Does Living Alone Confer a Higher Risk of Hospitalisation?

The rise in one‐person households is a worldwide trend. This means that informal care is less available, particularly for elderly people, with important implications for health‐care utilisation and health expenditure. This paper uses a two‐part model to examine the relationship between living alone and hospitalisations in Australia in terms of both the likelihood and the length of hospitalisation. The results show living alone increases the probability of hospitalisation by 2.9 percentage points and length of stay by 3.8 days for people aged 45 and above. Further analysis indicates that these impacts depend on the length of living alone. Additionally, the probability and the length of hospitalisation vary depending on whether the cause of living alone is separation/divorce, widowhood or never having married.     

Estimated cost savings associated with the use of valsartan in heart failure in a large US health plan

Summary

Results from a large, randomised clinical trial demonstrated reduced rates of hospitalisation and mortality, and reduced length of stay associated with valsartan added to the usual care of heart failure patients not currently receiving angiotensin-converting enzyme inhibitors (ACEIs). These results were used in a budget impact model for a large US health plan. Administrative claims data were used to estimate cost savings over 1 year. In the study health plan, 63,218 patients were identified with heart failure, with 55% not currently receiving ACEI or valsartan. Using health plan-specific cost data, care for the untreated heart failure patients with valsartan would reduce hospitalisation costs from $135 million to $43 million owing to averted heart failure-related hospitalisations and shortened length of stay for the remaining hospitalisations. Economic effects of other aspects of treatment with valsartan (e.g. outpatient or physician visits or adverse events) were not considered. Taking into account only hospitalisations and the costs of valsartan therapy, net savings in the study health plan would be expected to be $64 million.     

Measuring Inequality of Access to Higher Education in India

This paper uses data from the 71st NSS round (Education Survey: January–June 2014) to estimate the probabilities of person in India, between the ages of 18 and 22 years, of currently attending graduate or post-graduate courses in institutions of higher education , conditional on their social and economic status, their gender, their marital status, and their urban or rural location. It then examines inequality by social group in the quality of education received. Using the technique of inequality decomposition it estimates the proportionate contributions of the above factors to inequality in the interpersonal distribution of the probabilities of currently attending higher education. It compares how access to higher education has changed between the 64th NSS (July 2007–June 2008) and the 71st (January–June 2014) rounds of the NSS.

     

Comparative costs of hospitalisation among infants at high risk for respiratory syncytial virus lower respiratory tract infection during the first year of life

Abstract

Objective: This retrospective cohort study compared the total cost of hospitalisation due to respiratory syncytial virus (RSV) lower respiratory tract infection (LRI) during the first year of life between late-preterm (33–36 weeks gestational age [wGA]) and term (≥37 wGA) infants.

Research design and methods: A large national claims database of commercially insured members was examined to identify hospital admissions associated with RSV between January 2003 and June 2007 among infants at high risk for RSV LRI, including late-preterm infants. Hospital use and costs were compared with those of a reference cohort of term infants with RSV.

Results: The cost of hospitalisation for RSV among late-preterm infants with at least one hospital admission associated with RSV (n=173) was twice that of term infants (n=1,983; $20,269 vs. 9,635; p<?0.001). The mean length of stay was also higher (5.3 vs. 3.4 days; p<?0.001). Approximately 21.9% of hospitalisations for late-preterm infants included an intensive care unit admission compared with 9.6% among term infants (p<?0.001).

Limitations: Reliance on ICD-9 codes to identify potential cohort members may result in misclassification and underreporting the cohort size for conditions of interest.

Conclusions: Hospitalisation costs and length of stay due to RSV LRI were significantly greater among late-preterm infants compared with term infants and higher than general estimates previously reported in the broader paediatric population.     

Health,time allocation and work: empirical evidence from Turkey

This article investigates the relationship between health status and time allocation decisions of individuals. Although many studies address impacts of health on labour supply, few studies explore associations of health status with non-market work activities. Using a nationally representative sample from a recent Turkish Time Use Survey, this article employs Seemingly Unrelated Regression (SUR) framework to estimate multiple equations of various time use categories. Consistent with literature, empirical results indicate that higher levels of self-reported health status (SRHS) are associated with more time spent in market work. However, better health level is negatively correlated with time spent in leisure and sleep. There is mixed evidence between self-reported health status (SRHS) and time spent on non-market work. There is a negative weak association between health and time devoted to personal care. Finally, demographics such as gender, age, education and marital status display correlations with time allocation of Turkish individuals.     

