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  • 1.
    Avdic, Daniel
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation. CINCH, Essen, Germany.;Univ Duisburg Essen, Essen, Germany..
    Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden2016In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 48, p. 44-60Article in journal (Refereed)
    Abstract [en]

    Recent health care consolidation trends raise the important policy question whether improved emergency medical services and enhanced productivity can offset adverse quality effects from decreased access. This paper empirically analyzes how geographical distance from an emergency hospital affects the probability of surviving an acute myocardial infarction (AMI), accounting for health-based spatial sorting and data limitations on out-of-hospital mortality. Exploiting policy-induced variation in hospital distance derived from emergency hospital closures and detailed Swedish mortality data over two decades, results show a drastically decreasing probability of surviving an AMI as residential distance from a hospital increases one year after a closure occurred. The effect disappears in subsequent years, however, suggesting that involved agents quickly adapted to the new environment.

  • 2.
    Bergman, Mats A.
    et al.
    Sodertorn Univ, Stockholm, Sweden..
    Johansson, Per
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Lundberg, Sofia
    Umea Univ, Umea Sch Business & Econ, Dept Econ, S-90187 Umea, Sweden..
    Spagnolo, Giancarlo
    Univ Roma Tor Vergata, Ctr Econ Policy Res, EIEF, Stockholm Sch Econ SITE, Rome, Italy..
    Privatization and quality: Evidence from elderly care in Sweden2016In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 49, p. 109-119Article in journal (Refereed)
    Abstract [en]

    Non-contractible quality dimensions are at risk of degradation when the provision of public services is privatized. However, privatization may increase quality by fostering performance-improving innovation, particularly if combined with increased competition. We assemble a large data set on elderly care services in Sweden between 1990 and 2009 and estimate how opening to private provision affected mortality rates - an important and not easily contractible quality dimension - using a difference-in-difference in-difference approach. The results indicate that privatization and the associated increase in competition significantly improved non-contractible quality as measured by mortality rates.

  • 3.
    Flynn, Terry N
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Louviere, Jordan J
    Peters, Tim J
    Coast, Joanna
    Best--worst scaling: What it can do for health care research and how to do it.2007In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 26, no 1, p. 171-89Article in journal (Refereed)
    Abstract [en]

    Statements like "quality of care is more highly valued than waiting time" can neither be supported nor refuted by comparisons of utility parameters from a traditional discrete choice experiment (DCE). Best--worst scaling can overcome this problem because it asks respondents to perform a different choice task. However, whilst the nature of the best--worst task is generally understood, there are a number of issues relating to the design and analysis of a best--worst choice experiment that require further exposition. This paper illustrates how to aggregate and analyse such data and using a quality of life pilot study demonstrates how richer insights can be drawn by the use of best--worst tasks.

  • 4. Gronqvist, Hans
    et al.
    Johansson, Per
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Niknami, Susan
    Income inequality and health: Lessons from a refugee residential assignment program2012In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 31, no 4, p. 617-629Article in journal (Refereed)
    Abstract [en]

    This paper examines the effect of income inequality on health for a group of particularly disadvantaged individuals: refugees. Our analysis draws on longitudinal hospitalization records coupled with a settlement policy where Swedish authorities assigned newly arrived refugees to their first area of residence. The policy was implemented in a way that provides a source of plausibly random variation in initial location. The results reveal no statistically significant effect of income inequality on the risk of being hospitalized. This finding holds also for most population subgroups and when separating between different types of diagnoses. Our estimates are precise enough to rule out large effects of income inequality on health.

  • 5.
    Hall, Caroline
    et al.
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics.
    Lindahl, Erica
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Illness-related absence among preschool children: Insights from a health intervention in Swedish preschools2017In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 56, p. 191-200Article in journal (Refereed)
    Abstract [en]

    We evaluate the effect of a preschool health intervention aimed at reducing infections through improved hygiene practices and training of the staff. The large-scale design enables us to study heterogeneous effects with respect to several child and preschool characteristics that are related to the level of illness-related absence. We find no reduction, on average, in children's illness-related absence. This conclusion holds across different age groups of preschool children, and for preschools with varying levels of absence before the intervention. We find some suggestive evidence that the intervention may have induced effects operating in different directions: while improved hygiene practices may have reduced illness, stricter guidelines regarding absence during infections seems to have contributed to an increased absence level, resulting in an overall zero effect. Overall, our results suggest that reducing absence through improved hygiene practices is not easily accomplished in a child care setting. (c) 2017 Elsevier B.V. All rights reserved.

  • 6.
    Hallberg, Daniel
    et al.
    Swedish Social Insurance Inspectorate ISF, Stockholm, Sweden.;UCLS, Uppsala, Sweden..
    Johansson, Per
    Uppsala Univ, ISF, IFAU, Dept Econ,UCLS, Uppsala, Sweden.;IZA, Uppsala, Sweden..
    Josephson, Malin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Is an early retirement offer good for your health?: Quasi-experimental evidence from the army2015In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 44, p. 274-285Article in journal (Refereed)
    Abstract [en]

    This paper studies empirically the consequences on health of an early retirement offer. To this end we use a targeted retirement offer to military officers 55 years of age or older. Before the offer was implemented, the normal retirement age in the Swedish defense was 60 years of age. Estimating the effect of the offer on individuals' health within the age range 56-70, we find support for a reduction in both mortality and in inpatient care as a consequence of the early retirement offer. Increasing the mandatory retirement age may thus not only have positive government income effects but also negative effects on increasing government health care expenditures.

