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Essays in Health Economics.

Liu, Chuxin.

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Essays in Health Economics.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Essays in Health Economics./
作者:	Liu, Chuxin.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2023,
面頁冊數:	92 p.
附註:	Source: Dissertations Abstracts International, Volume: 85-04, Section: B.
Contained By:	Dissertations Abstracts International85-04B.
標題:	Health care management. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=30687102
ISBN:	9798380417457

Essays in Health Economics.
Liu, Chuxin.

Essays in Health Economics. - Ann Arbor : ProQuest Dissertations & Theses, 2023 - 92 p.

Source: Dissertations Abstracts International, Volume: 85-04, Section: B.

Thesis (Ph.D.)--City University of New York, 2023.

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

Chapter 1: Financial Incentive and New Technology Adoption in Hospitals In this chapter, I investigate the effect of a financial incentive from the Centers for Medicare and Medicaid Services (CMS) on new medical procedure technology diffusion. I examine how the incentive affects diffusion among Medicare patients, for whom hospitals receive the incentives, and non-Medicare patients for whom there are no incentives. I answer these two questions by studying the New Technology Add-on Payment (NTAP) program offered by Medicare (Part A). It is unknown whether its incentive is enough to encourage diffusion under the prospective payment system and it also remains unknown whether it spills over to non-Medicare patients or crowds them out. Using the State Inpatient Database (SID) provided by Healthcare Cost and Utilization Program (HCUP), I show that the NTAP program increases new medical procedure technology adoption in hospitals, which is mainly picked up by large hospitals, medical-school affiliated hospitals, and public hospitals. The policy also has a positive spillover effect on non-Medicare patients, despite in a smaller scale. As the NTAP program becomes more expensive, this research is helpful in future policy making.Chapter 2: Social determinants of the rates and trends in severe maternal morbidity and blood transfusions during hospitalization for childbirths In this chapter, my coauthor and I examine the issue of racial disparities in severe maternal morbidity (SMM) and blood transfusion events during inpatient delivery in the United States. Our findings indicate that SMM and blood transfusion events continue to be prevalent and slowly but steadily increasing. Beneath this trend, substantial disparities based on race are observed. Black women who are hospitalized for births have a significantly higher likelihood of experiencing SMM or requiring blood transfusion compared to their White peers. To understand the role of environmental factors in these disparities, we employ a machine learning technique to select measures of social determinants of health with predictive power and Oaxaca-Blinder decompositions to evaluate the explanatory power of these measures. The results show that environmental factors explain only a small portion of racial disparities.Chapter 3: Extreme Temperatures during Pregnancy and Severe Maternal Morbidity In this chapter, I study the effect of exposure to extreme temperatures during pregnancy on severe maternal morbidity (SMM). Using the State Inpatient Database (SID) from 2010 to 2018, I link maternal health outcomes during delivery to historical weather data during the entire pregnancy. I find that exposure to extremely cold weather during pregnancy increases the risk of severe maternal morbidity (SMM), especially the risk of blood transfusion. I also find that exposure to extremely hot weather during pregnancy increases the probability of a cesarean delivery. These effects are racially unequal, which exacerbates existing racial disparities in maternal health. My findings provide the first estimates of the impacts of prenatal exposure to extreme temperatures on severe maternal morbidity during delivery, while the literature has studied the impact of exposure to weather on pregnancy health and infant health. My findings are relevant to growing interest in understanding climate-related health risk. They are also crucial in understanding the widening racial disparities in maternal health.

ISBN: 9798380417457Subjects--Topical Terms:

2122906
Health care management.
Subjects--Index Terms:

Maternal health

Essays in Health Economics.
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520 $a Chapter 1: Financial Incentive and New Technology Adoption in Hospitals In this chapter, I investigate the effect of a financial incentive from the Centers for Medicare and Medicaid Services (CMS) on new medical procedure technology diffusion. I examine how the incentive affects diffusion among Medicare patients, for whom hospitals receive the incentives, and non-Medicare patients for whom there are no incentives. I answer these two questions by studying the New Technology Add-on Payment (NTAP) program offered by Medicare (Part A). It is unknown whether its incentive is enough to encourage diffusion under the prospective payment system and it also remains unknown whether it spills over to non-Medicare patients or crowds them out. Using the State Inpatient Database (SID) provided by Healthcare Cost and Utilization Program (HCUP), I show that the NTAP program increases new medical procedure technology adoption in hospitals, which is mainly picked up by large hospitals, medical-school affiliated hospitals, and public hospitals. The policy also has a positive spillover effect on non-Medicare patients, despite in a smaller scale. As the NTAP program becomes more expensive, this research is helpful in future policy making.Chapter 2: Social determinants of the rates and trends in severe maternal morbidity and blood transfusions during hospitalization for childbirths In this chapter, my coauthor and I examine the issue of racial disparities in severe maternal morbidity (SMM) and blood transfusion events during inpatient delivery in the United States. Our findings indicate that SMM and blood transfusion events continue to be prevalent and slowly but steadily increasing. Beneath this trend, substantial disparities based on race are observed. Black women who are hospitalized for births have a significantly higher likelihood of experiencing SMM or requiring blood transfusion compared to their White peers. To understand the role of environmental factors in these disparities, we employ a machine learning technique to select measures of social determinants of health with predictive power and Oaxaca-Blinder decompositions to evaluate the explanatory power of these measures. The results show that environmental factors explain only a small portion of racial disparities.Chapter 3: Extreme Temperatures during Pregnancy and Severe Maternal Morbidity In this chapter, I study the effect of exposure to extreme temperatures during pregnancy on severe maternal morbidity (SMM). Using the State Inpatient Database (SID) from 2010 to 2018, I link maternal health outcomes during delivery to historical weather data during the entire pregnancy. I find that exposure to extremely cold weather during pregnancy increases the risk of severe maternal morbidity (SMM), especially the risk of blood transfusion. I also find that exposure to extremely hot weather during pregnancy increases the probability of a cesarean delivery. These effects are racially unequal, which exacerbates existing racial disparities in maternal health. My findings provide the first estimates of the impacts of prenatal exposure to extreme temperatures on severe maternal morbidity during delivery, while the literature has studied the impact of exposure to weather on pregnancy health and infant health. My findings are relevant to growing interest in understanding climate-related health risk. They are also crucial in understanding the widening racial disparities in maternal health.
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