State and self investments in health

Fichera, Eleonora; Sutton, Matt

doi:10.1016/j.jhealeco.2011.09.002

Cited by 6 publications

(9 citation statements)

References 30 publications

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“…This is simply because prescription drug insurance, by reducing the effective price of medical preventive input, raises the relative price of nonmedical preventive health inputs. As such, this finding also contributes to the literature on the relationship between medical and nonmedical preventive health inputs (Fichera & Sutton, 2011;Kahn, 1999;Kaestner, Darden, & Lakdawalla, 2014;Schneider & Ulrich, 2008;Slade, 2012). To the degree prescription drug insurance reduces the price of prescription drugs, the health behavior response could be a result of greater access to medication rather than insurance against the financial risk of illness alone.…”

Section: Introductionmentioning

confidence: 58%

The effect of prescription drug insurance on health behavior: Evidence from Medicare Part D

Asfaw

2019

Health Economics

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Summary This paper provides empirical evidence on the health behavior effect of prescription drug insurance. Using the difference in the regression discontinuity research design, I compare health behavior changes at age 65 before and after the introduction of Medicare Part D. I find that the implementation of Medicare Part D increased prescription drug insurance coverage and reduced out‐of‐pocket spending per prescription and the use of cardiovascular and metabolic therapeutic class drugs. I also find that Medicare Part D led to a 6.36 percentage point decrease in the probability of engaging in moderate physical exercise and a 27.4 percentage point decrease in the amount of time spent on moderate physical activity. It also increased the probability of being overweight by 5.75 percentage points. Its effects on vigorous and muscle‐strengthening exercise both at the extensive and intensive margins, obesity, BMI, and cigarette consumption are not statistically significant.

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Section: Introductionmentioning

confidence: 58%

The effect of prescription drug insurance on health behavior: Evidence from Medicare Part D

Asfaw

2019

Health Economics

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“…Examining the impact of smoking on mortality, Adda and Lechene (2013) provided support for the notion that an individual's willingness to invest in health is governed by his or her survival chances: the analysis showed that individuals who are in relatively poor baseline health are more likely to start smoking and to smoke heavily. Finally, Fichera and Sutton (2011) and CobbClark et al (2014) provided evidence that health behaviours are shaped by both health policy and personality traits, such as self-control.…”

Section: Health Behaviour Along the Prolonged Life Coursementioning

confidence: 99%

Health, education, and retirement over the prolonged life cycle: a selective survey of recent research

Kühn

Prskawetz²,

Sunde³

2016

Populationyearbook

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“…A first group of such studies examine changes in medical treatment to determine its effects on health behaviours (Bennett (2012); Slade (2012); Fichera and Sutton (2011); Fichera et al (2016); Kaestner et al (2014); Wilson et al (2014)). For instance, Slade (2012) used nine waves of the Health and Retirement Study (HRS) to examine the relation between medication and the lifestyle behaviours of diabetics and found improvements in health behaviours, but only in the short-term.…”

Section: Introductionmentioning

confidence: 99%

Does patient health behaviour respond to doctor effort?

Fichera

Banks

Siciliani

et al. 2018

Journal of Economic Behavior & Organization

Self Cite

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Incentive pay systems have been introduced in public sectors such as education and health care. In these sectors the output (education or health respectively) depends on the actions of different agents and it is unclear what the effects of such incentive systems are on the behaviour of untargeted agents. In this study we focus on patient health, modelled as a joint product of patient effort (through lifestyle and behaviour) and doctor effort (through diagnosis and treatment). Patient response to doctor effort is shown to be a priori ambiguous and depends on the degree of complementarity or substitution between doctor and patient effort. We build an empirical model to estimate the effect of doctors' treatment effort on patient behaviour. To address the endogeneity of doctor effort we exploit a change in payments to doctors in the U.K. that led to incentive changes that varied by practice, depending on their prior performance levels. We use panel data on the physical activity, drinking and smoking behaviours of over 2,000 cardiovascular disease patients aged over 50 in England and link these data to their primary care practice performance data. Our results indicate that primary care practices increased the proportion of patients with controlled disease from 76% to 83% in response to the payment change. Patients responded by reducing the frequency of drinking alcohol and their cigarette consumption, suggesting that patient efforts are complements to doctor effort. Understanding such complementarities has implications for assessing the design and effectiveness of pay-for-performance schemes which encourage higher doctor effort.

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State and self investments in health

Cited by 6 publications

References 30 publications

The effect of prescription drug insurance on health behavior: Evidence from Medicare Part D

The effect of prescription drug insurance on health behavior: Evidence from Medicare Part D

Health, education, and retirement over the prolonged life cycle: a selective survey of recent research

Does patient health behaviour respond to doctor effort?

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