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Impact of a pension program on healthcare utilization among older farmers: Empirical evidence from health claims data

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  • Yang, Feng-An
  • Chang, Hung-Hao

Abstract

In many countries, family-owned farms are predominant, with self-employed farmers. When such farmers reach retirement age, they likely do not have access to pensions. Using the farmer pension program in Taiwan as an example, this study examines the effect of access to public pension on healthcare utilization among older farmers. We investigate whether this program affects healthcare utilization, number of visits, and the costs associated with outpatient or inpatient services and prescription drugs. We also explore whether these effects vary by medical specialty and the amount of pension received. By using health claims data from the universal health insurance program and a regression discontinuity design, we find that pension payments significantly increase the number of outpatient visits by 4% and outpatient expenditure by 5%. We also find that pension recipients spend more on family medicine, internal medicine, and Chinese medicine. As the pension program is designed to secure older farmers’ welfare, our results demonstrate an improvement in the health component of individual well-being.

Suggested Citation

  • Yang, Feng-An & Chang, Hung-Hao, 2023. "Impact of a pension program on healthcare utilization among older farmers: Empirical evidence from health claims data," World Development, Elsevier, vol. 169(C).
    • Handle: RePEc:eee:wdevel:v:169:y:2023:i:c:s0305750x23001134
    DOI: 10.1016/j.worlddev.2023.106295
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    as
    1. Frederik Plesner Lyngse, 2020. "Liquidity Constraints and Demand for Healthcare: Evidence from Danish Welfare Recipients," Papers 2010.14651, arXiv.org.
    2. Filmer, Deon & Schady, Norbert, 2011. "Does more cash in conditional cash transfer programs always lead to larger impacts on school attendance?," Journal of Development Economics, Elsevier, vol. 96(1), pages 150-157, September.
    3. Frederik Plesner Lyngse, 2020. "Liquidity Constraints and Demand for Healthcare: Evidence from Danish Welfare Recipients," CEBI working paper series 20-28, University of Copenhagen. Department of Economics. The Center for Economic Behavior and Inequality (CEBI).
    4. Hitoshi Shigeoka, 2014. "The Effect of Patient Cost Sharing on Utilization, Health, and Risk Protection," American Economic Review, American Economic Association, vol. 104(7), pages 2152-2184, July.
    5. Elliott Fan, 2010. "Who Benefits from Public Old Age Pensions? Evidence from a Targeted Program," Economic Development and Cultural Change, University of Chicago Press, vol. 58(2), pages 297-322, January.
    6. Bruce, Raphael & Lima, Rafael Costa, 2019. "Compulsory voting and TV news consumption," Journal of Development Economics, Elsevier, vol. 138(C), pages 165-179.
    7. Amy M. G. Kandilov & Ivan T. Kandilov, 2022. "The impact of the Affordable Care Act Medicaid expansions on agricultural workers' health insurance coverage, medical care utilization, and labor supply," American Journal of Agricultural Economics, John Wiley & Sons, vol. 104(3), pages 1026-1049, May.
    8. Marianne Bertrand & Sendhil Mullainathan & Douglas Miller, 2003. "Public Policy and Extended Families: Evidence from Pensions in South Africa," The World Bank Economic Review, World Bank, vol. 17(1), pages 27-50, June.
    9. Stefania Lovo, 2011. "Pension Transfers and farm household technical efficiency: Evidence from South Africa," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 93(5), pages 1391-1405.
    10. Niloofar Khalili & Muhammad Arshad & Zakaria Farajzadeh & Harald Kächele & Klaus Müller, 2021. "Does drought affect smallholder health expenditures? Evidence from Fars Province, Iran," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 23(1), pages 765-788, January.
    11. Tal Gross & Timothy J. Layton & Daniel Prinz, 2022. "The Liquidity Sensitivity of Healthcare Consumption: Evidence from Social Security Payments," American Economic Review: Insights, American Economic Association, vol. 4(2), pages 175-190, June.
    12. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics,, Palgrave Macmillan.
    13. Cheng, Lingguo & Liu, Hong & Zhang, Ye & Zhao, Zhong, 2018. "The health implications of social pensions: Evidence from China's new rural pension scheme," Journal of Comparative Economics, Elsevier, vol. 46(1), pages 53-77.
