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AimTo assess, from a United States (US) payer's perspective, the cost-effectiveness of gels designed to separate the endometrial surfaces (intrauterine spacers) placed following intrauterine surgery.Materials and methodsA decision tree model was developed to estimate the cost-effectiveness of intrauterine spacers used to facilitate endometrial repair and prevent the formation (primary prevention) and reformation (secondary prevention) of intrauterine adhesions (IUAs) and associated pregnancy- and birth-related adverse outcomes. Event rates and costs were extrapolated from data available in the existing literature. Sensitivity analyses were conducted to corroborate the base case results.ResultsIn this model, using intrauterine spacers for adhesion prevention led to net cost savings for US payers of $2,905 per patient over a 3.5-year time horizon. These savings were driven by the direct benefit of preventing procedures associated with IUA formation ($2,162 net savings) and the indirect benefit of preventing pregnancy-related complications often associated with IUA formation ($3,002). These factors offset the incremental cost of intrauterine spacer use of $1,539 based on an assumed price of $1,800 and the related increase in normal deliveries of $931. Model outcomes were sensitive to the probability of preterm and normal deliveries. Budget impact analyses show overall cost savings of $19.96 per initial member within a US healthcare plan, translating to $20 million over a 5-year time horizon for a one-million-member plan.LimitationsThere are no available data on the effects of intrauterine spacers or IUAs on patients' quality of life. Resultingly, the model could not evaluate patients' utility related to treatment with or without intrauterine spacers and instead focused on costs and events avoided.ConclusionThis analysis robustly demonstrated that intrauterine spacers would be cost-saving to healthcare payers, including both per-patient and per-plan member, through a reduction in IUAs and improvements to patients' pregnancy-related outcomes.

Public health events (PHEs) have emerged as significant threats to human life, health, and economic growth. PHEs, such as COVID-19, have prompted a reevaluation for enhanced regular prevention and control (RPC). In this study, we focus on the core concept of prevention and control intensity (PCI), and establish a neoclassical economic growth model from the long-term and macro perspective to balance life protection and economic growth. The model construct the mechanism of PCI on economic growth through population dynamics and capital accumulation under the backdrop of RPC for PHEs. We find the conditions for PCI when the economy achieves steady state, and provides an algorithm establishing the optimal strategy that maximises per capita disposable income based on the optimal PCI and consumption. Simulation result quantifies an inverted U-shaped relationship between PCI and capital per capita, output per capita and consumption per capita in the steady state. The model suggests that, given the PHEs of inducing potential unemployment shock, it is worthwhile to combine the implementation of moderate PCI with coordinated policies of income distribution. Highlights: • Building a Neoclassical economic growth model under public health events (PHEs). • Model links regular prevention and control (RPC) to macroeconomic factors. • Exploring mechanism of RPC for PHEs on economic growth. • Appropriate prevention and control intensity can engender economic growth. [ABSTRACT FROM AUTHOR]

At the beginning of 2020, the world experienced the COVID-19 pandemic in which several countries all around the world closed their borders and established isolation measures. These types of measures, in line with the spread of the virus, mainly affected those sectors where face-to-face interaction and mobility were central, as it was the case in the tourism sector. As a response to this crisis, some countries implemented policies to promote tourism within the same country. In this paper, we study the case of a tourist program applied in Argentina and estimate its effects on the tourism sector and the overall economy with a general equilibrium perspective addressing its implications in a context where government's budget constraints are binding. [ABSTRACT FROM AUTHOR]

