Consider that you want to apply the difference-in-differences approach to evaluate the Health Insurance Subsidy Program (HISP). In this scenario, you have two rounds of data on two groups of households: one group that enrolled in the program, and another that did not. You know that you cannot compare the average health expenditures of the two groups because of selection bias, thus you decide to compare change in health expenditures as follows: Table 7.2 Evaluating HISP: Difference-in-Differences Comparison of Means After Before (follow-up) (baseline) Difference Enrolled 7.84 14.49 -6.65 Nonenrolled 22.30 20.79 1.51
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- While it may seem intuitively obvious that health expenditures will increase as a population ages – older people after all are less healthy on average than younger people in fact, several prominent health economists have argued that it is not aging per se, but rather some of the correlates of an aging population that cause health expenditures to rise as a population ages. For instance, Getzen (1992) argues that, at least in part, rising health expenditures with an aging population are due to the higher incomes and resources of the older population; health care is a normal good, so higher incomes lead to higher expenditures. In a similar manner, Zweifel et al. (1999) argue that the real problem with an aging population, at least as far as health care costs are concerned, is that there will be more people who are within a couple of years of dying. Since health care expenditures rise sharply close to the end of life, it is this, rather than population aging by itself, that leads to higher…Suppose that in the fictional country ASU in 2012, a mandate was passed where everyone between the ages of 23-25 will receive health insurance at a discounted rate, while individuals aged 27-29 were not impacted by this policy. You, a researcher, want to study the effect of offering discounted health insurance coverage on the use of mental health services. You have data on the average number of visits for these two age groups over time. Using the information in the table below, a quick difference-in-difference calculation suggests that the mandate led to Time Periods Age group Avg. Avg. Number of Number of visits visits Pre-2012. Post-2012 23 to 25 2.3 27 to 29 2.5 approximately 0.3 more visits. approximately 0.7 more visits. approximately 0.4 fewer visits. approximately 0.7 fewer visits. approximately 0.3 fewer visits. 020202 337 SUCHARY 3.0 2.9 P 1302 126 70 5572 25 20120822 2012 CWhile it may seem intuitively obvious that health expenditures will increase as a population age – older people, after all, are less healthy on average than younger people – in fact, several prominent health economists have argued that it is not ageing per se, but rather some of the correlates of an ageing population that cause health expenditures to rise as population ages. For instance, Getzen (1992) argues that, at least in part, rising health expenditures with an ageing population are due to the higher incomes and resources of the older population; health care is a normal good, so higher incomes lead to higher expenditures. In a similar manner, Zweifel et al. (1999) argue that the real problem with an ageing population, at least as far as health care costs are concerned, is that there will be more people who are within a couple of years of dying. Since health care expenditures rise sharply close to the end of life, it is this, rather than population ageing by itself, that leads to…
- Consider the following box-and-whisker plot from Hall and Jones (2007). When focused on the youngest age group, a 20% increase in medical spending is associated with: FIGURE 3.1 Elasticity of health with respect to medical spending, by age. 0.5 - 0.4 - 0.3 - 0.2 - 0.1 - 20 40 60 80 100 Age Source: Hall and Jones, 2007. Note: “Whiskers" show standard errors of the estimates for each age group. 4% increase in conditional life expectancy 20% increase in conditional live expectancy O 8% increase in conditional life expectancy Elasticity of health with respect to medical spendingSuppose you are currently (i.e. 2024) performing a cost-effectiveness analysis and you wish to include the cost per visit of a hospital admission for an acute ischemic stroke in a patient without major complications or comorbidities in your analysis. The Agency for Healthcare Research and Quality's HCUP National Inpatient Sample online database reports the following information for 2015: 2015 National Medicare-Severity Diagnosis Related Groups (MS-DRG): #063 Acute ischemic stroke w use of thrombolytic agent w/o cc/mcc Number Total number of discharges: N All discharges + Rate Rate of discharges per 100,000 persons 2.2 Length of stay LOS (length of stay), days (mean) 3.0 LOS (length of stay), days (median) 3.0 Hospital charges Charges, $ (mean) 63,243 Hospital costs Costs, $ (mean) 15,239 + Due to the transition from ICD-9-CM to ICD-10-CM in October 2015, these 2015 statistics were calculated using only quarter 1-3 data, and the statistics available are limited What would you use for…Briefly Explain the differences between Rapid Upper Limb Assessment and Rapid Entire Body Assessment.
- One of the most robust, fundamental “facts” of health economics is the SES and health gradient. a) Define the SES and health gradient. b) Give three ways in which the SES and health gradient is robust. c) Provide evidence that some of the gradient is correlational (i.e., give a potential confounder) and evidence that the gradient is in fact causal. d) i. Give an interpretation of Figure 1 below in layperson terms. ii. What pattern do you see for men vs women? iii. “The education and mortality gradient does not depend on healthcare spending or whether the country has universal healthcare.” Use Figure 1 to support or refute this claim.In the early 2000s, the state of Massachusetts in the U.S. implemented a health reform aimed at enrolling people without health insurance into an insurance plan. The reform required people without health insurance (at least those who could afford it) to buy insurance, and put in place penalties on those who nevertheless chose not to buy insurance. Below is the abstract of a recent National Bureau of Economic Research working paper entitled “Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform” by Martin Hackmann, Jonathan Kolstad, and Amanda Kowalski. The authors conducted a study of the effects of the Massachusetts reform. They write: We implement an empirical test for selection into health insurance using changes in coverage induced by the introduction of mandated health insurance in Massachusetts. Our test examines changes in the cost of the newly insured relative to those who were insured prior to the…There is a consensus among health economists that socioeconomic status (SES) has a major impact on health, but health does not have a significant effect on SES. True False
- The following is an abstract from the paper "Discrimination in Health Care: A Field Experiment on the Impact of Patients' Socioeconomic Status on Access to Care," by Silvia Angerer, Christian Waibel, and Harald Stummer. We employ a large-scale field experiment to investigate the impact of patients' socioeconomic status on access to care. We request an appointment at more than 1,200 physicians in Austria, varying the educational level of the patient. Our results show that overall patients with a university degree receive an appointment significantly more often than patients without a degree. Differentiating between practice assistants and physicians as responders, we find that physicians provide significantly shorter response times and marginally significant shorter waiting times for appointments for patients with than without a university degree. Our results thus provide unambiguous evidence that discrimination by health providers contributes to the gradient in access to care.…Indicate whether the statement is true or false, and justify your answer.There is a consensus among health economists that socioeconomic status has a major impact on health, but health does not have a significant effect on SES.Describe Grossman's Improvement Model of Health. How does Grossman reconcile health as both something in demand and something produced by individuals?