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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 39389

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Prof. Dr. Antonio Montañés

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Departamento de Análisis Económico, Universidad de Zaragoza Dirección, 50005 Zaragoza, Spain
Interests: applied econometrics; time series analysis; health econometrics
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. David Cantarero-Prieto

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Guest Editor

Department of Economics, University of Cantabria, 39005 Santander, Spain
Interests: applied econometrics; time series analysis; health econometrics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Econometric analysis is a constantly expanding area of knowledge that is providing researchers with better tools to analyze different economic problems. These advances have occurred regardless of the type of data used. They can be found in timeseries analysis, where unit root tests and cointegration analysis play an essential role, as well as in the case of using cross-sectional data—the increasing use of spatial econometric techniques is a good example. Finally, the creation of new databases has led to a great growth in the use of panel data techniques.

The objective of this Special Issue is to collect applications that use recent advances in econometrics, all applied to the field of health economics. The Editors encourage presentations that address new econometric techniques to analyze and predict the evolution of different aspects of health economics.

Dr. Antonio Montañés
Dr. Cantarero-Prieto David
Guest Editors

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Keywords

applied econometrics
health econometrics
time series analysis
spatial econometrics
data panel analysis

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Related Special Issue

2nd Edition of Applied Health Econometrics in International Journal of Environmental Research and Public Health (3 articles)

Published Papers (10 papers)

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Research

14 pages, 390 KiB

Open AccessArticle

Impact of Environment, Life Expectancy and Real GDP per Capita on Health Expenditures: Evidence from the EU Member States

by Yilmaz Bayar, Marius Dan Gavriletea, Mirela Oana Pintea and Ioana Cristina Sechel

Int. J. Environ. Res. Public Health 2021, 18(24), 13176; https://doi.org/10.3390/ijerph182413176 - 14 Dec 2021

Cited by 14 | Viewed by 4927

Abstract

This research explores the impact of environment, life expectancy, and real GDP per capita on health expenditures in a sample of 27 EU member states over the 2000–2018 period through causality and cointegration analyses. The causality analysis revealed a significant unilateral causality from variables of greenhouse gas emissions, life expectancy, and real GDP per capita to health expenditures. In other words, greenhouse gas emissions, life expectancy, and real GDP per capita had a significant impact on health expenditures in the short run. The cointegration analysis indicated that life expectancy and real GDP per capita had a significant positive impact on health expenditures at the overall panel. On the other side, the country level cointegration coefficients revealed that life expectancy had a considerable positive impact on health expenditures, real GDP per capita had a moderate positive impact on the health expenditures in most of the countries in the panel, but the environment proxied by greenhouse gas emissions had a low positive or negative impact on the health expenditures in a limited number of countries. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

13 pages, 1083 KiB

Open AccessArticle

Inequality in the Face of Death: The Income Gradient in Mortality of the Spanish Pre-Recession Working-Age Population

by Pedro García-Castrillo and María A. González-Álvarez

Int. J. Environ. Res. Public Health 2021, 18(23), 12379; https://doi.org/10.3390/ijerph182312379 - 25 Nov 2021

Viewed by 1624

Abstract

The purpose of this paper is to evaluate the association between socioeconomic status (SES) and mortality over a three-year period for working-age Spaniards (2007–2009), paying particular attention to the effect of income level. The analysis is relatively new in Spain, and the studies are limited. Neither income nor wealth are included in existing Spanish mortality studies. The main reason for this limitation is the nature of the data sets used, mainly Census Records. We overcome this problem by using data on 693,994 individuals taken from a Social Security sampling and used to estimate the probabilities of death for each income decile and the mortality rate ratios in three different models: (1) using only income, controlled by age and sex, (2) adding socio-economic and geographical variables, and (3) adding level of education. However, the data used here also have some limitations. They do not include government employees, the military or the Department of Justice personnel, whose exclusion we believe causes an under-representation of highly educated people in our sample. The results confirm that there is a non-linear relationship between mortality and income. This non-linear relationship implies that income redistribution resulting from progressive taxation systems could lead to higher reductions in mortality for low-income groups than the reductions induced in the mortality of the high-income population, thus reducing overall mortality. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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18 pages, 5408 KiB