This study investigates the impact of well-being on carbon efficiency in the entertainment market from the perspective of geographic psycholinguistics. To analyze this impact, we employ quantile regression based on the method of moments and spatial econometric models that incorporate economic policy uncertainty. The results highlight the substantial impact of well-being on energy conservation and carbon emission reduction. On one hand, our findings indicate that well-being significantly reduces carbon emissions and exhibits a spatial externality effect. Furthermore, well-being indirectly contributes to carbon reduction by alleviating the adverse consequences of economic policy uncertainty. The rationale behind this relies on psycholinguistic expressions of well-being, which play a crucial role in enhancing the quality of life and serving as psychological foundations for individuals to adopt environmentally conscious actions and low-carbon lifestyles. This exploration is of great significance for understanding the synergistic growth of well-being and the development of the green economy. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to analyze the nature, magnitude and determinants of access to food among rural households in India during the COVID-19 pandemic. Design/methodology/approach: The study is based on the World Bank's Rural Impact Survey, which has documented the shocks of COVID-19 among 2,787 rural households across six states in India. The chi-square test and binary logistics regression have been used to analyze the data. Findings: About 49.7 % of rural households have reported the incidence of food inaccessibility and shortage, and the majority of them reported a reduction in food intake during the COVID-19 outbreak. However, the magnitude of food accessibility varied across the states and the sociodemographic characteristics of the households. Furthermore, regression analysis indicates that family size, social category and occupation as sociodemographic variables and membership in self-help groups, wage employment under Mahatma Gandhi National Rural Employment Guarantee Act and Cash transfer under Pradhan Mantri Kisan Samman Nidhi and Pradhan Mantri Garib Kalyan Yojana as institutional support factors have a significant effect on access to food among rural households. Practical implications: The findings of the study have far-reaching policy implications for developing an effective food distribution system in crisis situations like the COVID-19 outbreak. The study also provides directions for extending the research on determinants of access to food during crisis. Originality/value: The study is based on a large survey data from the rural households in India and provides empirical evidence on access to food faced by rural communities during the COVID-19 lockdown. [ABSTRACT FROM AUTHOR]

Colombia is among the countries with the most robust financial protection against personal health spending in the world, with out-of-pocket spending ranking lowest across OECD countries. We investigate the evolution, distribution, and persistence of health spending by age group, sex, health care setting, health condition and geographic region for over 19 million users of Colombia's health system between 2013 and 2021 (contributory scheme). We use average patient-level expenditure data from the Health-Promoting Entities of the Ministry of Health and Social Protection. We applied multivariate statistical techniques such as multiple correspondence analysis, factor maps and correlations. For both sexes, average health expenditure increases gradually with age until 60 years, accelerating thereafter abruptly. Health conditions with the highest percentage of expenditure were those related to neoplasms, blood diseases, circulatory system, pregnancy, puerperium and perinatal period. We found that home-based care in Amazonía-Orinoquía is almost non-existent, and that outpatient care represents a high proportion in all age groups (over 65%) compared to the other regions. There is a strong persistence of expenditure from one year to the next (i.e. they can provide relevant information for prediction), especially in areas with a larger supply of health services such as Bogotá-Cundinamarca. To the authors' knowledge, this is the most comprehensive and detailed micro-analysis of health spending that has been developed for a Latin American country to date. Key messages: • Health conditions with the highest percent of expenditure were those related to neoplasms and blood diseases. • A significant proportion of health spending for the different life cycles is in the hospital setting. • Medical expenditure is concentrated in people over 60 years of age. [ABSTRACT FROM AUTHOR]

Quality assessment in healthcare systems is challenging due to the multidimensional nature of healthcare services. This study evaluates the overall quality provided by hospitals using composite indicators under the Benefit of the Doubt (BoD) approach, which determines the weights of the indicators with minimal assumptions. We used data from 2015-2020 for Italian Local Health Authorities (LHAs) for 21 outcome measures, applying various non-parametric methods to address aggregation and weighting challenges. Our results show that the BoD measures are robust and effectively capture the dynamics of the quality of LHA, even during external shocks such as the COVID-19 pandemic. This research highlights the importance of methodological choices in the construction of composite indicators and demonstrates the effectiveness of the BoD approach in providing a comprehensive measure of healthcare quality. [ABSTRACT FROM AUTHOR]

We study the impact of socioeconomic factors on two key parameters of epidemic dynamics. Specifically, we investigate a parameter capturing the rate of deceleration at the very start of an epidemic, and a parameter that reflects the pre-peak and post-peak dynamics at the turning point of an epidemic like coronavirus disease 2019 (COVID-19). We find two important results. The policies to fight COVID-19 (such as social distancing and containment) have been effective in reducing the overall number of new infections, because they influence not only the epidemic peaks, but also the speed of spread of the disease in its early stages. The second important result of our research concerns the role of healthcare infrastructure. They are just as effective as anti-COVID policies, not only in preventing an epidemic from spreading too quickly at the outset, but also in creating the desired dynamic around peaks: slow spreading, then rapid disappearance. [ABSTRACT FROM AUTHOR]