Effects of tax benefits on the price elasticity of charitable contributions in South Korea

Using South Korean panel data from 2008 to 2019 and censored quantile regression method, this study calculates the effects of different tax incentives on charitable contributions. We observe price elasticity under two different tax-benefit systems in South Korea and find that, first, taxpayers tend to be more sensitive to tax incentives under a tax deduction system than a tax credit system. The price elasticity gap between a tax deduction and tax credit is approximately −2.3 to −1.0. Second, we show the existence of heterogeneity in taxpayers’ behaviour: the price elasticity of charitable contributions exhibits a convex shape, where more significant donors have lesser reactions to tax incentives. We further show that socioeconomic contexts, such as income, gender, marital status, and education, affect people's attitudes. In sum, the results are as expected: tax deductions work more efficiently than tax credits.     

Informal parental care and female labour supply in Japan

Using the Japanese Study of Aging and Retirement, Japan’s first globally comparable panel survey of the elderly, we estimate the effect on female employment in Japan due to the provision of informal parental care. We observe that informal parental care has little impact on female employment, after controlling for endogeneity of informal care or individual unobserved time-invariant heterogeneity. This finding is consistent with those observed in Europe and the US, underscoring a limited association between care and work in Japan, which is facing ageing at the fastest pace among advanced economies.     

Gender Differentials in Domestic Work, Market Work, and Total Work Time: UK Time Budget Survey Evidence for 1974/5 and 1987

We provide evidence about UK trends in gender differentials in market work time, domestic work time, and their sum (total work time) between the mid-1970s and mid-1980s. The ratio of women's total work hours to men's total work hours changed little, but for both sexes allocations of time to different types of work changed considerably. Breakdowns by marital status reveal additional interesting information. The trends in domestic work time are decomposed into 'coefficient change' and 'compositional change' components using regression-based shift-share methods.     

Sovereign debt and the length of economic depressions

We analyze the duration of economic depressions to see if there is an association with consecutive years of high public-debt-to-GDP ratios. We find that there is a positive, non-linear association between the sovereign debt ratio and the length of depressions. Inflation is negatively and linearly correlated with depression duration. These associations are robust to the inclusion of controls for development, but we do detect cross-country heterogeneity in the probability of exit. An analysis of causality finds little evidence that high levels of sovereign debt cause depressions to be longer. Rather, it appears that longer depressions elicit higher debt relative to GDP. Public deleveraging during a depression is not likely, therefore, to help bring it to an end.     

Gender difference in the impact of retirement on cognitive abilities: Evidence from urban China

This paper examines the impact of retirement on cognitive functioning by gender in urban China and investigates the underlying mechanisms. Based on data from the China Health and Retirement Longitudinal Study, the paper uses the mandatory retirement ages and different policy enforcement between the public and private sectors as instruments for retirement status. The analysis finds substantial gender heterogeneity in the effect of retirement on cognition, with a positive and significant effect for males, but a negative and less significant effect for females. The beneficial effects on cognition are stronger for male blue-collar workers, who are likely to pursue a more active lifestyle at retirement. Further investigation shows that the results are partly driven by differential behavioral changes at retirement, and the gender difference in retirement ages may also play a potential role.     

Pharmacoeconomic analysis of paricalcitol and calcitriol in the treatment of secondary hyperparathyroidism in haemodialysis: impact of hospitalisations and survival

Summary

The objective of this study was to evaluate the cost effectiveness of paricalcitol injection compared with calcitriol injection when used to reduce parathyroid hormone levels in patients undergoing haemodialysis. A decision tree was developed to model the 1-year costs and outcomes of therapy for secondary hyperparathyroidism from a US government payer's perspective (2005 US$). Probabilities of hospitalisations and survival with paricalcitol and calcitriol were obtained from published observational studies.

When only drug costs and survival were considered, the incremental cost effectiveness of paricalcitol over calcitriol was $9,900 per life saved. When utilities were included, the incremental cost-effectiveness ratio for paricalcitol compared with calcitriol was $13,200 per quality-adjusted life year. When both drug and hospitalisation costs were included in a cost analysis, paricalcitol treatment was cost saving compared with calcitriol, and when hospitalisation costs were included in both the cost-effectiveness analysis and cost-utility analysis paricalcitol demonstrated first-order dominance, cost savings and cost effectiveness.

This decision analysis demonstrated that paricalcitol injection is both cost effective and cost saving compared with calcitriol injection.     