Open AccessArticle

Multilevel Zero-One Inflated Beta Regression Model for the Analysis of the Relationship between Exogenous Health Variables and Technical Efficiency in the Spanish National Health System Hospitals

by Ricardo Ocaña-Riola, Carmen Pérez-Romero, Mª Isabel Ortega-Díaz and José Jesús Martín-Martín

Int. J. Environ. Res. Public Health 2021, 18(19), 10166; https://doi.org/10.3390/ijerph181910166 - 27 Sep 2021

Cited by 2 | Viewed by 2752

Abstract

Background: This article proposes a methodological innovation in health economics for the second stage analysis of technical efficiency in hospitals. It investigates the relationship between the installed capacity in regions and hospitals and their ownership structure. Methods: A multilevel zero-one inflated beta regression model is employed to model pure technical efficiency more adequately than other models frequently used in econometrics. Results: Compared to publicly managed hospitals, the mean efficiency index of hospitals with public-private partnership (PPP) formulas was 4.27-fold. This figure was 1.90-fold for private hospitals. Concerning the efficiency frontier, the odds ratio (OR) of PPP models vs. public hospitals was 42.06. The OR of private hospitals vs. public hospitals was 8.17. A one standard deviation increase in the percentage of beds in intensive care units increases the odds of being situated on the efficiency frontier by 50%. Conclusions: The proportion of hospital beds in intensive care units relates to a higher chance of being on the efficiency frontier. Hospital ownership structure is related to the mean efficiency index of Spanish National Health Service hospitals, as well as the odds of being situated on the efficiency frontier. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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10 pages, 455 KiB

Open AccessArticle

Estimated Direct Medical Cost of Osteoporosis in Saudi Arabia: A Single-Center Retrospective Cost Analysis

by Bander Balkhi, Ahmed Alghamdi, Sulaiman Alqusair, Bader Alotaibi, Yazed AlRuthia, Hisham Alsanawi, Ahmad Bin Nasser and Mona A. Fouda

Int. J. Environ. Res. Public Health 2021, 18(18), 9831; https://doi.org/10.3390/ijerph18189831 - 18 Sep 2021

Cited by 5 | Viewed by 3499

Abstract

Osteoporosis and its complications are a major health concern in Saudi Arabia, and the prevalence of osteoporosis is on the rise. The aim of this study was to estimate the direct healthcare cost for patients with osteoporosis. A retrospective study was carried out among adult patients with osteoporosis in a teaching hospital in Saudi Arabia. A bottom-up approach was conducted to estimate the healthcare resources used and the total direct medical cost for the treatment of osteoporosis and related fractures. The study included 511 osteoporosis patients, 93% of whom were female. The average (SD) age was 68.5 years (10.2). The total mean direct medical costs for patients without fractures were USD 975.77 per person per year (PPPY), and for those with osteoporotic fractures, the total direct costs were USD 9716.26 PPPY, of which 56% of the costs were attributable to surgery procedures. Prior to fractures, the main cost components were medication, representing 61%, and physician visits, representing 18%. The findings of this study indicated the economic impact of osteoporosis and related fractures. With the aging population in Saudi Arabia, the burden of disease could increase significantly, which highlights the need for effective prevention strategies to minimize the economic burden of osteoporosis. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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14 pages, 882 KiB

Open AccessArticle

Heterogeneous Effects of Health Insurance on Rural Children’s Health in China: A Causal Machine Learning Approach

by Hua Chen, Jianing Xing, Xiaoxu Yang and Kai Zhan

Int. J. Environ. Res. Public Health 2021, 18(18), 9616; https://doi.org/10.3390/ijerph18189616 - 12 Sep 2021

