we find a strong link between hope and better contemporary and future outcomes. Individuals with high levels of hope had improved later wellbeing, education, economic and employment outcomes, perceived and objective health, and are less likely to be lonely. Hope is associated with higher resilience, ability to adapt, and internal locus of control. It also serves as a psychological buffer during bad times. Respondents with high levels of hope were less likely to be influenced by negative life events and adapted more quickly and completely after these major events. Better understanding the drivers and consequences of hope can ultimately inform public policy to improve people's lives.

本文首次报道了幸福感的一个鲜为人知的维度——希望——与一系列生活领域的长期结果之间的大规模纵向联系。希望具有代理属性，这与人们未来的结果有关。在2007年至2021年的14年间，我们对25000名随机抽样的澳大利亚成年人进行了跟踪调查（N > 115,000），发现希望与更好的当代和未来结果之间存在密切联系。抱有高度希望的人在以后的福祉、教育、经济和就业成果、感知和客观健康方面都有所改善，而且不太可能感到孤独。希望与更高的恢复力、适应能力和内在控制点有关。在经济不景气的时候，它也起到心理缓冲的作用。希望程度高的受访者不太可能受到负面生活事件的影响，在这些重大事件发生后适应得更快、更彻底。更好地了解希望的驱动因素和后果，最终可以为改善人们生活的公共政策提供信息。

引用次数: 0

The Effects of Paid-Sick-Leave Mandates on Care Provision 带薪病假对医疗服务的影响。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-10-07 DOI: 10.1002/hec.70049

Xiaohui Guo, Lizhong Peng

The U.S. paid-sick-leave (PSL) mandates allow private-sector workers to take time off for their own or family members' illnesses. However, the impacts of these laws on workers' care seeking and provision activities are relatively understudied. We address this gap by exploiting cross-state variation in mandate enactment between 2012 and 2019. Using data from the American Time Use Survey, our difference-in-differences estimates show little evidence that PSL mandates affect the probability of spending time on overall care provision at the population level. However, we find a positive association between the mandates and care provided to adults by workers in industries with larger exposure to the policies. Our results provide empirical support for the potential of paid leave policies to help workers who otherwise have limited access to the benefit reconcile workplace responsibilities and caregiving.

美国的带薪病假（PSL）规定允许私营部门的员工因自己或家人生病而休假。然而，这些法律对工人寻求护理和提供活动的影响研究相对不足。我们通过利用2012年至2019年期间各州在任务制定方面的差异来解决这一差距。使用来自美国时间使用调查的数据，我们的差异中差异估计显示，在人口水平上，PSL任务影响花费时间在总体护理提供上的概率的证据很少。然而，我们发现，在受政策影响较大的行业中，授权和工人向成年人提供的照顾之间存在正相关关系。我们的研究结果为带薪休假政策的潜力提供了实证支持，以帮助那些在其他方面无法获得福利的工人协调工作场所的责任和照顾。

引用次数: 0

Historical Racial Oppression and Healthcare Access: Unveiling Disparities Post-ACA in the American South 历史上的种族压迫和医疗服务：揭露aca后美国南部的差异。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-10-01 DOI: 10.1002/hec.70042

Vinish Shrestha

This study investigates geographical disparities in the implementation and effectiveness of the Affordable Care Act (ACA) by linking them to the historical legacy of racial oppression in the American South. Using a cross-border regression discontinuity design that leverages variations in racial oppression intensity, we find that bordering counties in states with less oppressive regime experienced significantly greater benefits from the ACA compared to neighboring counties in more oppressive states. This divergence in insurance outcomes, which did not exist before the ACA, underscores the influence of historical racial regimes on contemporary policy efficacy. Furthermore, we demonstrate that political preferences from the Jim Crow era are correlated with the observed variations in ACA effectiveness. Our findings suggest that the racialization of the ACA is deeply rooted in the historical context of racial oppression in the American South.

