This paper uses the British Health and Lifestyle Survey (1984-1985) data and the longitudinal follow-up of May 2003 to investigate the determinants of premature mortality risk in Great Britain. A behavioral model, which relates premature mortality to a set of observable and unobservable factors, is considered. We focus on unobservable individual heterogeneity and endogeneity affecting the mortality equation. A MSL approach for a multivariate probit (MVP) is used to estimate a recursive system of equations for deaths and lifestyles. This model is then compared with the univariate probit models that include or exclude lifestyles. In order to detect inequality in the distribution of health within the population and to calculate the contribution of socioeconomic factors, we compare the range measure of health inequality to the Gini coefficient for overall health inequality. A Gini decomposition analysis for predicted premature mortality shows that endogenous lifestyles and unobservable heterogeneity strongly contribute to inequality in mortality, reducing the role of socio-economic status. JEL codes I1 C0

This paper investigates long-term home care utilization in Europe. Data from the first wave of the Survey on Health, Ageing and Retirement (SHARE) on formal (nursing care and paid domestic help) and informal care (support provided by relatives) are used to study the probability and the quantity of both types of care. The overall process is framed in a fully simultaneous equation system that takes the form of a bivariate two-part model where the reciprocal interaction between formal and informal care is estimated. Endogeneity and unobservable heterogeneity are addressed using a common latent factor approach. The analysis of the relative impact of age and disability on home care utilization is enriched by the use of a proximity to death (PtD) indicator built using the second wave of SHARE. All these indicators are important predictors of home care utilization. In particular, a strong significant effect of PtD is found in the paid domestic help and informal care models. The relationship between formal and informal care moves from substitutability to complementarity depending on the type of care considered, and the estimated effects are small in absolute size. This might call for a reconsideration of the effectiveness of incentives for informal care as instruments to reduce public expenditure for home care services.

No abstract

Interregional patient mobility in a decentralized healthcare system. Regional Studies. Interregional patient mobility,\ud measured as origin–destination patient flows between any two regions, is analysed within a dynamic spatial panel data\ud framework using 2001–10 data on Italian hospital discharges. The aim is to assess the effects of the main determinants\ud of patient flows, distinguishing between the impacts of regional health policies and those exerted by exogenous factors\ud (geography, size, neighbouring regions, national policies). Empirical results indicate that the main drivers of mobility are\ud regional income, hospital capacity, organizational structure, performance and technology. Moreover, neighbouring\ud regions’ supply factors, specialization and performance largely affect mobility by generating significant local externalities

The recent COVID-19 pandemic and related social distancing measures have significantly changed worldwide employment conditions. In developed economies, institutions and organizations, both public and private, are called upon to reflect on new organizational models of work and human resource management, which - in fact - should offer workers sufficient flexibility in adapting their work schedules remotely to their personal (and family) needs. This study aims to explore, within a Job Demands-Resources framework, whether and to what extent job demands (workload and social isolation), organizational job resources (perceived organizational support), and personal resources (self-efficacy, vision about the future and commitment to organizational change) have affected workers’ quality of life during the pandemic, taking into account the potential mediating role of job satisfaction and perceived stress. Using data from a sample of 293 workers, we estimate measurement and structural models, according to the Item Response Theory and the Path analysis frameworks, which allow us to operationalize the latent traits and study the complex structure of relationships between the latent dimensions. We inserted in the model as control variables, the socio-economic and demographic characteristics of the respondents, with particular emphasis on gender differences and the presence and age of children. The study offers insights into the relationship between remote work and quality of life, and the need to rethink human resource management policies considering the opportunities and critical issues highlighted by working full-time remotely.

The paper presents a latent factor model for initiation of smoking, cessation and mortality using the British Health and Lifestyle Survey. This allows us to investigate inequality of opportunity in risk of mortality, focusing on the intergenerational transmission of smoking. We find that the hazard of mortality is higher for current and former smokers relative to never smokers. Furthermore we find that parental smoking plays an important role in the dynamics of smoking and indirectly affects mortality. Predictions derived from the model show that inequality in mortality decreases if individuals adopt the best level of effort (not smoking) or if circumstances are favourable (if parents are non-smokers)

Patient mobility is often described as a marginal phenomenon in Europe since the overall number of patients that receive cross border care remains minor compared to the total population. However this phenomenon is increasing markedly. The process of globalization and the availability of medical information means that patients are more informed on treatment available well beyond their national boundaries. Patient empowerment implies that new generations will actively ask to be treated by the health care system that best meets their needs. A succession of individuals has already challenged the status quo and, in many cases, the European Court of Justice has upheld their arguments. At a political level, the EU has issued the EU Directive no. 24/2011/CE of 9th March 2011 concerning the application of patients' rights in cross border healthcare. This Directive has reformed the authorization procedures that were previously required to allow patients to go abroad to access health care services. In this respect, the Directive has contributed to improving the level of freedom of choice for the European citizen, but it does not seem to have increased actual patient mobility across Europe. Freedom to choose is a necessary condition to grant the people of Europe the same access to public sector health care services. The latter is a key instrument for an efficiently functioning ''single market'' ensuring real mobility within the EU. The aim of this book is to study the current European health care market and discuss the hypothesis of a European right of citizenship with reference to health care services. The book is intended to provide a deeper understanding of the health market and stimulate reflection on European integration studies at a university level. The hypothesis for a fully coordinated European Health System will be investigated in great detail, highlighting the connected social and economic implications. This publication is a result of the Jean Monnet Lifelong Programme. Patient mobility for health within the EU borders is an issue of great interest in the European Union debate. The health side of European integration is generally undervalued but, on the contrary, it is crucial to fostering an effective internal market and to ensuring economic and social progress in Europe. Effective health integration in the European Union would represent a value-added resource in the path toward the effective mobility of people. For this purpose, it is extremely important that policy-makers of different European States agree on a unique international agreement to regulate the economic implications of patient mobility. v

This article aims to assess how the risk perceptions of smokers affect survival expectations and subjective health. Data from the Survey of Health, Ageing and Retirement in Europe, which include a numerical measure of subjective survival probability, are used to estimate a joint recursive system of equations that describe the relationships among survival expectations, subjective health status and smoking duration. A finite mixture model is used to address endogeneity and unobservable heterogeneity. This approach allows for two types of individuals with different observable characteristics to be identified in the examined population. We find that only in the population of the first type, current and former smokers incorporate the effects of smoking duration into their assessments of survival probabilities. For both types, quitting smoking affects current perceptions of smoking risks, causing the overestimation of both survival probability and subjective health