Pub Date : 2025-03-26DOI: 10.1016/j.jhealeco.2025.102986
Alexander Ahammer , Analisa Packham
We provide new evidence on the returns to more targeted disability insurance (DI) programs in terms of labor force participation, program spillovers, and worker health. To do so, we analyze Austrian workers after a workplace injury that experience differential levels of application screening. We find that when workers face stricter screening, they are more likely to remain in the labor force. However, we estimate no statistical differences in any physical or mental health outcomes, and can rule out large effects on overall healthcare utilization. Our findings imply that imposing stricter DI screening can yield large fiscal benefits, on the margin.
{"title":"Disability insurance screening and worker health","authors":"Alexander Ahammer , Analisa Packham","doi":"10.1016/j.jhealeco.2025.102986","DOIUrl":"10.1016/j.jhealeco.2025.102986","url":null,"abstract":"<div><div>We provide new evidence on the returns to more targeted disability insurance (DI) programs in terms of labor force participation, program spillovers, and worker health. To do so, we analyze Austrian workers after a workplace injury that experience differential levels of application screening. We find that when workers face stricter screening, they are more likely to remain in the labor force. However, we estimate no statistical differences in any physical or mental health outcomes, and can rule out large effects on overall healthcare utilization. Our findings imply that imposing stricter DI screening can yield large fiscal benefits, on the margin.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102986"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-24DOI: 10.1016/j.jhealeco.2025.102990
Julian House, Nicola Lacetera, Mario Macis, Nina Mazar
{"title":"Corrigendum to \"Nudging the Nudger: A Field Experiment on the Effect of Performance Feedback to Increase Organ Donor Registrations\" [Journal of Health Economics, 97, 102914, 2024].","authors":"Julian House, Nicola Lacetera, Mario Macis, Nina Mazar","doi":"10.1016/j.jhealeco.2025.102990","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2025.102990","url":null,"abstract":"","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":" ","pages":"102990"},"PeriodicalIF":3.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-19DOI: 10.1016/j.jhealeco.2025.102988
Casper Worm Hansen , Holger Strulik
A strong regularity of human life is Gompertz’s law, which predicts a near-perfect exponential increase in mortality with age. In this paper, we take into account that chronological age is not a cause of death and decompose Gompertz’s law into two equally strong laws: (i) an exponential increase in health deficits as measured by the frailty index, and (ii) a power law association between the frailty index and the mortality rate. We show how the increase in the frailty index can be derived from the feature of self-productivity of health deficits. We explore the robustness of the Gompertz decomposition across countries, sex, and over time and show how information about mortality rates can be used to infer the state of health of an age-structured population. Finally, we use this method to infer the biological ages of past populations, such as Australians in 1940 and Swedes in 1770.
{"title":"How do we age? A decomposition of Gompertz law","authors":"Casper Worm Hansen , Holger Strulik","doi":"10.1016/j.jhealeco.2025.102988","DOIUrl":"10.1016/j.jhealeco.2025.102988","url":null,"abstract":"<div><div>A strong regularity of human life is Gompertz’s law, which predicts a near-perfect exponential increase in mortality with age. In this paper, we take into account that chronological age is not a cause of death and decompose Gompertz’s law into two equally strong laws: (i) an exponential increase in health deficits as measured by the frailty index, and (ii) a power law association between the frailty index and the mortality rate. We show how the increase in the frailty index can be derived from the feature of self-productivity of health deficits. We explore the robustness of the Gompertz decomposition across countries, sex, and over time and show how information about mortality rates can be used to infer the state of health of an age-structured population. Finally, we use this method to infer the biological ages of past populations, such as Australians in 1940 and Swedes in 1770.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102988"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-14DOI: 10.1016/j.jhealeco.2025.102989
Wei Lyu , George L. Wehby , Robert Kaestner
During the COVID-19 pandemic, the federal government issued stimulus checks and expanded the child tax credit. These payments varied by marital status and the number of children in the household. We exploit this plausibly exogenous variation in income during pregnancy to obtain estimates of the effect of income on infant health. Data are from birth certificates and the sample focuses on mothers with high school or less education. The main estimates indicate that pandemic cash payments had virtually no statistically significant, or clinically or economically meaningful effects on infant health (birth weight, gestational age, and fetal growth outcomes), at least for the range of payments received by most mothers.