  • 7.
    Johansson, Per
    et al.
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics.
    Pekkarinen, Tuomas
    Verho, Jouko
    Cross-border health and productivity effects of alcohol policies2014In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 36, p. 125-136Article in journal (Refereed)
    Abstract [en]

    This paper studies the cross-border health and productivity effects of alcohol taxes. We estimate the effect of a large cut in the Finnish alcohol tax on mortality, alcohol-related illnesses and work absenteeism in Sweden. This tax cut led to large differences in the prices of alcoholic beverages between these two countries and to a considerable increase in cross-border shopping. The effect is identified using differences-in-differences strategy where changes in these outcomes in regions near the Finnish border are compared to changes in other parts of northern Sweden. We use register data where micro level data on deaths, hospitalisations and absenteeism is merged to population-wide micro data on demographics and labour market outcomes. Our results show that the Finnish tax cut did not have any clear effect on mortality or alcohol-related hospitalisations in Sweden. However, we find that workplace absenteeism increased by 9% for males and by 15% for females near the Finnish border as a result of the tax cut. 

  • 8.
    Laun, Lisa
    et al.
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Thoursie, Peter Skogman
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Does privatisation of vocational rehabilitation improve labour market opportunities?: Evidence from a field experiment in Sweden2014In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 34, p. 59-72Article in journal (Refereed)
    Abstract [en]

    This paper analyses if privatisation of vocational rehabilitation can improve labour market opportunities for individuals on long-term sickness absence. We use a field experiment performed by the Public Employment Service and the Social Insurance Agency in Sweden during 2008-2010, in which over 4000 participants were randomly offered private and public rehabilitation. We find no differences in employment rates following rehabilitation between individuals who received rehabilitation by private and public providers. Also the average cost of rehabilitation was essentially equal for the two types of providers. This suggests that there are no large efficiency gains from privatising vocational rehabilitation. (C) 2013 Elsevier B.V. All rights reserved.

  • 9. Lindeboom, Maarten
    et al.
    Portrait, France
    van den Berg, Gerard J.
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Long-run effects on longevity of a nutritional shock early in life: The Dutch Potato famine of 1846-18472010In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 29, no 5, p. 617-629Article in journal (Refereed)
    Abstract [en]

    Nutritional conditions in utero and during infancy may causally affect health and mortality during childhood, adulthood, and at old ages. This paper investigates whether exposure to a nutritional shock in early life negatively affects survival at older ages, using individual data. Nutritional conditions are captured by exposure to the Potato famine in the Netherlands in 1846-1847, and by regional and temporal variation in market prices of potato and rye. The data cover the lifetimes of a random sample of Dutch individuals born between 1812 and 1902 and provide individual information on life events and demographic and socioeconomic characteristics. First we non-parametrically compare the total and residual lifetimes of individuals exposed and not exposed to the famine in utero and/or until age 1. Next, we estimate survival models in which we control for individual characteristics and additional (early life) determinants of mortality. We find strong evidence for long-run effects of exposure to the Potato famine. The results are stronger for boys than for girls. Boys and girls lose on average 4, respectively 2.5 years of life after age 50 after exposure at birth to the Potato famine. Lower social classes appear to be more affected by early life exposure to the Potato famine than higher social classes. These results confirm the mechanism linking early life (nutritional) conditions to old-age mortality. Finally, higher food prices at birth appear to reduce later life mortality of children of farmers from higher social classes. We interpret this as an income effect.

  • 10.
    Mitrut, Andreea
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics.
    Wolff, Francois-Charles
    The impact of legalized abortion on child health outcomes and abandonment: Evidence from Romania2011In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 30, no 6, p. 1219-1231Article in journal (Refereed)
    Abstract [en]

    We use household survey data and a unique census of institutionalized children to analyze the impact of abortion legalization in Romania. We exploit the lift of the abortion ban in December 1989, when communist dictator Ceausescu and his regime were removed from power, to understand its impact on children's health at birth and during early childhood and whether the lift of the ban had an immediate impact on child abandonment. We find insignificant estimates for health at birth outcomes and anthropometric z-scores at age 4 and 5, except for the probability of low birth weight which is slightly higher for children born after abortion became legal. Additionally, our findings suggest that the lift of the ban had decreased the number of abandoned children.

  • 11. Scholte, Robert S.
    et al.
    van den Berg, Gerard J.
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Lindeboom, Maarten
    Long-run effects of gestation during the Dutch Hunger Winter famine on labor market and hospitalization outcomes2015In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 39, p. 17-30Article in journal (Refereed)
    Abstract [en]

    The Dutch Hunger Winter (1944/45) is the most-studied famine in the literature on long-run effects of malnutrition in utero. Its temporal and spatial demarcations are clear, it was severe, it was not anticipated, and nutritional conditions in society were favorable and stable before and after the famine. This is the first study to analyze effects of in utero exposure on labor market outcomes and hospitalization late in life, and the first to use register data covering the full Dutch population to examine long-run effects of this famine. We provide results of famine exposure by sub-interval of gestation. We find a significantly negative effect of exposure during the first trimester of gestation on employment outcomes 53 or more years after birth. Hospitalization rates in the years before retirement are higher after middle or late gestational exposure.

  • 12.
    van den Berg, Gerard J.
    et al.
    Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
    Gupta, Sumedha
    The role of marriage in the causal pathway from economic conditions early in life to mortality2015In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 40, p. 141-158Article in journal (Refereed)
    Abstract [en]

    This paper analyzes the interplay between early-life conditions and marital status, as determinants of adult mortality. We use individual data from Dutch registers (years 1815-2000), combined with business cycle conditions in childhood as indicators of early-life conditions. The empirical analysis estimates bivariate duration models of marriage and mortality, allowing for unobserved heterogeneity. Results show that conditions around birth and school going ages are important for marriage and mortality. Men typically enjoy a protective effect of marriage, whereas women suffer during childbearing ages. However, having been born under favorable economic conditions reduces female mortality during childbearing ages.

1 - 12 of 12
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