本研究通过将《平价医疗法案》（ACA）的实施和有效性与美国南部种族压迫的历史遗产联系起来，调查了这些地区在实施和有效性方面的差异。利用跨界回归不连续设计，利用种族压迫强度的变化，我们发现，与压迫程度较低的州的边境县相比，压迫程度较高的州的邻国县从ACA中获得的好处要大得多。这种在ACA之前并不存在的保险结果差异，突显了历史上的种族制度对当代政策效力的影响。此外，我们证明了来自吉姆·克劳时代的政治偏好与观察到的ACA有效性变化相关。我们的研究结果表明，ACA的种族化深深植根于美国南部种族压迫的历史背景。

引用次数: 0

Cognitive, Noncognitive, and Social Skills and Alcohol Consumption 认知、非认知和社交技能与酒精消费。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-10-01 DOI: 10.1002/hec.70046

Sun Hyung Kim, Young C. Joo

We study the effects of cognitive, noncognitive, and social skills on alcohol consumption, measured through total quantity, frequency, typical quantity, and binge drinking. Using the data from the NLSY79, we find that cognitive skills increase drinking frequency but reduce binge drinking and typical quantity. Noncognitive skills negatively impact frequency, typical quantity, and binge drinking, whereas social skills positively affect all measures of alcohol consumption. We present a framework and employ parametric causal mediation analysis to explore transmission channels, identifying mental wellness, future planning, and occupation prestige as significant mediators. However, the direction of this influence varies, highlighting the heterogeneity of the transmission channels.

我们研究了认知、非认知和社交技能对酒精消费的影响，通过总量、频率、典型量和酗酒来衡量。利用NLSY79的数据，我们发现认知技能增加了饮酒频率，但减少了酗酒和典型量。非认知技能对饮酒频率、典型数量和酗酒有负面影响，而社交技能对饮酒的所有指标都有积极影响。我们提出了一个框架，并采用参数因果中介分析来探索传播渠道，确定心理健康、未来规划和职业声望是重要的中介。然而，这种影响的方向各不相同，突出了传播渠道的异质性。

引用次数: 0

The Rise of Health Economics: Transforming the Landscape of Economic Research 卫生经济学的兴起：改变经济研究的格局。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-09-24 DOI: 10.1002/hec.70044

Lorenz Gschwent, Björn Hammarfelt, Martin Karlsson, Mathias Kifmann

This paper explores the evolving role of health economics within economic research and publishing over the past 30 years. Historically, largely a niche field, health economics has become increasingly prominent, with the share of health economics papers in top journals growing significantly. We aim to identify the factors behind this rise. Using a combination of bibliometric methods and natural language processing (NLP), we classify abstracts to define health economics. Adapting NLP methods to evaluate the novelty, impact, and quality of academic papers, we demonstrate that the mainstreaming of health economics is driven by innovative, high-quality research, with two notable waves in quality ratings that highlight the emergence and impact of distinct subfields within the discipline. We find a strong positive correlation between citations and quality ratings, with health economics papers receiving fewer citations for their quality compared to other economics fields. Pandemic-related research received a high number of citations during 2020 and 2021; however, our findings indicate that this work was not systematically more novel or impactful than prior studies within the same subfield.

本文探讨了卫生经济学在过去30年经济研究和出版中的演变作用。从历史上看，卫生经济学在很大程度上是一个利基领域，但随着卫生经济学论文在顶级期刊上的份额显著增长，它已变得越来越突出。我们的目标是找出这种增长背后的因素。采用文献计量学方法和自然语言处理（NLP）相结合的方法，我们分类摘要来定义卫生经济学。采用NLP方法来评估学术论文的新颖性、影响力和质量，我们证明了卫生经济学的主流化是由创新的、高质量的研究推动的，在质量评级方面有两个显著的浪潮，突出了该学科中不同子领域的出现和影响。我们发现引用次数与质量评级之间存在很强的正相关关系，与其他经济学领域相比，卫生经济学论文的质量被引用次数较少。2020年和2021年期间，与大流行相关的研究获得了大量引用；然而，我们的研究结果表明，这项工作并不比以前在同一子领域的研究系统地更新颖或更有影响力。