中国中年人群婚姻满意度的影响因素：基于计量经济学模型的分析

本文利用2002年中国高龄老人健康长寿跟踪调查（CLHLS）子女问卷数据,通过多元回归模型对35～65岁的中年人群婚姻满意度的影响因素进行了分析。研究表明,健康状况及受教育程度对于婚姻满意度有显著性影响;在控制住受教育程度时,职业及收入等经济因素对婚姻满意度无显著影响;父母与其成年子女的婚姻满意度有正相关关系。本文未发现中年人群存在婚姻的家庭生命周期效应,婚姻满意度不受婚龄及子女离家生活事件的影响。研究还发现,男女婚姻满意度的影响因素存在差别,当通过相亲途径结婚或家庭经济权由男性掌握时,男性的婚姻满意度较低,但这些因素对女性无显著影响。     

Household Formation,Female Labor Supply,and Savings

In this paper, we aim to quantify the impact of changing family structures on labor supply and savings in Western societies. Our dynamic general equilibrium model features both genders, and it takes into account changes in marital status as a stochastic process. The numerical results indicate that changes in household formation can partly explain the reallocation of male and female labor supply observed during the last decades in Germany. We also find a negative impact on capital accumulation, and we show that a combination of higher marital risk and a narrowing gender wage gap can explain the changes in hours ratios between single and married men and women.     

Personal characteristics and lying: An experimental investigation

We explore the relationship between personal characteristics and the decision to lie to an anonymous partner in a cheap talk environment. We find that sex, age, grade point average, student debt, size of return, socioeconomic status, and average time spent in religious observation are not related to the decision to lie. A subject’s major of study, the marital status of their parents, whether or not they were raised by a single parent, religious importance and whether or not the subjects came to collect their pay were important explanatory variables.     

Experimental Estimates of Taxpayer Ethics

This paper extends the existing literature on taxpayer ethics in three ways. First, we construct a two-stage model of decision making, which allows us to disentangle risk preferences from ethical motivations for income tax compliance. Second, we develop a new experimental data set, which permits us to estimate the magnitudes of the relevant personality traits, risk aversion and morality, at the individual level. Third, we combine the experimental data with participant surveys so that ethical preferences are not only measured but also linked to demographic characteristics. We find that ethical preferences are correlated with risk aversion, age, gender, and marital status, among other characteristics.     

A new approach to understanding labour supply of disabled people

The main interest of this article is to propose an individual utility maximization model to explain the low participation of disabled people. We account for heterogeneity of preferences and furthermore time of self-caring for disabled individuals is considered as an argument in the utility function. The hours of work decided by disabled individuals are neither homogeneous (they depend on unknown characteristics) nor continuous (discrete choice sets). We use data of 4790 households from the Spanish Survey of Disability, Personal Autonomy and Dependency and find association between time of informal care and labour participation and, consequently, the choice between jobs.     

Measuring wage discrimination in Italy: a random-coefficient approach

Using data from a representative 1989 household survey for Italy we estimate random-coefficient earnings frontiers by gender, marital status and location. These estimates are used to calculate discrimination indices. Our results show that fixed coefficients can be rejected in all cases. A wide range on the estimated coefficients indicates a high degree of variation in the quality of the observed human-capital variables as well as different degrees of ability as perceived by the employer. We find reverse discrimination for single females in the South and the North. For married females there is evidence of discrimination, particularly in the South. We isolate the effects of tenure and education on discrimination and find that these reduce discrimination for Southern-married females.     

The cost effectiveness of palivizumab in term Inuit infants in the Eastern Canadian Arctic

Abstract

Introduction: Canadian, Inuit, full term infants have the highest rate of respiratory syncytial virus (RSV) infection globally, which results in substantial costs associated hospitalisation.

Methods: Decision-analytical techniques were used to estimate the incremental cost-effectiveness ratio (ICER) for palivizumab compared to no prophylaxis for Inuit infants of all gestational age. The time horizon was that of life-time follow-up, and costs and effectiveness were discounted at 5% per year. Costs (2007 CAD$) for palivizumab, hospitalisation (including medical evacuation, intensive care unit [ICU]), physician visits, and transportation were calculated based on the Canadian payer's perspective. Benefits on decreasing RSV hospitalisation were expressed as quality-adjusted life-years (QALYs). One-way and probabilistic sensitivity analysis (PSA) were conducted, varying: mortality rates, utilities, length of stay in hospital and ICU.

Results: For all of Baffin Island infants (<1 year), the ICER was $39,435/QALY. However, when infants were grouped by age and area of residence, those residing in Iqaluit (<1 year) had an ICER of $152,145/QALY, while those residing in rural areas (outside of Iqaluit) had an ICER of $24,750/QALY. Prophylaxis was a dominant strategy (cost saving) for rural infants under 6 months of age, with the PSA demonstrating that it was dominant 98% of the time.

Conclusions: The ICERs suggested that palivizumab is a cost-effective option for the prevention of RSV for Inuit infants on Baffin Island compared to no prophylaxis. Palivizumab is highly cost effective in Arctic infants <1 year of age specifically residing outside of Iqaluit and is a dominant strategy for those under 6 months of age in rural areas. However, palivizumab is not cost effective compared to no treatment for infants of all ages residing in Iqaluit.