HCHE Research Paper
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2020
Autor: Bach, P.; Chernozhukov, V.; Spindler, M. Titel: Insights from optimal pandemic shielding in a multi-group SEIR framework Abstract: The COVID-19 pandemic constitutes one of the largest threats in recent decades to the health and economic welfare of populations globally. In this paper, we analyze different types of policy measures designed to fight the spread of the virus and minimize economic losses. Our analysis builds on a multi-group SEIR model, which extends the multi-group SIR model introduced by Acemoglu et al. (2020). We adjust the underlying social interaction patterns and consider an extended set of policy measures. The model is calibrated for Germany. Despite the trade-off between COVID-19 prevention and economic activity that is inherent to shielding policies, our results show that efficiency gains can be achieved by targeting such policies towards different age groups. Alternative policies such as physical distancing can be employed to reduce the degree of targeting and the intensity and duration of shielding. Our results show that a comprehensive approach that combines multiple policy measures simultaneously can effectively mitigate population mortality and economic harm. |
Autor: Bäuml, M.; Kümpel, C. Abstract: Many OECD countries have replaced per- diem hospital reimbursement with lump sum payments by diagnosis- related groups (DRGs). However, modern DRG systems still allow hospitals to pass on actual treatment costs to payers, which might hinder the efficiency of heath care provision. This paper analyzes hospital responses to a large- scale refinement of reimbursement practices in Germany on January 1, 2006, in which regulating authorities introduce reimbursements by treatment intensity in the market for stroke disorder. |
Autor: Boggiano, B. Titel: Long-term effects of the Paraguayan War (1864-1870): from male scarcity to intimate partner violence. |
2019
Autor: Margaryan, S. Titel: Low Emission Zones and Population Health Abstract: Air pollution has a major detrimental impact on population health but little is known about the effectiveness of policy measures targeting pollution. I exploit the staggered implementation of low emission zones in large cities in Germany as a natural experiment to asses their health impact. Using outpatient and inpatient health care data, I demonstrate that low emission zones reduce the number of patients with cardiovascular diagnoses by 2-3 percent. This effect is particularly pronounced for the elderly above 65. The findings suggest that this kind of policies can be an efficient way to reduce air pollution and improve health. |
Autor: Bayindir, E. Titel: Hospital Ownership Type and Service Provision, a Structural Approach Abstract: In this work, I estimate the valuations hospitals assign to service provision relative to the value they assign to profits by hospital ownership, (for-profit, not-for-profit or government owned) in a structural way and present evidence that valuations differ significantly by ownership type. Despite the absence of requirements, not-for-profit hospitals value services relative to profits much more than their for-profit counterparts. |
Autor: Everding, J. ; Marcus, J. Titel: The Effect of Unemployment on the Smoking Behavior of Couples Abstract: This is the first paper to estimate effects of unemployment on the smoking behavior of both spouses. One spouse’s unemployment increases both spouses’ smoking probability and intensity. Smoking relapses and decreased smoking cessation drive the effects. |
Autor: Everding, J. Titel: Heterogeneous Spillover Effects of Children's Education on Parental Mental Health Abstract: Despite extensive research on nonmarket returns to education, direct and spillover effects on mental health are widely unstudied. This study is the first to analyze heterogeneous intergenerational effects of children's education on parents' mental health. Increasing children's education reduces parents' long-term probability of developing depression. |
2018
Autor: Kvasnicka, M.; Siedler, T.; Ziebarth, Nicolas R. Titel: The Health Effects of Smoking Bans: Evidence from German Hospitalization Data Abstract: This paper studies the short-term impact of public smoking bans on hospitalizations in Germany. It exploits the staggered implementation of smoking bans over time and across the 16 federal states along with the universe of hospitalizations from 2000-2008 and daily county-level weather and pollution data. |
2017
Autor: Bach, P.; Farbmacher, H.; Spindler, M. Titel: Semiparametric Count Data Modeling with an Application to Health Service Demand Abstract: Heterogeneous effects are prevalent in many economic set-tings. As the functional form between outcomes and regressors is generally unknown a priori, a semiparametric negative binomial count data model is proposed which is based on the local likelihood approach and generalized product kernels. |
Autor: Himmel, K.; Schneider, U. Titel: Ambulatory Care at the End of a Billing Period Abstract: The ambulatory physician payment system in the German Social Health Insurance (SHI) offers incentives to reduce practice activity at the end of a billing period. Using claims data from Germany’s largest sickness fund, we find a decrease of all services limited by a threshold at the end of a billing period and an immediate increase at the beginning of the following period. |
2016
Autor: Bahrs, M.; Schumann, M. Titel: Unlucky to Be Young? The Long-Term Effects of School Starting Age on Smoking Behaviour and Health Abstract: In this study, we analyse the long-term effects of school starting age on smoking behaviour and health in adulthood. School entry rules combined with birth month are used as an instrument for school starting age. The analysis adopts the German Socio-Economic Panel data and employs a fuzzy regression discontinuity design. |