This study explores the relationship between women's representation in political power and school closures during the coronavirus pandemic (COVID-19). Using a cross-country dataset in Europe, we document a striking negative relationship between the share of female members in national governments and school closures. We show that a one-standard deviation increase in female members of national governments is associated with a significant reduction in the likelihood of school lockdowns by 24% relative to the average share of school closures. This result is robust to an extensive set of sensitivity checks. We attribute this pattern to a higher awareness of female politicians about the potential costs that school closures imply for families, in particular working mothers with young children. [ABSTRACT FROM AUTHOR]

Occupational licensing laws are designed to improve service quality and protect consumers from harm by establishing entry requirements and oversight of practising professionals. Evidence on the effects of licensing is mixed. The quality of services is difficult to measure objectively, complicating attempts to compare costs and benefits of regulation. A 2017 executive order in the US state of Idaho required licensing boards to report disciplinary actions against professionals. This new source of data provides some insight into the type of enforcement undertaken by licensing boards. We find that disciplinary actions directly related to quality are rare. Between 0.01 and 0.38 per cent of licensees are disciplined for quality‐related issues; 36 to 53 per cent of total disciplinary actions are directly related to quality, with the rest covering technical breaches. [ABSTRACT FROM AUTHOR]

Inducing behavior change is a missing factor in the face of viral threats. We provide evidence from a natural experiment in 2020 on the effects of containment, closure, and economic policy responses to COVID-19 on change in human mobility behavior in the Middle East and North Africa (MENA) region and worldwide. We also examine how social norms, namely risk taking and patience, and institutional trust, could explain the heterogenous effects of policy responses on behavior change. Our results show that the stringency of containment and closure policies decreased human mobility in MENA and worldwide. Risk-averse populations and populations with low-time preference were more likely to pre act and lower their mobility independent of containment and closure policies. The effectiveness of risk communication in promoting positive mobility change increased by the level of institutional trust. Specifically in MENA, populations were less responsive to the actual disease risk and the public perception of that risk. Familiarity with COVID-19 induced negative behavior change among impatient populations. Economic support policies promoted strong positive mobility change among low-risk and high-time preference populations. Income support seems to be the effective economic policy response in low-income countries and debt relief the effective one in higher-income countries. [ABSTRACT FROM AUTHOR]

While the descriptive impacts of the pandemic on women have been well documented in the aggregate, we know much less about the impacts of the pandemic on different groups of women. After controlling for detailed job and demographic characteristics, including occupation and industry, we find that the pandemic led to significant excess labor force exits among women living with children under age six relative to women without children. We also find evidence of larger increases in exits among lower-earning women. The presence of children predicted larger increases in exits during the pandemic among Latina and Black women relative to White women. Overall, we find evidence that pandemic induced disruptions to childcare, including informal care from family and friends. Our results suggest that the unique effect of childcare disruptions during the pandemic exacerbated pre-existing racial and income inequalities among women. [ABSTRACT FROM AUTHOR]

We adopt a pandemic-macroeconomic model to simulate the macroeconomic impact of COVID-19 on various occupations under both laissez-faire and government lockdown scenarios. We integrate a SIR model of virus transmission into a simplified neoclassical model and categorize occupations into two groups based on their ability to work remotely. Subsequently, we assess the shock impact of the pandemic on GDP, consumption, and working hours of flexible and rigid occupations. We find that these three variables declined during the pandemic, yet the consumption varied among individuals with different health status. The labour market experienced a recession, with workers in flexible occupations experiencing a relatively milder impact compared to those in rigid occupations. A larger proportion of remote work mitigated the recessionary effects, although it accentuated the disparities between occupations' income and working hours. The implementation of lockdown policies detrimentally affects welfare, similar to the pandemic itself, but the impact on flexible and rigid occupations differs from that in a laissez-faire scenario. [ABSTRACT FROM AUTHOR]

ABSTRACTThe COVID-19 pandemic has brought about a significant impact on people's lives, both in terms of health and socioeconomic aspects. The pandemic has led to a shift in the work environment, with a massive increase in the number of people working from home due to movement restrictions. In this study, we analyse data from two waves (2019 and 2020) of the Swiss Labour Force Survey to investigate the prevalence of working from home in Switzerland before and during the pandemic. The study has two aims: to identify the characteristics of Swiss teleworkers during the pandemic and to determine if there is a gender gap in working from home. The findings reveal that highly educated workers with children in high-level occupations are more likely to telework. However, there is a gender gap in teleworking in some sectors, since part-time workers, who are mostly women (74 percent), are less likely to work from home than full-time workers.