{"title":"Effects of income on infant health: Evidence from the expanded child tax credit and pandemic stimulus checks","authors":"Wei Lyu , George L. Wehby , Robert Kaestner","doi":"10.1016/j.jhealeco.2025.102989","DOIUrl":"10.1016/j.jhealeco.2025.102989","url":null,"abstract":"<div><div>During the COVID-19 pandemic, the federal government issued stimulus checks and expanded the child tax credit. These payments varied by marital status and the number of children in the household. We exploit this plausibly exogenous variation in income during pregnancy to obtain estimates of the effect of income on infant health. Data are from birth certificates and the sample focuses on mothers with high school or less education. The main estimates indicate that pandemic cash payments had virtually no statistically significant, or clinically or economically meaningful effects on infant health (birth weight, gestational age, and fetal growth outcomes), at least for the range of payments received by most mothers.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102989"},"PeriodicalIF":3.4,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-04DOI: 10.1016/j.jhealeco.2025.102987
Øyvind Snilsberg, Tor Iversen
This study evaluates Norway's Primary Healthcare Teams (PHT) pilot program, which introduced team-based care in general practice clinics to improve care for patients with complex conditions. Practices hired nurses and chose between an activity-based or block funding model. This analysis examines the activity-based funding model, which incorporated fee-for-service (FFS) for nurses. Using a difference-in-differences (DID) approach, the study assesses the program's impact on quality-related primary care services, out-of-hours care, hospitalizations, general practitioners’ (GPs’) working hours, and patient list length. The findings show that PHTs increased quality-related services for target groups (primarily provided by nurses) without affecting GP working hours or list length, suggesting that added nurse capacity was used to enhance care for target patients, not expand primary care access. There is little evidence of changes in healthcare utilization outside primary care, except a possible reduction in hospitalizations for type 2 diabetes patients with ambulatory care-sensitive conditions.
{"title":"The impact of team-based primary care on quality-related healthcare services and access to primary care: Norway's primary healthcare teams pilot program","authors":"Øyvind Snilsberg, Tor Iversen","doi":"10.1016/j.jhealeco.2025.102987","DOIUrl":"10.1016/j.jhealeco.2025.102987","url":null,"abstract":"<div><div>This study evaluates Norway's Primary Healthcare Teams (PHT) pilot program, which introduced team-based care in general practice clinics to improve care for patients with complex conditions. Practices hired nurses and chose between an activity-based or block funding model. This analysis examines the activity-based funding model, which incorporated fee-for-service (FFS) for nurses. Using a difference-in-differences (DID) approach, the study assesses the program's impact on quality-related primary care services, out-of-hours care, hospitalizations, general practitioners’ (GPs’) working hours, and patient list length. The findings show that PHTs increased quality-related services for target groups (primarily provided by nurses) without affecting GP working hours or list length, suggesting that added nurse capacity was used to enhance care for target patients, not expand primary care access. There is little evidence of changes in healthcare utilization outside primary care, except a possible reduction in hospitalizations for type 2 diabetes patients with ambulatory care-sensitive conditions.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102987"},"PeriodicalIF":3.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-03DOI: 10.1016/j.jhealeco.2025.102976
Kurt R. Brekke , Dag Morten Dalen , Odd Rune Straume
We study the competitive effects of combination therapies in pharmaceutical markets, which crucially hinge on the additional therapeutic value of combinatory use of drugs and the therapeutic substitutability with the most relevant monotherapy. If the therapeutic value is sufficiently large, the introduction of combination therapies leads to higher prices and, somewhat paradoxically, may reduce the health plan’s surplus, defined as total health benefits net of drug expenditures. If the firms are allowed to coordinate their price setting, this will lead to higher prices under uniform pricing but lower prices under indication-based pricing. Allowing for the latter type of pricing scheme might increase allocational efficiency, but only at the expense of higher drug expenditures.