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引用次数: 0

Vaccination and Risk Aversion: Evidence From a Flu Vaccination Campaign 疫苗接种和风险规避：来自流感疫苗接种运动的证据。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-09-24 DOI: 10.1002/hec.70037

Clémentine Garrouste, Arthur Juet, Anne-Laure Samson

We examine the causal effect of a French flu vaccination campaign on vaccination behavior. Individuals aged 65 and over receive an invitation letter with a voucher for a free flu shot, while those who are not eligible have to cover the costs themselves. Using a Fuzzy Regression Discontinuity Design, we find that receiving the invitation letter with the voucher leads to a significant increase in the likelihood of getting vaccinated. This effect is driven by individuals who are risk-averse. As illustrated in our theoretical model, for them, the costs of influenza infection outweigh the costs of the vaccine's side effects.

我们研究了法国流感疫苗接种运动对疫苗接种行为的因果效应。65岁及以上的人会收到一封带有免费流感疫苗券的邀请函，而那些不符合条件的人必须自己支付费用。使用模糊回归不连续设计，我们发现收到带有优惠券的邀请函导致接种疫苗的可能性显着增加。这种效应是由规避风险的个人驱动的。正如我们的理论模型所示，对他们来说，流感感染的成本超过了疫苗副作用的成本。

引用次数: 0

Hope Walks: The Impact of Clubfoot Treatment on Human Flourishing in Ethiopia 希望行走：内翻足治疗对埃塞俄比亚人类繁荣的影响。

IF 2.4 3区医学 Q2 ECONOMICS

Health economics

Pub Date : 2025-09-18 DOI: 10.1002/hec.70040

Bruce Wydick, Gianna Camacho, Patrizio Piraino

Children born with severe congenital conditions in low-income countries rank among the most disadvantaged among the global ultra-poor. We study the impact of clubfoot and its treatment across multiple dimensions of human flourishing on data collected from 564 children in Ethiopia. Working with Hope Walks, an organization that funds clubfoot interventions in numerous countries, we use a quasi difference-in-differences approach that generates counterfactual outcomes from the nearest-age siblings of children born with clubfoot, nested within a family-level fixed effect. We find that clubfoot status (early treatment) results in an impairment (restoration) of −1.44<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math> (0.91<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math>) in physical mobility, −1.17<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math> (0.79<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math>) in mental health, −1.07<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math> (0.64<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math>) in social inclusion, −0.48<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math> (0.98<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math>) in an education index, −0.76<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math> (0.42<math> <semantics> <mrow> <mi>σ</mi> </mrow> <annotation> $sigma $</annotation> </semantics></math>) in religious fa

低收入国家出生时患有严重先天性疾病的儿童在全球极度贫困人口中处于最不利的地位。我们从埃塞俄比亚564名儿童收集的数据中研究了足内翻对人类繁荣的多个维度的影响及其治疗。我们与“希望之路”（Hope Walks）合作，该组织为许多国家的内翻足干预提供资金。我们采用了一种准差异中差异的方法，从出生时患有内翻足的孩子的年龄最近的兄弟姐妹中得出反事实的结果，嵌套在家庭层面的固定效应中。研究发现，内翻足状态（早期治疗）对身体活动能力的损害（恢复）为-1.44 σ $sigma $ (0.91 σ $sigma $)，对心理健康的损害为-1.17 σ $sigma $ (0.79 σ $sigma $)，对社会包容的损害为-1.07 σ $sigma $ (0.64 σ $sigma $)，对教育的损害为-0.48 σ $sigma $ (0.98 σ $sigma $)，对宗教信仰的损害为-0.76 σ $sigma $ (0.42 σ $sigma $)，对宗教信仰的损害为-0.76 σ $sigma $ （0.42 σ $sigma $）。人类繁荣总指数为-1.32 σ $sigma $ (0.94 σ $sigma $)（均p 0.05$ p< 0.05$）。我们将内翻足治疗的巨大、广泛和显著影响归因于：(i)在贫困环境中（ii）对先天残疾儿童缺乏现有支持的高度有效的医疗干预，（iii）在关键发展成果中广泛产生溢出效应。

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