Despite concerns about reporting biases and interpretation, self-assessed health (SAH) remains the measure of health most used by researchers, in part reflecting its ease of collection and in part the observed correlation between SAH and objective measures of health. Using a unique Australian data set, which consists of survey data linked to administrative individual medical records, we present empirical evidence demonstrating that SAH indeed predicts future health, as measured by hospitalizations, out-of-hospital medical services and prescription drugs. Our large sample size allows very disaggregate analysis and we find that SAH predicts more serious, chronic illnesses better than less serious illnesses. Finally we compare the predictive power of SAH relative to administrative data and an extensive set of selfreported health measures, SAH does not add to the predictive power of future utilization when the administrative data is included and improves prediction only marginally when the extensive survey-based health measures are included. Clearly there is value in the more extensive survey and administrative health data as well as greater cost of collection. Running title: Does self-assessed health measure health?
Rising rates of obesity are a public health concern in every industrialized country. This study investigates the relationship between obesity and health care expenditure in Australia, where the rate of obesity has tripled in the last three decades. Now one in four Australians is considered obese, defined as having a body mass index (BMI, kg/m(2)) of 30 or over. The analysis is based on a random sample survey of over 240,000 adults aged 45 and over that is linked at the individual-level to comprehensive administrative health care claims for the period 2006-2009. This sub-population group has an obesity rate that is nearly 30% and is a major consumer of health services. Relative to the average annual health expenditures of those with normal weight, we find that the health expenditures of those with a BMI between 30 and 35 (obese type I) are 19% higher and expenditures of those with BMI greater than 35 (obese type II/III) are 51% higher. We find large and significant differences in all types of care: inpatient, emergency department, outpatient and prescription drugs. The obesity-related health expenditures are higher for obese type I women than men, but in the obese type II/III state, obesity-related expenditures are higher for men. When we stratify further by age groups, we find that obesity has the largest impact among men over age 75 and women aged 60-74 years old. In addition, we find that obesity impacts health expenditures not only through its link to chronic diseases, but also because it increases the cost of recovery from acute health shocks.
This paper investigates the determinants of married women's autonomy in Indonesia using the 2000 Indonesian Family Life Survey 3 (IFLS3). It considers the role of kinship norms and the effect of labor force participation on married women's autonomy. The measure of autonomy is based on self-reported answers to an array of questions relating to decision-making authority in the household. They include own-clothing, child-related and personal autonomy, physical mobility, and economic autonomy. The analysis examines if variations in women's autonomy are due to the prevailing kinship norms related to marriage in the community. In keeping with the anthropological literature, the analysis finds that living in patrilocal communities reduces physical autonomy for married women, whereas living in uxorilocal communities improves personal and child-related decision-making autonomy. Estimation results show that labor force participation, higher educational attainment, and increases in household wealth all have positive effects on married women's autonomy in Indonesia.Female autonomy, kinship norms, labor force participation, Indonesia,
One of the core goals of a universal health care system is to eliminate discrimination on the basis of socioeconomic status. We test for discrimination using patient waiting times for non-emergency treatment in public hospitals. Waiting time should reflect patients' clinical need with priority given to more urgent cases. Using data from Australia, we find evidence of prioritisation of the most socioeconomically advantaged patients at all quantiles of the waiting time distribution. These patients also benefit from variation in supply endowments. These results challenge the universal health system's core principle of equitable treatment.
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