We examine the impact of a home visiting program targeting pregnant women in Mexico City on maternal mortality. Using administrative data and taking advantage of the program’s rollout, we estimate a staggered difference-in-differences model. We find that the program substantially reduces the maternal mortality rate by 23 maternal deaths per 100,000 births, leading to a total of 105 lives saved in the study period, which amounts to social welfare gains of 17 million dollars. We complement our analysis using call data from a government telehealth program and show that the program led to more pregnancy-related calls, suggesting that the reduction in maternal mortality was at least partially driven by the type of information provided during the home visits, which increased mothers’ awareness of common pregnancy complications signs and connected pregnant women with the healthcare system. [ABSTRACT FROM AUTHOR]

Behaviour change communication (BCC) remains a central component of the interventions used in the fight against malaria in Ghana. However, there is limited evidence of its effectiveness. This study evaluated the effects of BCC strategies on knowledge (symptoms, causes and prevention) and overall knowledge of malaria among Ghanaian women aged 15–49 years. The propensity score matching (PSM) approach and logistic regression were used to analyse data from the 2016 edition of the Malaria Indicator Survey (MIS). Women who participated in community-level education or heard/saw media messages on malaria, or both, had significantly more knowledge of the disease than women who lacked access to any of these mediums of communication. The effect of these strategies on women's overall knowledge of malaria is about 2% to 4% and is higher on their knowledge of the symptoms (3% to 6%) and prevention (2% to 4%) than the causes (2%). The combined effects of both mediums of communication are relatively higher than the effect of either of them as a single medium of communication. Further analysis showed that improved knowledge of the disease is associated with higher preventive measures taken by women for themselves and for their children. The results are more significant in rural and poor households than in urban and non-poor households. These findings underscore the need for the Ministry of Health and its partner institutions to adopt an innovative approach which combines the two strategies in intensively educating Ghanaians, and women in particular, on the symptoms and prevention of malaria, giving due cognisance to households' socioeconomic status and geographical location. [ABSTRACT FROM AUTHOR]

Purpose: This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways. Design/methodology/approach: This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking. Findings: Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty. Practical implications: This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions. Social implications: Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain. Originality/value: The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector. [ABSTRACT FROM AUTHOR]

Purpose: This work aims to analyse the relationship between public health efficiency and well-being considering a panel of 102 Italian provinces from 2000 to 2016 and evaluates if there are omitted variable biases and endogeneity biases and also evaluates if there are heterogeneous effects among provinces with different income levels. Design/methodology/approach: We use a multi-input and output bootstrap data envelopment analysis to assess public health efficiency. Then, we measure well-being indices using the min-max linear scaling transformation technique. A two-stage least squares model is used to identify the causal effect of improving public health efficiency on well-being to account for time-invariant heterogeneity, omitted variable bias and endogeneity bias. Findings: After controlling for important economic factors, the results show a significant effect of an accountable and efficient public health system on well-being. Those effects are concentrated in the North, the most economically, geographically and environmentally advantageous areas. Research limitations/implications: The use of the sample mean, probably the oldest and most used method for aggregating the indicators, could be affected by variable compensation, with consequent misleading results in the process of constructing the well-being index. Another limitation is the use of lagged values of the main predictor as an instrument in the instrumental variables setting because it could lead to information loss. Finally, the availability of data over a long period of time. Practical implications: The findings could help policymakers adopt measures to strengthen the public health system, encourage private providers and inspire countries worldwide. Social implications: These results draw the attention of local authorities, who play an important role in designing and implementing policies to stimulate local public health efficiency, which puts individuals in the conditions of achieving overall well-being in their communities. Originality/value: For the first time in Italy, a panel of well-being indices was constructed by developing new methodologies based on microeconomic theory. Furthermore, for the first time, the assessment of the relationship between public health efficiency and well-being is carried out using a panel of 102 Italian provinces. [ABSTRACT FROM AUTHOR]