Autor: Blome, C.; Augustin, M. Abtract: We propose to use subjective well-being (SWB) measures to determine patient-relevant treatment benefit. Benefit can be measured either prospectively (pre-post) or retrospectively, but both approaches can be biased: Prospective evaluation may be subject to response shift; retrospective evaluation may be subject to recall bias. As prospective and retrospective evaluations often differ in effect size and since there is no gold standard to compare against, the extent of the two bias needs to be determined. |
Autor: Varabyova, Y.; Blankart, C.R.; Schreyögg, J. Abstract: We use data from 178 departments of interventional cardiology and consider three different measures of quality: patient satisfaction, risk-adjusted mortality, and patient radiation exposure. Our empirical assessment shows that the impact of quality on the production process differs according to the utilized quality measure. |
Autor: Bleiber, F.; König, H.-H. Abstract: Fractures are associated with high economic costs, increased mortality and loss of health related quality of life. A clinical trial showed that a yearly dose of 5mg intravenous zoledronic acid (IZA) had a fracture-reducing effect in individuals with a prior hip fracture. As to our knowledge no evidence about the cost-effectiveness of IZA is available, the objective of this study is to evaluate the cost-effectiveness of 5mg IZA in women with a previous hip fracture in comparison to no intervention. |
2015
Autor: Milstein, R.; Schreyögg, J. Titel: A review of pay-for-performance programs in the inpatient sector in OECD countries Abstract: Across the member countries of the OECD, several pay-for-performance (P4P) programs have been implemented in the inpatient sector to improve the quality of care provided by hospitals. However, little is known about whether such programs can live up to expectations. We aimed to provide an overview of existing P4P programs and to assemble information on their effects. |
2014
Autor: Kifmann, M.; Siciliani, L. Titel: Average-cost Pricing and Dynamic Selection Incentives in the Hospital Sector Abstract: This study investigates hospitals‘ dynamic incentives to select patients when hospitals are remunerated according to a prospective payment system of the DRG type. Given that prices typically reflect past average costs, we use a discrete-time dynamic framework. Patients differ in severity within a DRG. Providers are to some extent altruistic. |
2013:
Autor: Heimeshoff, M.; Schreyögg, J. Titel: Estimation of a physician practice cost function Abstract: This is the first study to specify a physician practice cost function with practice costs as the unit of analysis. Our study is based on the data of 3,706 physician practices for the years 2006 to 2008. We propose a model using physician practices as the unit of observation and considering the endogenous character of physician input. |
Autor: Kifmann, M.; Nell, M. Titel: Fairer Systemwettbewerb zwischen gesetzlicher und privater Krankenversicherung Abstract: Wir entwickeln einen Reformvorschlag, der den problematischen Selektionswettbewerb zwischen GKV und PKV beendet und zu einem fairen Systemwettbewerb führt. Jeder Bürger leistet dabei einen einkommensabhängigen Beitrag zum Gesundheitsfonds und hat bei einem Wechsel in die PKV Anspruch auf risikogerechte Zahlungen aus dem Gesundheitsfonds. |
2012
Autor: Hinz, V.; Drevs, F.; Wehner, J. Titel: Electronic Word of Mouth about Medical Services Abstract: Electronic word of mouth (eWOM) about medical services gains growing popularity from the part of health care users, accompanied with a high reluctance of health care providers towards existing platforms, fearing unqualified, negative reviews driven by motives of vengeance. Purpose of this research is to shed light on the characteristics, content, and motives of eWOM about medical services. |
Autor: Stargardt, T.; Schreyögg, J.; Kondofersky, I. Abstract: In this paper, we propose a methodological approach to measure the relationship between hospital costs and health outcomes. We propose to investigate the relationship for each condition or disease area using patient-level data. |
2011
Autor: Roll, K.; Stargardt, T.; Schreyögg, J. Titel: Effect of Type of Insurance and Income on Waiting Time for Outpatient Care Abstract: This paper analyzes the impact of type of insurance, income, and reason for appointment on waiting time for an appointment and waiting time in the physician’s practice in the outpatient sector. Data were obtained from a German patient survey conducted between 2007 and 2009. We differentiated between GP and specialist and controlled for socioeconomic, structural, and institutional characteristics as well as interactions between type of insurance and control variables. |
Autor: Tiemann, O.; Schreyögg, J. Titel: Changes in Hospital Efficiency after Privatization Abstract: We investigated the effects of privatization on hospital efficiency in Germany. To do so, we obtained bootstrapped DEA efficiency scores in the first stage of our analysis and subsequently employed a difference-in-difference matching approach within a panel regression framework. Our findings show that conversions from public to private for-profit status were associated with an increase in efficiency of between 3.2 and 5.4%. |
Autor: Kifmann, M.; Roeder, K. Titel: Premium Subsidies and Social Insurance: Substitutes or Complements? Abstract: Premium subsidies have been advocated as an alternative to social health insurance. These subsidies are paid if expenditure on health insurance exceeds a given share of income. In this paper, we examine whether this approach is superior to social insurance from a welfare perspective. We show that the results crucially depend on the correlation of health and productivity. For a positive correlation, we find that combining premium subsidies with social insurance is the optimal policy. |