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. If you’d like to write one of our weekly journal round-ups, get in touch.
Volume 29, Issue 12
The December issue of Health Economics is particularly chunky, featuring 20 articles.
A couple of articles are loosely relevant to the COVID-19 pandemic. One study attempts to estimate the welfare loss associated with an Ebola outbreak in Liberia, coming out with a headline figure of between $90 million and $190 million. This is based on an analysis of household survey data and age- and sex-specific mortality estimates to identify individual-level willingness to pay to avoid the outbreak. The author suggests that this approach may provide a more accurate estimate than cost-of-illness or value of a statistical life approaches. Another study compares health expenditures for self-employed people and employed people in the Netherlands. In the UK, we’ve seen a massive drop in the number of people moving into self-employment since the start of the pandemic. This study finds that healthy people are more likely to become self-employed.
This issue includes numerous policy evaluations. One study uses an interrupted time-series analysis to estimate the impact of the US Mental Health Parity and Addiction Equity Act. A long list of outcomes is tested, relating to children’s access to behavioural health services, using a range of different models. In general, the policy was associated with greater plan expenditures and increased use of outpatient services. Another policy getting the evaluation treatment is minimum unit pricing for alcohol in Scotland. The author uses country-level data on sales and prices within a difference-in-differences framework by way of comparison with England and Wales. Prices went up and sales went down, to the tune of between 4% and 15% fewer litres of alcohol per adult drinker.
There are several interesting studies on maternal and infant health in this issue. One article looks at maternal stress and birth outcomes, demonstrating that earthquakes in New Zealand were associated with a range of negative consequences for newborn health. On a similar note, another study finds that the collapse of a dam in Brazil was associated with increased infant mortality for those exposed to the disaster in utero. Other studies in this issue demonstrate the benefits to maternal health of greater availability of paid parental leave and healthier birth weights in US states with more generous unemployment benefits.
A couple of studies examine the effects of Medicaid expansion. One looks at health behaviours over five years, finding favourable effects in relation to preventive care use, drinking, smoking, and exercise. Another looks at hospital revenue, showing that increased Medicaid revenue associated with the expansion is offset by reduced commercial insurance revenue. The overall impact on revenue varies by hospitals’ urbanicity and size.
Several studies are concerned with socioeconomic status and health inequalities. Using data on causes of death among women in Denmark, one study observed that stagnating life expectancy is especially driven by people in low‐middle and middle‐affluence groups and by cancer and lung disease. Another study using data from Denmark found that only certain procedures are associated with waiting list inequalities that can be explained by a person’s income level or education. There’s also a study suggesting that patients’ income is predictive of the amount of research conducted on their diseases: patient income predicts innovation.
There’s loads more in this issue, with studies on austerity and mortality, home care and inpatient stays, hospital performance under changing demand, noncommunicable disease shocks, pharmacy costs and drug prices, the cost of free prescriptions in Spain, and supplier-induced demand in diagnostic imaging.
Volume 128, Issue 11
The November issue of JPE included three articles on health and health care.
One study shows how doctors can game the system. The research is concerned with an incentive programme in New Jersey, whereby doctors could receive a bonus for reducing hospital costs for Medicare patients. Some hospitals participated and some did not, creating a suitable experimental setting for a difference-in-difference analysis. The results show that, once you control for patient health, the doctors don’t reduce total costs or change procedure use. But they still get their bonuses by sorting healthier patients into participating hospitals and admitting those patients who may be more likely to contribute to their bonus ambitions.
Two other studies relate to labour market issues in health care. One study uses some old data to answer a contemporary question; how important is occupational licensing in midwifery? The authors used data from the US for the early 20th century, when midwifery laws were variously introduced across states. Licensing is shown to be associated with reduced maternal mortality (around 7-8%) and infant mortality. Another study implements an equilibrium labour market search model to evaluate health insurance reform in the US. The goal is to understand what might contribute to the sustainability of different policies and programmes in a context where labour conditions may be as important as people’s health. The authors argue that income-based subsidies are very important in avoiding adverse selection, while some other features of the Affordable Care Act may be less important.
Over to the other JPE, which includes a few health-related papers worth highlighting.
There are two articles on COVID. One study looks at trust and compliance in relation to public health policies in Europe. People in regions with higher levels of trust in their government tended to decrease their mobility to a greater extent in response to containment policies. The authors suggest that a higher level of trust is associated with thousands fewer deaths. With vaccines on the horizon, we may see this dynamic become even more important. Another study evaluates the impact of the pandemic on minority unemployment in the US, painting a complex picture of inequalities along occupational distributions and skills levels.
Finally, there is a study of expanded access to contraception. The researchers evaluated the impact of an initiative in Colorado that made long-acting contraceptives available to low-income women. A difference-in-differences analysis was created on the basis of distance from clinics. The result was that proximity to a clinic was associated with a reduction in births for 15-19 year olds, by as much as 20%. The evidence also shows that the initiative was effectively supported by a media campaign.