Cited by 7 | Viewed by 3162

Abstract

This paper investigates the impact of Urban and Rural Resident Basic Medical Insurance (URRBMI) on the health of preschool and school-age children in rural China using data from the 2018 wave of the China Family Panel Studies (CFPS). We employ the propensity score matching approach and causal forest to evaluate impacts. Results show that the URRBMI has significantly improved the health status of preschool children. However, the health improvement of school-age children by URRBMI is only limited to obese children, and this effect is not significant. In addition, this paper identifies important variables related to heterogeneity through the causal forest and evaluates the heterogeneity of the impact of URRBMI on the health of two types of children. For preschool children, we find disadvantaged mothers (i.e., with lower wealth, lower educated, or in rural areas) benefit more from the URRBMI. No significant heterogeneity is found for the school-age children. Our study demonstrates the power of causal forest to uncover the heterogeneity in policy evaluation, hence providing policymakers with valuable information for policy design. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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21 pages, 4788 KiB

Open AccessArticle

Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?

by José M. Cordero, Agustín García-García, Enrique Lau-Cortés and Cristina Polo

Int. J. Environ. Res. Public Health 2021, 18(16), 8630; https://doi.org/10.3390/ijerph18168630 - 15 Aug 2021

Cited by 3 | Viewed by 2762

Abstract

In Latin American and Caribbean countries, the main concern of public health care managers has been traditionally placed on problems related to funding, payment mechanisms, and equity of access. However, more recently, there is a growing interest in improving the levels of efficiency and reducing costs in the provision of health services. In this paper we focus on measuring the technical efficiency and productivity change of public hospitals in Panama using bootstrapped Malmquist indices, which allows us to assess the statistical significance of changes in productivity, efficiency, and technology. Specifically, we are interested in comparing the performance of hospitals belonging to the two different management schemes coexisting in the country, the Social Security Fund (SSF) and the Ministry of Health (MoH). Our dataset includes data about 22 public hospitals (11 for each model) during the period between 2005 and 2015. The results showed that the productivity growth of hospitals belonging to the SSF has been much higher than that of the hospitals belonging to the Ministry of Health over the evaluated period (almost 4% compared to 1.5%, respectively). The main explanation for these divergences is the superior growth of technological change in the former hospitals, especially in the final years of the evaluated period. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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20 pages, 1889 KiB

Open AccessArticle

Disparities in the Evolution of the COVID-19 Pandemic between Spanish Provinces

by Héctor López-Mendoza, Antonio Montañés and F. Javier Moliner-Lahoz

Int. J. Environ. Res. Public Health 2021, 18(10), 5085; https://doi.org/10.3390/ijerph18105085 - 11 May 2021

Cited by 10 | Viewed by 3337

Abstract

Spain experienced a second wave of the COVID-19 pandemic in autumn 2020, which has been approached with different measures by regional authorities. We analyze the presence of convergence in the cumulative incidence for 14 days (CI₁₄) in provinces and self-governing cities. The Phillips–Sul methodology was used to study the grouping of behavior between provinces, and an ordered logit model was estimated to understand the forces that drive creating the different convergence clubs. We reject the presence of a single pattern of behavior in the evolution of the CI₁₄ across territories. Four statistically different convergence clubs and an additional province (Madrid) with divergent behavior are observed. Provinces with developed agricultural and industrial economic sectors, high mobility, and a high proportion of Central and South American immigrants had the highest level of CI₁₄. We show that the transmission of the virus is not homogeneous in the Spanish national territory. Our results are helpful for identifying differences in determinants that could explain the pandemic’s evolution and for formulating hypotheses about the effectiveness of implemented measures. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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20 pages, 1978 KiB

Open AccessArticle

The Interplay between Public Health, Well-Being and Population Aging in Europe: An Advanced Structural Equation Modelling and Gaussian Network Approach

by Mirela Cristea, Graţiela Georgiana Noja, Cecilia-Nicoleta Jurcuţ, Constantin Ştefan Ponea, Elena Sorina Caragiani and Alin Viorel Istodor

Int. J. Environ. Res. Public Health 2021, 18(4), 2015; https://doi.org/10.3390/ijerph18042015 - 19 Feb 2021