{"title":"Taking the competitor’s pill: When combination therapies enter pharmaceutical markets","authors":"Kurt R. Brekke , Dag Morten Dalen , Odd Rune Straume","doi":"10.1016/j.jhealeco.2025.102976","DOIUrl":"10.1016/j.jhealeco.2025.102976","url":null,"abstract":"<div><div>We study the competitive effects of combination therapies in pharmaceutical markets, which crucially hinge on the additional therapeutic value of combinatory use of drugs and the therapeutic substitutability with the most relevant monotherapy. If the therapeutic value is sufficiently large, the introduction of combination therapies leads to higher prices and, somewhat paradoxically, may reduce the health plan’s surplus, defined as total health benefits net of drug expenditures. If the firms are allowed to coordinate their price setting, this will lead to higher prices under uniform pricing but lower prices under indication-based pricing. Allowing for the latter type of pricing scheme might increase allocational efficiency, but only at the expense of higher drug expenditures.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102976"},"PeriodicalIF":3.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1016/j.jhealeco.2025.102974
Alicia Atwood, Sarah Pearlman
We investigate the impacts on education and employment of a reduction in measles stemming from a nationwide immunization program in Mexico. The program lead to significant improvements in childhood health as measles causes “immune amnesia”, leaving individuals susceptible to illness from other diseases. We find the measles vaccine led to large increases in educational attainment for both men and women, with the effects being concentrated in lower secondary school for women and split between lower and upper secondary school for men. Labor market outcomes also improved with women experiencing large increases in employment and men seeing significant gains in income.
{"title":"The long term benefits of the measles vaccine in Mexico","authors":"Alicia Atwood, Sarah Pearlman","doi":"10.1016/j.jhealeco.2025.102974","DOIUrl":"10.1016/j.jhealeco.2025.102974","url":null,"abstract":"<div><div>We investigate the impacts on education and employment of a reduction in measles stemming from a nationwide immunization program in Mexico. The program lead to significant improvements in childhood health as measles causes “immune amnesia”, leaving individuals susceptible to illness from other diseases. We find the measles vaccine led to large increases in educational attainment for both men and women, with the effects being concentrated in lower secondary school for women and split between lower and upper secondary school for men. Labor market outcomes also improved with women experiencing large increases in employment and men seeing significant gains in income.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102974"},"PeriodicalIF":3.4,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public finance constraints following the 2008 financial crisis in Europe often affected the hospital sector. This paper investigates i) the causal health impacts of reduced hospital supply, and ii) possible mechanisms to explain these. Using a staggered difference-in-differences framework, we study the effects of hospital closures on outcomes of all heart attack patients admitted to an Italian hospital between 2008 and 2015. Results show that closures increased in-hospital mortality by 10 % and length-of-stay by 0.3 days, but had no impact on readmissions. We explore potential mechanisms using different estimation approaches, and show that increased travel time following closures explains most of the mortality effect.
{"title":"The impact of budget cuts on individual patient health: Causal evidence from hospital closures","authors":"Simone Ghislandi , Anna-Theresa Renner , Nirosha Elsem Varghese","doi":"10.1016/j.jhealeco.2025.102975","DOIUrl":"10.1016/j.jhealeco.2025.102975","url":null,"abstract":"<div><div>Public finance constraints following the 2008 financial crisis in Europe often affected the hospital sector. This paper investigates i) the causal health impacts of reduced hospital supply, and ii) possible mechanisms to explain these. Using a staggered difference-in-differences framework, we study the effects of hospital closures on outcomes of all heart attack patients admitted to an Italian hospital between 2008 and 2015. Results show that closures increased in-hospital mortality by 10 % and length-of-stay by 0.3 days, but had no impact on readmissions. We explore potential mechanisms using different estimation approaches, and show that increased travel time following closures explains most of the mortality effect.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"101 ","pages":"Article 102975"},"PeriodicalIF":3.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1016/j.jhealeco.2025.102970
Yoko Ibuka , Junya Hamaaki
Studies indicate that mortality increases after income receipt. To explore whether this is due to increased economic activity around the period of receiving income, we examine within-month patterns in ambulance transport incidents, focusing on location and timing. Using Japan’s National Pension payments made every two months, we compare the number of ambulance transport incidents on the day of pension payment and on surrounding days in payment months with those in non-payment months. The results show a 4.5% increase in ambulance transport incidents on the day of pension payment, linked to increased activities such as gambling, shopping, and dining out. We show suggestive evidence that income receipt boosts economic activities by the mechanism of easing liquidity constraints. These findings have implications for healthcare system preparedness and the optimal design of public benefit payment.