Air pollution has emerged as a profoundly critical global environmental issue, primarily due to its adverse effects on human health and its impediment to national development. We investigate the spatial and heterogeneous impacts of air pollution on common prosperity across 295 cities in China from 2006 to 2020, using the spatial Durbin model. Moreover, our research explores the mediating effect of air pollution on common prosperity. The research results are summarized as follows: Firstly, there has been a distinct upward trend in China’s common prosperity in recent years. Secondly, air pollution significantly hinders common prosperity, and this impact shows a spatial spillover effect. Specifically, it not only affects the local realization of common prosperity but also has a detrimental effect on that of neighboring cities. Thirdly, heterogeneity analysis indicates that air pollution adversely affects the common prosperity of neighboring cities only in high-common-prosperity and high-air-pollution groups. Fourthly, air pollution hinders common prosperity by reducing the availability of human capital. This article offers a novel perspective on achieving common prosperity. [ABSTRACT FROM AUTHOR]

Military families experience frequent moves, which poses significant challenges for career options for military spouses. One of the most common professions for military spouses is a registered nurse, which has state-level licensing requirements that add additional hurdles to continuing employment after a move. A series of reforms in the 2010s for military spouses in licensed professions allows nurses to obtain a license in a state where their service member spouse is stationed, as long as their license from their previous state is current and in good standing. This policy is crucial for military families and can provide job stability for registered nurses. We find suggestive evidence that the full recognition of military spouse licenses increases the probability of employment mobility by around 12%, while more restrictive reforms have the opposite effect. Our finding highlights the importance of policies supporting military personnel's families and has implications for healthcare workforce planning and recruitment efforts. [ABSTRACT FROM AUTHOR]

After the US Supreme Court's decision in Dobbs vs. Jackson Women's Health Organization, abortion regulations are subject to state jurisdiction. Therefore, individuals in different states face very different levels of restrictions. We compare self-reported symptoms of anxiety and depression among individuals living in states with limited or no access to abortion care to individuals in states with relatively few or no restrictions before and after the Dobbs decision using high-frequency, nationally representative data from the Household Pulse Survey and Difference in Difference regressions. Estimates suggest that respondents in the restricted states are 7.4% more likely to experience moderate to severe anxiety compared to unrestricted states. We show that trends in anxiety were similar in restricted and unrestricted states before the Dobbs decision, suggesting that the estimates may have a causal interpretation. Robustness checks rule out alternative explanations, such as the ending of the Emergency Allotment of Supplemental Nutrition Assistance Program. [ABSTRACT FROM AUTHOR]

This article focuses on the most evident effects of COVID-19 influenced by the elements of the regional economic landscape, emphasizing the importance of shock and crisis management plans. Algeria could benefit from revitalizing the construction of the North African bloc and enhancing cooperation in the Maghreb. The main objective of this work is to identify the most urgent challenges related to the socio-economic impact of COVID-19 on the regional economic landscape, and the economic integration of Algeria highlights the importance of shock and crisis management plans.

Healthcare financing is crucial for sustainable development and has been gaining attention, particularly since the COVID-19 pandemic. Although ample studies have explored the determinants of healthcare spending, the current study examines the determinants of health financing transition in 124 low- and middle-income countries (LMICs) for 19 years, from 2000 to 2018. The study first estimates the elasticity of health expenditure (i.e., government, private, and external) to per capita income, fiscal spending, age dependency, control of corruption, and time; second, it investigates crowding-out/in effects between domestic and external health financing. As the sample countries are heterogeneous in terms of development and universal health coverage (UHC) reform, our study employs a panel regression model with cluster-robust fixed effects and a bootstrapping quantile regression with fixed effects model to capture unobserved heterogeneity and produce robust estimates across quantile distributions. The results show that an increase in per capita government health expenditure (GHE) and per capita external health expenditure from foreign donors can reduce the share of out-of-pocket health expenditure to total health expenditure (OOPHE), thereby improving the health status and well-being of the people. The study also finds crowding-out effects of per capita external health financing on GHE in LIMCs. Interestingly, the results show that the control of corruption increases the per capita GHE in low-income countries. Thus, in low-income countries, improving governance would improve efficiency in fund utilization and strengthen the health system. Further, our study concludes that those countries that have passed UHC legislation are moving faster toward health financing transition by increasing public spending on health care. Healthcare policy in developing countries should prioritize (i) the adoption and implementation of UHC reform, (ii) alternative revenue mobilization strategy for financing public health care. [ABSTRACT FROM AUTHOR]

