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Essays on the Economics of Health

Rodriguez Lesmes, PA; (2016) Essays on the Economics of Health. Doctoral thesis , UCL (University College London). Green open access

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Abstract

This thesis presents three empirical studies related to the economics of health interventions. All of them use data from England and are related to preventive care. The first study estimates the potential impact of early diagnosis programmes on medication, subjective health and lifestyle. By taking advantage of the survey design of the English Longitudinal Study of Ageing (ELSA), a regression discontinuity design based on the blood pressure of the respondents allows for estimates free of selection bias due to screening. There is evidence of a temporal increase in the use of medication as a treatment for the condition, and induced lifestyle changes. The second study proposes a structural dynamic life-cycle model for studying the economic value of the adoption of medical innovations. It allows for both cost-benefit and cost-effectiveness calculations, by considering long-run gains on productivity and on welfare derived from adjusting savings and labour supply throughout life. In particular, the case of a medication that reduces the odds of developing cardiovascular diseases, namely statins, is considered. Using data from ELSA, it is possible to calculate the value of such treatment, and to consider counterfactual policy scenarios. The last study proposes an empirical test for determining whether rewarded tasks are cost complements or substitutes in a pay for performance scheme with kinks on linear task-specific reward functions. The test is based on the insensitivity of effort exerted on a particular task to variations in the price of competing tasks for agents who are bunched near the kink. As a case study, we consider the case of the Quality and Outcomes Framework, which is a pay for performance scheme for family doctors in the UK. We found no evidence of effort-diversion as a result of the changes introduced in 2011.

Type: Thesis (Doctoral)
Title: Essays on the Economics of Health
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Keywords: Retirement, cost-benefit analysis, cost-efficiency analysis, cardiovascular diseases, structural model, life-cycle model, health prevention, value of health, lifestyle and information, health production, financial incentives, hypertension, statins, multitasking
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL SLASH
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS
URI: https://discovery.ucl.ac.uk/id/eprint/1532022
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