    14. Chang, Hung-Hao & Meyerhoefer, Chad D., 2019. "Inter-brand competition in the convenience store industry, store density and healthcare utilization," Journal of Health Economics, Elsevier, vol. 65(C), pages 117-132.
    15. Douglas Almond & Joseph J. Doyle, 2011. "After Midnight: A Regression Discontinuity Design in Length of Postpartum Hospital Stays," American Economic Journal: Economic Policy, American Economic Association, vol. 3(3), pages 1-34, August.
    16. Case, Anne & Deaton, Angus, 1998. "Large Cash Transfers to the Elderly in South Africa," Economic Journal, Royal Economic Society, vol. 108(450), pages 1330-1361, September.
    17. Kaushal, Neeraj, 2014. "How Public Pension affects Elderly Labor Supply and Well-being: Evidence from India," World Development, Elsevier, vol. 56(C), pages 214-225.
    18. Wei Huang & Chuanchuan Zhang, 2021. "The Power of Social Pensions: Evidence from China's New Rural Pension Scheme," American Economic Journal: Applied Economics, American Economic Association, vol. 13(2), pages 179-205, April.
    19. Fukushima, Kazuya & Mizuoka, Sou & Yamamoto, Shunsuke & Iizuka, Toshiaki, 2016. "Patient cost sharing and medical expenditures for the Elderly," Journal of Health Economics, Elsevier, vol. 45(C), pages 115-130.
    20. Sebastian Bauhoff & David R. Hotchkiss & Owen Smith, 2011. "The impact of medical insurance for the poor in Georgia: a regression discontinuity approach," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1362-1378, November.
    21. Xiaoyong Zheng & David M. Zimmer, 2008. "Farmers' Health Insurance and Access to Health Care," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 90(1), pages 267-279.
    22. Hung-Hao Chang, 2013. "Old Farmer Pension Program and Farm Succession: Evidence from a Population-Based Survey of Farm Households in Taiwan," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 95(4), pages 976-991.
    23. David S. Lee & Thomas Lemieux, 2010. "Regression Discontinuity Designs in Economics," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 281-355, June.
    24. Hsing-Wen Han & Hsien-Ming Lien & Tzu-Ting Yang, 2020. "Patient Cost-Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design," American Economic Journal: Economic Policy, American Economic Association, vol. 12(3), pages 238-278, August.
    25. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    26. Jayachandran N. Variyam & Ashok Mishra, 2005. "The Well-Being of U.S. Farm Workers: A Look at Health ," Review of Agricultural Economics, Agricultural and Applied Economics Association, vol. 27(3), pages 369-376.
    27. Lai, Mun Sim & Orsuwan, Meechai, 2009. "Examining the Impact of Taiwan's Cash Allowance Program on Private Households," World Development, Elsevier, vol. 37(7), pages 1250-1260, July.
    28. Unnikrishnan, Vidhya & Imai, Katsushi S., 2020. "Does the old-age pension scheme improve household welfare? Evidence from India," World Development, Elsevier, vol. 134(C).
    29. Matias D. Cattaneo & Nicolas Idrobo & Rocio Titiunik, 2019. "A Practical Introduction to Regression Discontinuity Designs: Foundations," Papers 1911.09511, arXiv.org.
    30. Buntin, Melinda Beeuwkes & Zaslavsky, Alan M., 2004. "Too much ado about two-part models and transformation?: Comparing methods of modeling Medicare expenditures," Journal of Health Economics, Elsevier, vol. 23(3), pages 525-542, May.
    31. Jing You & Miguel Niño‐Zarazúa, 2019. "The Intergenerational Impact of China's New Rural Pension Scheme," Population and Development Review, The Population Council, Inc., vol. 45(S1), pages 47-95, December.
    32. Pan, Yao & Singhal, Saurabh, 2019. "Agricultural extension, intra-household allocation and malaria," Journal of Development Economics, Elsevier, vol. 139(C), pages 157-170.
    33. McCrary, Justin, 2008. "Manipulation of the running variable in the regression discontinuity design: A density test," Journal of Econometrics, Elsevier, vol. 142(2), pages 698-714, February.
    34. Croppenstedt, Andre & Muller, Christophe, 2000. "The Impact of Farmers' Health and Nutritional Status on Their Productivity and Efficiency: Evidence from Ethiopia," Economic Development and Cultural Change, University of Chicago Press, vol. 48(3), pages 475-502, April.
    35. Likwang Chen & Winnie Yip & Ming‐Cheng Chang & Hui‐Sheng Lin & Shyh‐Dye Lee & Ya‐Ling Chiu & Yu‐Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242, March.
    36. Manning, Willard G. & Mullahy, John, 2001. "Estimating log models: to transform or not to transform?," Journal of Health Economics, Elsevier, vol. 20(4), pages 461-494, July.
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