Cited by 4 | Viewed by 3223

Abstract

Given the COVID-19 pandemic crisis that has deeply affected the health and well-being of people worldwide, the main objective of this paper was to explore the existing relationship between health, welfare, and population aging until the pandemic burst, on the basis of two distinctive groups of European Union (EU) countries, namely, the old and the new member states. The methodological endeavor was based on two advanced econometric techniques, namely, structural equation modelling and network analysis through Gaussian graphical models, applied for each group of EU countries, analyzed during the period of 1995–2017. The main results revealed significant differentiation among the new and old EU countries as follows: public health support was found to have a positive impact on healthy aging and well-being of older people, on other social determinants, and on people’s perceived good and very good health; overall, significant influences were revealed in terms of the aging dimensions. The main implications of our findings relate to other researchers as a baseline comparison with the existing situation before the COVID-19 pandemic outbreak, but also to policymakers that have to rethink the public health allocations, both in old and new EU member states, in order to endorse the aging credentials, underpinning a successful and healthy integration of the elderly within all life dimensions. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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14 pages, 771 KiB

Open AccessArticle

Socioeconomic Inequality in the Use of Long-Term Care among European Older Adults: An Empirical Approach Using the SHARE Survey

by Javier Lera, Marta Pascual-Sáez and David Cantarero-Prieto

Int. J. Environ. Res. Public Health 2021, 18(1), 20; https://doi.org/10.3390/ijerph18010020 - 22 Dec 2020

Cited by 24 | Viewed by 3891

Abstract

The increase in the proportion of elderly people in developed societies has several consequences, such as the rise in demand for long-term care (LTC). Due to cost, inequalities may arise and punish low-income households. Our objective is to examine socioeconomic inequalities in LTC utilization in Europe. We use the last wave from the Survey of Health, Aging, and Retirement in Europe SHARE (Munich Center for the Economics of Ageing, Munich, Germany), dated 2017, to analyze the impact of socioeconomic status (SES) on LTC. For this purpose, we construct logistic models and control for socioeconomic/household characteristics, health status, and region. Then, concentration indices are calculated to assess the distribution of LTC. Moreover, we also analyze horizontal inequity by using the indirect need-standardization process. We use two measures of SES (household net total income and household net wealth) to obtain robust results. Our findings demonstrate that informal care is concentrated among low-SES households, whereas formal care is concentrated in high-SES households. The results for horizontal concentration indices show a pro-rich distribution in both formal and informal LTC. We add new empirical evidence by showing the dawning of deep social inequalities in LTC utilization. Policymakers should implement policies focused on people who need care to tackle socioeconomic inequalities in LTC. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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20 pages, 2456 KiB

Open AccessArticle

Global Trends in Child Obesity: Are Figures Converging?

by María A. González-Álvarez, Angelina Lázaro-Alquézar and María Blanca Simón-Fernández

Int. J. Environ. Res. Public Health 2020, 17(24), 9252; https://doi.org/10.3390/ijerph17249252 - 10 Dec 2020

Cited by 35 | Viewed by 8788

Abstract

Childhood obesity has become one of the most serious global health challenges of our time. The combined prevalence of overweight and obesity has rapidly increased worldwide during the last two decades, especially in some developing countries where obesity is reaching levels on a par with some industrialized countries, or even higher. This fast growth has occurred especially in countries in the midst of rapid social-economic transitions. Most international comparisons focus on the adult population while analyses focusing on the child population are more limited. Using the methodology developed by Phillips and Sul, this paper studies the worldwide evolution of children’s body mass index (BMI), overweight and obesity prevalence for a large sample of countries during the period 1975–2016. Our results indicate that the figures for BMI or the prevalence of obesity in different countries do not converge, while the opposite is the case for overweight prevalence in children. Furthermore, there is a non-linear relationship between obesity and income or human capital, indicating that low and middle-income countries require a strong initiative for health policies targeting obesity prevention. Full article

(This article belongs to the Special Issue Applied Health Econometrics)

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