Copyright of Sozialer Fortschritt is the property of Duncker & Humblot GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sozialer Fortschritt is the property of Duncker & Humblot GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The following article presents an analysis of the impact of the Environmental, Social and Governance-ESG determinants on Hospital Emigration to Another Region-HEAR in the Italian regions in the period 2004-2021. The data are analysed using Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled Ordinary Least Squares-OLS, Weighted Least Squares-WLS, and Dynamic Panel at 1 Stage. Furthermore, to control endogeneity we also created instrumental variable models for each component of the ESG model. Results show that HEAR is negatively associated to the E, S and G component within the ESG model. The data were subjected to clustering with a k-Means algorithm optimized with the Silhouette coefficient. The optimal clustering with k=2 is compared to the sub-optimal cluster with k=3. The results suggest a negative relationship between the resident population and hospital emigration at regional level. Finally, a prediction is proposed with machine learning algorithms classified based on statistical performance. The results show that the Artificial Neural Network-ANN algorithm is the best predictor. The ANN predictions are critically analyzed in light of health economic policy directions. [ABSTRACT FROM AUTHOR]

During the early days of the initial outbreak of the novel coronavirus disease 2019 (COVID-19) in Japan, preschools were exempt from nationwide school closures, which came into effect on March 2, 2020. In addition, Japan is unique in that it experienced preschool closures without any heavy restrictions on daily life activities, making it possible to separate the effects of preschool closures from those of other anti-COVID-19 policies such as lockdown measures. This study conducted a placebo test that revealed that the decision to close or keep preschools open was left to each facility and the municipality where they were located and was characterized by relatively high randomness. Based on these advantages, we explored the effects of children's preschool absence during March 2020 on mothers' psychological distress. Our results showed that preschool closures caused immediate deterioration in mothers' psychological states, with moderate psychological distress persisting for at least 5 months. [ABSTRACT FROM AUTHOR]

Background: The value of a Quality-Adjusted Life-Year (QALY) is of great importance for the healthcare system. It helps when it comes to defining a cost-effectiveness threshold for the evaluation of health technologies. No willingness-to-pay value for a QALY exists in the province of Quebec, Canada. Objectives: In this paper, we empirically investigated the monetary value of a QALY for the population of Quebec. Methods: Based on the Short-Form 6-Dimension version 2 (SF-6Dv2), we conducted an online survey with a representative adult sample living in Quebec. We used a time trade-off (TTO) combined with contingent valuation (CV), and a discrete choice experiment (DCE) to assess both the population's willingness to pay (WTP) for one QALY and the marginal WTP for health attributes. A health utility algorithm using hybrid regression was developed to determine a preference-based value set for health states. Results: Main analysis was conducted on 993 answers for the CV and 2143 answers for the DCE. The willingness-to-pay per QALY varied from CA$ 47,048.84 (CI: 21,554.38; 72,543.30) for CV to CA$ 73,936.87 (CI: 63,105.40; 84,768.35) for DCE. Among the 6 dimensions of the SF-6Dv2, marginal WTP varied from CA$ 4499.15 (CI: 2975.06; 6023.25) for more role accomplishment in daily activities to CA$ 15,867.12 (CI: 13,825.75; 17,908.49) for less pain. Robustness check with multiple alternative samples, as well as alternative health utility algorithms, showed that the results were robust and the DCE method provided 50% larger results than the CV method, although confidence intervals overlap. Conclusion: This paper provides useful information for decision-makers on the monetary value of a QALY in Quebec. [ABSTRACT FROM AUTHOR]

