International differences in the impact of doctors on health: a multilevel analysis of OECD countries

Or, Zeynep; Wang, Jia; Jamison, Dean T.

doi:10.1016/j.jhealeco.2004.09.003

Cited by 80 publications

(69 citation statements)

References 14 publications

(14 reference statements)

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“…Real GDP per capita is treated as exogenous on the grounds that current GDP per capita could be mainly affected by past and current economic conditions rather than projections of current life expectancy and premature mortality. Considering GDP per capita as exogenous variable in a health production function context is consistent with previous research in this area (Jiménez-Rubio, 2011a, b; Kennelly et al, 2003;Or et al, 2005). Poor health can induce households to take on additional debt and encourage unhealthy behaviours.…”

Section: Empirical Strategysupporting

confidence: 82%

“…We adopt a parsimonious model consistent with previous literature where cross-country differences of health status depend on country-level variables and health behaviours (Jiménez-Rubio, 2011b;Kennelly et al, 2003;Or, 2000;Or et al, 2005). We expand the health production functions developed in the previous literature by introducing different types of debt indicators.…”

Section: Empirical Strategymentioning

confidence: 99%

“…Drawing on insights afforded by previous research, our measures of health outcomes include years of life expectancy at birth, life expectancy at age 65 and premature mortality (Kennelly et al, 2003;Or, 2000;Or et al, 2005). The use of these health indicators complements and augments previous research, which uses self-reported health conditions from surveys conducted in individual countries.…”

Section: Introductionmentioning

confidence: 99%

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Does debt affect health? Cross country evidence on the debt-health nexus

Clayton

Liñares-Zegarra

Wilson

2015

Social Science & Medicine

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We investigate the relationship between household debt and health outcomes for OECD countries over the period 1995 to 2012. Using a dataset of aggregated, standardized and objective measures of household debt and health outcomes, we estimate an instrumental variable (GMM) model in order to deal with endogeneity and reverse causality concerns between health and debt. We find that higher household debt is linked to poorer general health. The results are also significant in extreme cases where households are among the most financially distressed (overindebted). We also find a link between debt maturity and health. Long-term household debt reduces life expectancy and increases premature mortality. The opposite holds for the relation between short and medium term debt and health. The results are robust after controlling for other socio-economic factors (including GDP per capita, government expenditure on health, percentage of rural population and alcohol consumption) that affect health. We investigate the relationship between household debt and health outcomes for OECD countries over the period 1995 to 2012. Using a dataset of aggregated, standardized and objective measures of household debt and health outcomes, we estimate an instrumental variable (GMM) model in order to deal with endogeneity and reverse causality concerns between health and debt. We find that higher household debt is linked to poorer general health. The results are also significant in extreme cases where households are among the most financially distressed (overindebted). We also find a link between debt maturity and health. Long-term household debt reduces life expectancy and increases premature mortality. The opposite holds for the relation between short and medium term debt and health. The results are robust after controlling for other socio-economic factors (including GDP per capita, government expenditure on health, percentage of rural population and alcohol consumption) that affect health.JEL Classification: D12, D14, I12

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Section: Empirical Strategysupporting

confidence: 82%

Section: Empirical Strategymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Does debt affect health? Cross country evidence on the debt-health nexus

Clayton

Liñares-Zegarra

Wilson

2015

Social Science & Medicine

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“…One of the factors determining the health condition is access to health services [3,4]. Relatively low expenditures on health care in Poland limit the access to health services.…”

Section: Introductionmentioning

confidence: 99%

Availability of health services vs. health condition of residents of rural areas in Poland – Analysis performed on the basis of EHIS 2009

Laskowska¹

2015

Ann Agric Environ Med.

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Introduction. One of the aspects considered in a debate preceding the establishment of the new retirement age in Poland, was the health condition of the Polish population. A steady increase in the average life expectancy, observed for several years, is much higher in the cities than in the country. One of the reasons for this might be a limited availability of health services in rural areas. Objective. The aim of the study is to assess the scale of income-related inequalities in the access to health services in rural areas, and subsequently to assess the impact of having to give up some medical services on the subjective perception of health condition by rural inhabitants. Materials and methods. Individual data derived from the European Health Interview Survey (EHIS) conducted in 2009 constituted the basis for the presented analysis. The concentration index was used to measure the income-related inequalities in the use of medical services. The ordered logit model was used to verify the hypothesis that the availability of health services has an impact on the health condition. Results. Significant differences in the distribution of medical services utilization with regard to income, were found only in the case of hospital services. People with low income stay in hospital more often. The obtained inequality indices show a lack of income-related inequality in the use of outpatient services. The performed analyses confirm a negative impact of giving up this type of services on the health condition of residents of rural areas. Conclusions. The availability of medical services is an important determinant of the health condition. Too few medical institutions and scarce medical personnel limits the use of these services, and not only for people with low income.

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“…A number of methodological and ethical issues have been raised in association with quality-or disability-adjusted life expectancy measures. 37,38 The second group (such as Or, 2005, 40 and Wagstaff and Wang, 2011 30 ) uses an avoidable mortality approach. They consider the main goals of the health system to be the delivery of quality treatment to the sick and provision of illness and injury prevention, and accordingly measure performance based on the ability of the system to contribute to survival rates or reductions in the number of potential years of life lost (PYLL) or avoidable mortality (see Box 6: Key Concepts).…”

Section: Choosing Between Health System Outputs and Outcomesmentioning

confidence: 99%