Health economics最新文献

Low birth weight and preterm birth are key indicators of neonatal health, influencing both immediate and long-term infant outcomes. While low birth weight may reflect fetal growth restrictions, preterm birth captures disruptions in gestational development. Ignoring the potential interdependence between these variables may lead to an incomplete understanding of their shared determinants and underlying dynamics. To address this, a copula distributional regression framework is adopted to jointly model both indicators as flexible functions of maternal characteristics and geographic effects. Applied to female birth data from North Carolina, the methodology identifies shared factors of low birth weight and preterm birth, and reveals how maternal health, socioeconomic conditions and geographic disparities shape neonatal risk. The joint modeling approach provides a more nuanced understanding of these birth metrics, offering insights that can inform targeted interventions, prenatal care strategies and public health planning.

A substantial proportion of alcohol related fatalities and their consequences are preventable, prompting policymakers to implement measures aimed at reducing these deaths. I exploit time and geographic variation in the adoption of zero-tolerance laws in a difference-in-differences design to study the impact of these regulations on traffic-related incidents. Using county-level data, I find no sizable reductions in fatalities and an increase in injury counts after the adoption of such laws. I do not find significant changes in several measures of alcohol consumption, consistent with the lack of reduction in driving fatalities.

Primary medical care has traditionally been provided by small organisations. Recent policy developments in many countries have encouraged larger practices in the hope of benefiting from increasing returns to scale, but there is little research evidence to support this. Using monthly data from 6149 primary care practices in England between August 2022 and July 2024, we applied a Generalized Linear Model with a logarithmic link and Poisson distribution to examine the relationship between staffing levels and appointment volumes. At the median level of administrative staffing, the estimated marginal productivity of doctors and other clinical staff on total appointments are 223 and 152 per month, respectively. The marginal effects of all types of staff on appointment volumes increase with staffing levels. We plot the isoquant and isocost curves at the median level of production and examine the implications of our findings for skill-mix and patient access. The current ratios of doctors to other clinical staff and nurses to Direct Patient Care (DPC) staff are lower than cost optimal, though this is less of an issue for larger practices who benefit more from DPC roles. Additional clinical staff improve patient access more when employed in larger practices.

We propose a method for studying the value of insurance. For this purpose, we analyze the well-being of the same individuals, comparing sick and healthy years, using German panel survey data on life satisfaction. We impose structure on the income–well-being gradient by fitting a flexible utility function to the data, focusing on the differences in marginal utility in the sick and the healthy states. Notably, our empirical specification allows for a “fixed cost of sickness.” We find a higher marginal utility of income in the sick state. We use our estimates to gauge the value of sickness insurance for Baily-Chetty–type optimal policy calculations.

Using comprehensive U.S. drug claims data, we show that adherence to asthma control medication declined during the COVID-19 pandemic. We find that young children exhibited a 40 percent decrease in adherence by the end of 2020. The responses were less negative for older children and positive for adults. We provide additional evidence that parental attention played a role in driving this decrease, based on heterogeneity by pre-pandemic mail order usage and number of parental scripts. Policy implications for improving pediatric adherence are discussed.

Doctor and non-doctor visit frequencies are key indicators of healthcare access, utilization and individual health-seeking behavior. While doctor visits reflect engagement with formal medical services, non-doctor visits, such as to nurses, physiotherapists or alternative providers, offer insights into patient preferences and system adaptability. Modeling these outcomes separately can hide relevant interdependencies and hence lead to incomplete conclusions. To address this, we employ a copula additive distributional regression framework to jointly model doctor and non-doctor visits as flexible functions of demographic, socioeconomic and health-related covariates. The estimation approach allows all the distributional parameters, including location, scale and the dependence structure, to vary with covariates via additive predictors. Application of the model to data from the 2012 Medical Expenditure Panel Survey reveals key determinants of physician and non-physician visits, such as age, income and health status. Importantly, the method allows for the modeling of shared unobserved heterogeneity and effectively captures how changes in one type of utilization influence the other, thereby yielding a deeper understanding of healthcare behavior.

Monetary incentives for vaccination may undermine intrinsic motivation, but evidence on this effect remains scarce. We conducted an experiment among 513 vaccine-hesitant adults to test whether priming individuals with a monetary incentive reduces their willingness to vaccinate against COVID-19. Our findings show that one in seven were willing to vaccinate without an incentive but declined the vaccine when asked to consider a payment. Additionally, priming participants lowered their perceptions of vaccine safety by 9 pp and prosocial attitudes toward vaccination by 10 pp. These negative effects were concentrated among men, racial and ethnic minorities, and participants with lower preexisting trust in the vaccine. Our results highlight an unintended consequence of vaccine incentives.