This article investigates the effect of remittances on health capital accumulation. Total expenditure is divided into expenditure on medicines; and expenditure on visits and laboratory services. An ...estimation is presented for rural and urban sub-groups. Both instrumental variable and propensity score matching are used to assess the impact of remittances on health capital investment. Households increase their expenditure on medicines and other health services in the presence of remittances. This positive relationship is statistically significant in the case of remittance-receiving households living in rural areas, although the magnitude is lower in the case of total expenditure on visits and laboratory services. However, total expenditure here is likely to have a significant impact on health outcomes given their preventive nature. Remittance flows thus play a heterogeneous role in the decision-making processes of remittance-receiving household members. However, such non-labour income flows may play an important role in supporting expenditures, especially for those living in rural areas.
Group purchasing organizations gain increasing importance with respect to the supply of pharmaceutical products and frequently use multiple, exclusive or partially exclusive rebate contracts to ...exercise market power. Based on a Hotelling model of horizontal and vertical product differentiation, we examine the controversy around whether a superior rebate scheme exists, as far as consumer surplus, firms' profits and total welfare are concerned. We find that firms clearly prefer partially exclusive over multiple, and multiple over exclusive rebate contracts. In contrast, no rebate form exists that lowers total costs per se for the consumers or maximizes total welfare.
Background: Medicaid waiver home and community-based longterm care services (HCBS) may provide a partial solution to the escalating costs of long-term care. Persons with dementia can have complex ...caregiving needs; it is unknown whether their expenditures and resource utilization differ between community-based versus institutional settings. Objective: To compare expenditures and resource utilization for Medicaid recipients with dementia who received long-term care through a nursing home versus HCBS waivers. Design: Twelve-month cohort study. Setting: Indiana Medicaid administrative data from 2001 through 2004. Participants: Medicaid recipients with dementia who lived in the community 6 months before receiving long-term care through nursing homes (N = 1534) or HCBS waivers (N = 174). Measurements: Monthly inpatient and emergency department rates and total expenditures adjusted for prior use, demographics, insurance status, and comorbidities. Results: Adjusted rates of inpatient use were stable for nursing home patients (0.06) but significantly increased over 12 months for HCBS recipients (0.07- 0.12; P = 0.048). Adjusted total expenditures increased over 12 months from $1419 to $2002 for HCBS recipients (P < 0.001), but remained stable for those in nursing homes ($3413—$3336). Long-term care expenditures were on average $1688 per month higher for those in nursing homes. Conclusions: The escalation in inpatient use for HCBS waiver recipients suggests that future development of HCBS programs should consider the unique needs of persons with dementia so as to optimize their health outcomes. Despite increasing inpatient use among HCBS recipients, their overall expenditures remained significantly lower than those of nursing home patients.
The Demand for Food and Calories Subramanian, Shankar; Deaton, Angus
The Journal of political economy,
02/1996, Letnik:
104, Številka:
1
Journal Article
Recenzirano
We investigate nutrition and expenditure in rural Maharashtra in India. We estimate that the elasticity of calorie consumption with respect to total expenditure is 0.3-0.5, a range that is in accord ...with conventional wisdom. The elasticity declines only slowly with levels of living and is far from the value of zero suggested by a recent revisionist literature. In these Indian data, the calories necessary for a day's activity cost less than 5 percent of the daily wage, which makes it implausible that income is constrained by nutrition rather than the other way around.
We examine demand behaviour for intertemporal dependencies, using Spanish panel data. We present evidence that there is both state dependence and correlated heterogeneity in demand behaviour. Our ...specific findings are that food outside the home, alcohol and tobacco are habit forming, whereas clothing and small durables exhibit durability. We conclude that demand analyses using cross-section data that ignore these effects may be seriously biased. On the other hand, the degree of intertemporal dependence is not sufficiently strong to make composite 'consumption' significantly habit forming, as has been suggested in some recent analyses.
Objectives: Little research has addressed differences in health care expenditures among women who are currently experiencing intimate partner violence (IPV) compared with those who are not. The ...purpose of this work is to provide estimates of direct medical expenditure for physician, drug, and hospital utilization among Medicaid-eligible women who screened as currently experiencing IPV compared with those who are not currently experiencing IPV. Methods: In this family practice-based cross-sectional study, women were screened for current IPV using a 15-item Index of Spouse Abuse--Physical (ISA-P) between 1997 and 1998. Consents were obtained from study subjects to review Medicaid expenditure and utilization data for the same time period. Results: Mean physician, hospital, and total expenditures were higher for those women with higher IPV scores compared with those who scored as not currently experiencing IPV, after adjusting for confounders. Higher IPV scores were associated with a three-fold increased risk of having a total expenditure over $5,000 (95% confidence interval CI 1.3, 8.4). The mean total expenditure difference between the high IPV and no IPV groups was $1,064 (95% CI $623, $1506). The adjusted risk ratio for high IPV score and the log of total Medicaid expenditures was 2.3 (95% CI 1.2, 4.4). Conclusions: Women screened as experiencing higher IPV scores had higher Medicaid expenditures compared with women not currently experiencing IPV. Early IPV assessment partnered with effective clinic or community-based interventions may help to identify IPV earlier and reduce the health impact and cost of IPV.
This article considers a rent-seeking model with N asymmetric contestants. Each contestant may have a different valuation of the rent or a different relative ability to win the rent. One of the N ...contestants is selected as the winner based on Tullock's probabilistic contest rule with constant returns to scale. A pure strategy Nash equilibrium solution is obtained and its consequences are investigated.
This paper provides the first estimates of overall CPI bias prior to the 1970s and new estimates of bias since the 1970s. It finds that annual CPI bias was −0.1 percent between 1888 and 1919 and rose ...to 0.7 percent between 1919 and 1935. Annual CPI bias was 0.4 percent in the 1960s and then rose to 2.7 percent between 1972 and 1982 before falling to 0.6 percent between 1982 and 1994. The findings imply that we have underestimated growth rates in true income in the 1920s and 1930s and in the 1970s.
We construct a model in which all rational rent-seekers may be willing to accept a negative payoff in a Tullock contest in which the rent-seekers are driven by reciprocity motives. We show that in ...the reciprocal Tullock contest, a unique reciprocity equilibrium exists if the reciprocal concerns of rent-seekers are sufficiently small relative to their material concerns, and that otherwise, there are two reciprocity equilibria: a destructive equilibrium and a constructive equilibrium. The individual rent-seeking expenditure in the former equilibrium is more than that in the Nash equilibrium in the original Tullock contest; moreover, over-dissipation can occur in a destructive equilibrium even in the case of constant returns to expenditure. These results derived from our reciprocal contest model are consistent with observations in most existing experimental studies on the Tullock contest.
We compare nonexperimental impact estimates based on matching methods with those from a randomized evaluation to determine whether the nonexperimental approach can “match” the so‐called gold ...standard. The social experiment we use was carried out to evaluate a geographically targeted conditional cash transfer antipoverty program in Nicaragua. The outcomes we assess include several components of household expenditure and a variety of children’s health outcomes, including breast‐feeding, vaccinations, and morbidity. We find that using each of the following improves performance of matching for these outcomes: (1) geographically proximate comparison samples, (2) stringent common support requirements, and (3) both geographic‐ and household‐level matching variables. Even for a geographically targeted program, in which the selection is at the geographic, rather than at the individual or household level, and in which it is not possible to find comparison individuals or households in the program locales, matching can perform reasonably well. The results also suggest that the techniques may be more promising for evaluating the more easily measured individual‐level binary outcomes than for outcomes that are more difficult to measure, such as expenditure.
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