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Three Essays on Health and Labor Economics.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Three Essays on Health and Labor Economics./
Author:	Eck, Chase S.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2021,
Description:	154 p.
Notes:	Source: Dissertations Abstracts International, Volume: 82-12, Section: B.
Contained By:	Dissertations Abstracts International82-12B.
Subject:	Health care management. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28498347
ISBN:	9798515256715

Three Essays on Health and Labor Economics.
Eck, Chase S.

Three Essays on Health and Labor Economics. - Ann Arbor : ProQuest Dissertations & Theses, 2021 - 154 p.

Source: Dissertations Abstracts International, Volume: 82-12, Section: B.

Thesis (Ph.D.)--The University of Arizona, 2021.

This item must not be sold to any third party vendors.

In Chapter 1, I explore how the way policies are implemented influence how consumer's respond to them. The Supplemental Nutrition Assistance Program (SNAP) provides food assistance to nearly 44 million Americans each year. I document a substantial increase in the program's ability to stimulate food consumption from 1990 to 2010, as measured by the marginal propensity to consume food (MPCf) out of SNAP. I provide the first evidence for a mechanism driving this increase: the transition from paper coupons to Electronic Benefit Transfer (EBT) cards. Using plausibly exogenous variation over states and time I estimate that the introduction of EBT doubles the MPCf out of SNAP and accounts for 25 percent of its observed increase.In Chapter 2, I examine the effects of occupational licensing regulations on patient choice, costs, and outcomes in maternal care. In the United States, there are substantial restrictions on who can provide healthcare and how they do so. These labor market restrictions seek to improve quality, but may also increase the cost to provide services and limit consumer choice. I examine this tradeoff by using plausibly exogenous variation in the strictness of Scope-of-Practice laws for Certified Nurse Midwives (CNMs). Half of all states have relaxed their SOP laws to allow CNMs to practice and prescribe independently of a physician. I estimate the effect of granting CNMs full independence on hospital facility costs using administrative data from the Centers for Medicare and Medicaid Services (CMS) and inpatient discharge records from the Healthcare Cost and Utilization Project (HCUP). Using a difference-in-differences research design, I find that allowing CNMs to practice independently substantially reduces hospital facility costs per birth and the use of intensive procedures, such as cesarean sections. These cost reductions are concentrated in hospitals that are well-positioned to integrate CNMs into their practice. I find that maternal health outcomes, as measured by the rate of Severe Maternal Morbidity, also improve. Using a structural choice model, I decompose the overall effect of the policy into savings generated from increased hospital efficiency and savings due to changing selection of patients into hospitals. I find that the savings are primarily driven by increased hospital efficiency for low-risk patients and higher-risk patients select into higher-cost hospitals after the law change. These effects are attenuated by market concentration and a high density of OBGYNs.Finally, in Chapter 3 I investigate the extent to which hospitals are able to pass on cost increases (or decreases) to consumers via changes in prices. This marginal cost pass-through rate is a key parameter in estimating the incidence of policy changes on patients and hospitals. I create an instrument for marginal cost by combining plausibly exogenous variation in the price of a key input, electricity, with differential exposure to this variation due to capital decisions made in the past. I find that hospitals completely pass on changes in marginal costs to patients via changes in prices. I find no evidence that hospitals adjust their volume, patient mix, or mix of inputs in the short-run.

ISBN: 9798515256715Subjects--Topical Terms:

2122906
Health care management.
Subjects--Index Terms:

Certified Nurse Midwives

Three Essays on Health and Labor Economics.
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245 1 0 $a Three Essays on Health and Labor Economics.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2021
300 $a 154 p.
500 $a Source: Dissertations Abstracts International, Volume: 82-12, Section: B.
500 $a Advisor: Langer, Ashley.
502 $a Thesis (Ph.D.)--The University of Arizona, 2021.
506 $a This item must not be sold to any third party vendors.
520 $a In Chapter 1, I explore how the way policies are implemented influence how consumer's respond to them. The Supplemental Nutrition Assistance Program (SNAP) provides food assistance to nearly 44 million Americans each year. I document a substantial increase in the program's ability to stimulate food consumption from 1990 to 2010, as measured by the marginal propensity to consume food (MPCf) out of SNAP. I provide the first evidence for a mechanism driving this increase: the transition from paper coupons to Electronic Benefit Transfer (EBT) cards. Using plausibly exogenous variation over states and time I estimate that the introduction of EBT doubles the MPCf out of SNAP and accounts for 25 percent of its observed increase.In Chapter 2, I examine the effects of occupational licensing regulations on patient choice, costs, and outcomes in maternal care. In the United States, there are substantial restrictions on who can provide healthcare and how they do so. These labor market restrictions seek to improve quality, but may also increase the cost to provide services and limit consumer choice. I examine this tradeoff by using plausibly exogenous variation in the strictness of Scope-of-Practice laws for Certified Nurse Midwives (CNMs). Half of all states have relaxed their SOP laws to allow CNMs to practice and prescribe independently of a physician. I estimate the effect of granting CNMs full independence on hospital facility costs using administrative data from the Centers for Medicare and Medicaid Services (CMS) and inpatient discharge records from the Healthcare Cost and Utilization Project (HCUP). Using a difference-in-differences research design, I find that allowing CNMs to practice independently substantially reduces hospital facility costs per birth and the use of intensive procedures, such as cesarean sections. These cost reductions are concentrated in hospitals that are well-positioned to integrate CNMs into their practice. I find that maternal health outcomes, as measured by the rate of Severe Maternal Morbidity, also improve. Using a structural choice model, I decompose the overall effect of the policy into savings generated from increased hospital efficiency and savings due to changing selection of patients into hospitals. I find that the savings are primarily driven by increased hospital efficiency for low-risk patients and higher-risk patients select into higher-cost hospitals after the law change. These effects are attenuated by market concentration and a high density of OBGYNs.Finally, in Chapter 3 I investigate the extent to which hospitals are able to pass on cost increases (or decreases) to consumers via changes in prices. This marginal cost pass-through rate is a key parameter in estimating the incidence of policy changes on patients and hospitals. I create an instrument for marginal cost by combining plausibly exogenous variation in the price of a key input, electricity, with differential exposure to this variation due to capital decisions made in the past. I find that hospitals completely pass on changes in marginal costs to patients via changes in prices. I find no evidence that hospitals adjust their volume, patient mix, or mix of inputs in the short-run.
590 $a School code: 0009.
650 4 $a Health care management. $3 2122906
650 4 $a Obstetrics. $3 634501
653 $a Certified Nurse Midwives
653 $a Electronic Benefit Transfer
653 $a Hospital price
653 $a Marginal Cost Pass-through
653 $a Scope of practice
653 $a Supplemental Nutrition Assistance Program
690 $a 0769
690 $a 0380
710 2 $a The University of Arizona. $b Economics. $3 1057439
773 0 $t Dissertations Abstracts International $g 82-12B.
790 $a 0009
791 $a Ph.D.
792 $a 2021
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28498347