{"title":"Income receipt, economic activities, and health: Evidence from ambulance transport patterns","authors":"Yoko Ibuka , Junya Hamaaki","doi":"10.1016/j.jhealeco.2025.102970","DOIUrl":"10.1016/j.jhealeco.2025.102970","url":null,"abstract":"<div><div>Studies indicate that mortality increases after income receipt. To explore whether this is due to increased economic activity around the period of receiving income, we examine within-month patterns in ambulance transport incidents, focusing on location and timing. Using Japan’s National Pension payments made every two months, we compare the number of ambulance transport incidents on the day of pension payment and on surrounding days in payment months with those in non-payment months. The results show a 4.5% increase in ambulance transport incidents on the day of pension payment, linked to increased activities such as gambling, shopping, and dining out. We show suggestive evidence that income receipt boosts economic activities by the mechanism of easing liquidity constraints. These findings have implications for healthcare system preparedness and the optimal design of public benefit payment.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"Article 102970"},"PeriodicalIF":3.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1016/j.jhealeco.2025.102973
Chad D. Meyerhoefer , Bingjin Xue , Anna Poznańska
Theories of minority stress suggest recent legislation limiting LGBT rights can reduce the health of LGBT individuals and their families. We investigate how the creation of LGBT-free zones across Poland during 2019 and 2020 affected mental health and mortality. We find that annual suicide attempts increased by 16.5 %, or 5 attempts per 100k, deaths from external causes, including automobile accidents, suicides and other accidents and injuries increased 10.6 %, or 5.6 deaths per 100k, and suicide deaths increased 17.0 % (p = 0.108), or 1.9 deaths per 100k, in LGBT-free zones. The rise in suicide attempts was concentrated among individuals aged 13–18 and 45–49 and coincided with an 8.8 % increase in sales of prescription drugs for addictive disorders. However, there was no change in the use of psychotropic medications used to treat mental health conditions, indicative of limited access to mental health care.
{"title":"Implications of the decline in LGBT rights for population mental health: Evidence from Polish “LGBT-free zones”","authors":"Chad D. Meyerhoefer , Bingjin Xue , Anna Poznańska","doi":"10.1016/j.jhealeco.2025.102973","DOIUrl":"10.1016/j.jhealeco.2025.102973","url":null,"abstract":"<div><div>Theories of minority stress suggest recent legislation limiting LGBT rights can reduce the health of LGBT individuals and their families. We investigate how the creation of LGBT-free zones across Poland during 2019 and 2020 affected mental health and mortality. We find that annual suicide attempts increased by 16.5 %, or 5 attempts per 100k, deaths from external causes, including automobile accidents, suicides and other accidents and injuries increased 10.6 %, or 5.6 deaths per 100k, and suicide deaths increased 17.0 % (<em>p</em> = 0.108), or 1.9 deaths per 100k, in LGBT-free zones. The rise in suicide attempts was concentrated among individuals aged 13–18 and 45–49 and coincided with an 8.8 % increase in sales of prescription drugs for addictive disorders. However, there was no change in the use of psychotropic medications used to treat mental health conditions, indicative of limited access to mental health care.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"100 ","pages":"Article 102973"},"PeriodicalIF":3.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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