Background: The Affordable Care Act (ACA), enacted in 2010, aimed to improve healthcare coverage for American citizens. This study investigates the impact of Medicaid expansion (ME) under the ACA on the racial and ethnic composition of nursing home admissions in the U.S., focusing on whether ME has led to increased representation of racial/ethnic minorities in nursing homes. Methods: A difference-in-differences estimation methodology was employed, using U.S. county-level aggregate data from 2000 to 2019. This approach accounted for multiple time periods and variations in treatment timing to analyze changes in the racial and ethnic composition of nursing home admissions post-ME. Additionally, two-way fixed effects (TWFE) regression was utilized to enhance robustness and validate the findings. Results: The analysis revealed that the racial and ethnic composition of nursing home admissions has become more homogeneous following Medicaid expansion. Specifically, there was a decline in Black residents and an increase in White residents in nursing homes. Additionally, significant differences were found when categorizing states by income inequality, and poverty rate levels. These findings remain statistically significant even after controlling for additional variables, indicating that ME influences the racial makeup of nursing home admissions. Conclusions: Medicaid expansion has not diversified nursing home demographics as hypothesized; instead, it has led to a more uniform racial composition, favoring White residents. This trend may be driven by nursing home preferences and financial incentives, which could favor residents with private insurance or higher personal funds. Mechanisms such as payment preferences and local cost variations likely contribute to these shifts, potentially disadvantaging Medicaid-reliant minority residents. These findings highlight the complex interplay between healthcare policy implementation and racial disparities in access to long-term care, suggesting a need for further research on the underlying mechanisms and implications for policy refinement. [ABSTRACT FROM AUTHOR]

More than 18 % of US adults meet the diagnostic criteria for a mental illness. Yet, many who could benefit from mental health care do not receive any treatment, primarily due to inability to pay for care or lack of health insurance coverage. How does a change in health insurance coverage affect psychological well-being and mental health? We explore this question using age-based health insurance coverage policies in the United States as natural experiments. We provide evidence that losing health insurance coverage at the age 26 due to aging out from dependent coverage is associated with a statistically significant deterioration in certain mental health indicators and psychological well-being among young adults. On the other hand, we find no evidence of an improvement in mental health or psychological well-being among the elderly at the age 65 due to becoming eligible for Medicare. These results are robust to potential changes in risk-taking behavior and physical health at the same age cutoffs. [ABSTRACT FROM AUTHOR]

In about last three decades, many developing countries have experienced a large decline in maternal mortality rates. Global initiatives leading to better maternal health policies may have contributed to this decline. In this paper, we investigate whether maternal health intervention also improves the fetal survival rate. For this purpose, we consider the Village Midwife Program in Indonesia, which was launched in 1989 as a part of the safe motherhood strategy. Using the Indonesian Family Life Survey (IFLS), we investigate the impact of midwives on fetal survival rate in terms of a change in the likelihood of a live birth being male. Our results show that the provision of a midwife in a community increases the probability of a live birth being male by about 3 percentage points. Greater antenatal care, skilled birth-attendance, and an improvement in nutrition among reproductive-age women—in terms of greater BMI—are the likely pathways. We do not find the results to be driven by pre-treatment trends, and they remain robust to a number of checks. [ABSTRACT FROM AUTHOR]

Previous studies have observed heterogeneous changes in domestic violence-related 911 calls, police incident reports, and arrests at the onset of the COVID-19 pandemic. In this study, we use a large-scale medical claims database with coverage of over 100 million patients to examine the impact on domestic violence victims' use of emergency department care for their injuries in the early weeks of the pandemic compared to the corresponding weeks in previous years. We find a 23–35% decrease in utilization of emergency medical services by domestic violence victims between March and June of 2020. Based on this finding, it is essential to use caution when using medical claims to measure domestic violence in future research covering this time period. Decreases in care utilization also have important implications for the detection, screening, and treatment of domestic violence injuries during future public health crises. [ABSTRACT FROM AUTHOR]

This study employs panel data encompassing 31 provinces in China, spanning the period from 2010 to 2020, to investigate the distributional impact of foreign direct investment (FDI) on green innovation (GI). Employing a panel quantile regression model, the research finds the close association between FDI and GI, particularly considering the local GI foundation. Specifically, FDI plays a crucial and influential role in fostering GI within regions characterized by lower levels of GI. However, it does not have a significant impact on promoting GI in regions with higher levels of GI. Further analysis of regional heterogeneity demonstrates that in coastal areas, FDI exhibits a positive and significant impact on GI in provinces with a moderate level of GI. Conversely, in inland areas, FDI can only facilitate GI in provinces with a high level of GI. The research conclusion suggests that the government should enhance the intensity of FDI and implement tailored policies according to the specific characteristics of coastal and inland regions.