Every Monday our authors provide a round-up of the latest peer-reviewed journal publications. We cover all issues of major health economics journals as well as some other notable releases. Visit our Resources page for links to more journals or follow the HealthEconBot. If you’d like to write one of our weekly journal round-ups, get in touch.
Medical Care
Volume 58, Issue 6
The main interest for me in this issue is two papers on the SF-6D. The first paper describes the development of a new classification system based on the SF-36v2, using factor analysis, Rasch analysis, and testing for differential item functioning. The core features of the dimensions are largely unchanged, but there are quite a few changes to the framing and terminology, with some changes to the number of response options. All in all, the descriptive system for the SF-6Dv2 is much neater than its predecessor. The second paper describes a UK valuation study. Discrete choice experiments with duration were used to value states described by the SF-6Dv2. The authors provide a great deal of discussion about preference heterogeneity and describe their value set as ‘provisional’, which isn’t very encouraging!
Quite a few studies in this issue look at Medicaid expansion in the US. One study employs difference-in-difference analyses to identify the impact of expansion on different types of emergency department use by low-income adults. The authors find no overall increase but see a decrease in attendances that are associated with barriers to accessing other services. Another difference-in-difference analysis evaluates the impact of expansion on dual use of care funded by Medicaid and the Veterans Health Administration. Dual enrolment increased with expansion for low-income veterans, who increased their use of Medicaid-funded services. Another study reports on changes in self-reported health in the first four years following the Affordable Care Act and finds no difference for health in general. However, the authors do find that Medicaid expansion reduced the number of days with poor mental health.
The DiDs continue with another looking at preventive care use, including cancer screening and diabetes care, for low-income adults with our without Medicaid expansion. Of the 15 outcomes analysed, only a few popped out positive findings, with increases in aspirin use, flu jabs, and HIV screening. Another study looks at preventive care use by new mothers and finds that many women (38%) had no adult preventive visits within one year after the birth. Women are much more likely to access pediatric preventive services. Inequality in low birthweight in the US is the focus of another study on the impact of Medicaid expansion, with the study finding that expansion was associated with more equitable birth outcomes.
A study from California finds that hospital expenditure grew 66.6% between 2007 and 2016. Some cost centres (e.g. paediatrics) grew very little, while some (e.g. emergency services at 165%) grew a lot. This could be partly explained by volume growth, though prices seem to be key. There’s an intriguing study looking at the association between maternal citizenship and health care use for Latino youth born in the US. I don’t think it’s easy to make claims about causality here, but mothers who were not US citizens were more likely to report being uninsured and their kids were less likely to access health care, a relationship that is partly moderated by maternal distress.
Another study looks at risk adjustment models used within the insurance markets reformed as part of the Affordable Care Act. The authors find that including the use of certain prescription drugs can improve the models’ predictions, while this might also be a means of preventing insurers from avoiding enrolment of people who use high cost drugs. Finally, the issue includes a methodological paper on the identification of physicians in US claims data. The authors develop a matching algorithm that could potentially be applied to datasets that lack physician identifiers.
Health Economics Review
Volume 10, May 2020
As the first fully open access health economics journal (as far as I’m aware), I really wish this journal was better. But their copyediting is abysmal and I find many of the articles almost unreadable. Nevertheless, I shall endure for you, dear reader. Four articles were published in the journal in May 2020, covering a variety of topics.
A study in Spain finds that families bear more than 90% of the economic burden of informal care. The authors analysed survey data that apparently included all people dependent on care in Spain, using information on the support payments received by carers from the government and estimates of the time value of informal care.
An online experiment explores decision-making in pharmaceutical pricing negotiations. Participants were allocated to the perspective of either a health minister or a representative of the pharmaceutical industry and negotiated under different pricing conditions and with different societal impacts. Unsurprisingly, the context of the decisions is important if negotiations are to be successful.
A study from rural Malawi reveals that, in around a quarter of cases, curative treatment involves people having to pay out of pocket. Yet, health care in Malawi is ‘free’. Expenditures are lower than in some similar settings, but the study suggests that these expenditures may dissuade people from seeking formal care.
Last up, a study from Germany investigates parents’ willingness to pay for preventing childhood obesity, linked to a school-based health promotion programme. It seems that most parents didn’t answer the willingness to pay questions or weren’t willing to pay anything, so it’s difficult to draw any clear conclusions from this study.
Credits
When I read the last paragraph, I thought that article didn’t sound very impressive – but I respect any article that uses both the McNemar test and the Wilcoxon signed-rank test. Heroes!