IDEAS home Printed from https://ideas.repec.org/p/egc/wpaper/994.html
   My bibliography  Save this paper

Healthcare Choices, Information and Health Outcomes

Author

Listed:
  • Achyuta Adhvaryu

    (MEPH Health Policy and Administration, Yale University)

  • Anant Nyshadham

    (Department of Economics, Yale University)

Abstract

Self-selection into healthcare options on the basis of severity likely biases estimates of the effects of healthcare choice on health outcomes. Using an instrumental variables strategy which exploits exogenous variation in the cost of formal-sector care, we show that using such care to treat acute sickness decreases the incidence of fever and malaria in young children in Tanzania. Compared to the instrumental variables estimates, ordinary least squares estimates significantly understate the effects of formal-sector healthcare use on health outcomes. Improved information and more timely treatment, rather than greater access to medicines, seem to be the primary mechanisms for this effect.

Suggested Citation

  • Achyuta Adhvaryu & Anant Nyshadham, 2011. "Healthcare Choices, Information and Health Outcomes," Working Papers 994, Economic Growth Center, Yale University.
    • Handle: RePEc:egc:wpaper:994
    as

    Download full text from publisher

    File URL: http://www.econ.yale.edu/growth_pdf/cdp994.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Michael Kremer & Edward Miguel, 2007. "The Illusion of Sustainability," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(3), pages 1007-1065.
    2. Jessica Cohen & Pascaline Dupas, 2008. "Free Distribution or Cost-Sharing? Evidence from a Malaria Prevention Experiment," NBER Working Papers 14406, National Bureau of Economic Research, Inc.
    3. Lavy, Victor & Strauss, John & Thomas, Duncan & de Vreyer, Philippe, 1996. "Quality of health care, survival and health outcomes in Ghana," Journal of Health Economics, Elsevier, vol. 15(3), pages 333-357, June.
    4. John Strauss & Duncan Thomas, 1998. "Health, Nutrition, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 36(2), pages 766-817, June.
    5. Chang, Fwu-Ranq, 1996. "Uncertainty and investment in health," Journal of Health Economics, Elsevier, vol. 15(3), pages 369-376, June.
    6. Cropper, M L, 1977. "Health, Investment in Health, and Occupational Choice," Journal of Political Economy, University of Chicago Press, vol. 85(6), pages 1273-1294, December.
    7. Selden, Thomas M., 1993. "Uncertainty and health care spending by the poor: The health capital model revisited," Journal of Health Economics, Elsevier, vol. 12(1), pages 109-115, April.
    8. Zhu, Minmin & Dib, Hassan H. & Zhang, Xinping & Tang, Shengchun & Liu, Liqun, 2008. "The influence of health insurance towards accessing essential medicines: The experience from Shenzhen labor health insurance," Health Policy, Elsevier, vol. 88(2-3), pages 371-380, December.
    9. Douglas Almond & Joseph J. Doyle & Amanda E. Kowalski & Heidi Williams, 2010. "Estimating Marginal Returns to Medical Care: Evidence from At-risk Newborns," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(2), pages 591-634.
    10. David M. Cutler & Robert S. Huckman & Mary Beth Landrum, 2004. "The Role of Information in Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Surgery," American Economic Review, American Economic Association, vol. 94(2), pages 342-346, May.
    11. Harsha Thirumurthy & Joshua Graff Zivin & Markus Goldstein, 2008. "The Economic Impact of AIDS Treatment: Labor Supply in Western Kenya," Journal of Human Resources, University of Wisconsin Press, vol. 43(3), pages 511-552.
    12. Joseph J. Doyle Jr., 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," NBER Working Papers 11099, National Bureau of Economic Research, Inc.
    13. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    14. Achyuta Adhvaryu & Anant Nyshadham, 2011. "Labor Supply, Schooling and the Returns to Healthcare in Tanzania," Working Papers 995, Economic Growth Center, Yale University.
    15. Esther Duflo & Christopher Udry, 2003. "Intrahousehold Resource Allocation in Côte D'ivoire: Social Norms, Separate Accounts and Consumption Choices," Working Papers 857, Economic Growth Center, Yale University.
    16. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408, Elsevier.
    17. Julie S. Downs & George Loewenstein & Jessica Wisdom, 2009. "Strategies for Promoting Healthier Food Choices," American Economic Review, American Economic Association, vol. 99(2), pages 159-164, May.
    18. Germano Mwabu & Martha Ainsworth & Andrew Nyamete, 1993. "Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis," Journal of Human Resources, University of Wisconsin Press, vol. 28(4), pages 838-862.
    19. Chern, Wen S & Loehman, Edna T & Yen, Steven T, 1995. "Information, Health Risk Beliefs, and the Demand for Fats and Oils," The Review of Economics and Statistics, MIT Press, vol. 77(3), pages 555-564, August.
    20. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    21. Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July.
    22. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    23. Jessica Cohen & Pascaline Dupas, 2010. "Free Distribution or Cost-Sharing? Evidence from a Randomized Malaria Prevention Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(1), pages 1-45.
    24. Jishnu Das & Jeffrey Hammer & Kenneth Leonard, 2008. "The Quality of Medical Advice in Low-Income Countries," Journal of Economic Perspectives, American Economic Association, vol. 22(2), pages 93-114, Spring.
    25. Leonard, Kenneth L, 2007. "Learning in Health Care: Evidence of Learning about Clinician Quality in Tanzania," Economic Development and Cultural Change, University of Chicago Press, vol. 55(3), pages 531-555, April.
    26. Gowrisankaran, Gautam & Town, Robert J., 1999. "Estimating the quality of care in hospitals using instrumental variables," Journal of Health Economics, Elsevier, vol. 18(6), pages 747-767, December.
    27. Gustavo J. Bobonis & Edward Miguel & Charu Puri-Sharma, 2006. "Anemia and School Participation," Journal of Human Resources, University of Wisconsin Press, vol. 41(4).
    28. Joseph J. Doyle, 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," The Review of Economics and Statistics, MIT Press, vol. 87(2), pages 256-270, May.
    29. Achyuta R. Adhvaryu & Anant Nyshadham, 2012. "Schooling, Child Labor, and the Returns to Healthcare in Tanzania," Journal of Human Resources, University of Wisconsin Press, vol. 47(2), pages 364-396.
    30. Dow, W & Gertly, P & Schoeni, R-F & Strauss, J & Thomas, D, 1997. "Health Care Prices, Health and Labor Outcomes : Experimental Evidence," Papers 97-01, RAND - Labor and Population Program.
    31. Card, David, 2001. "Estimating the Return to Schooling: Progress on Some Persistent Econometric Problems," Econometrica, Econometric Society, vol. 69(5), pages 1127-1160, September.
    32. Paul Gertler, 2004. "Do Conditional Cash Transfers Improve Child Health? Evidence from PROGRESA's Control Randomized Experiment," American Economic Review, American Economic Association, vol. 94(2), pages 336-341, May.
    33. John Geweke & Gautam Gowrisankaran & Robert J. Town, 2003. "Bayesian Inference for Hospital Quality in a Selection Model," Econometrica, Econometric Society, vol. 71(4), pages 1215-1238, July.
    34. Bjorklund, Anders & Moffitt, Robert, 1987. "The Estimation of Wage Gains and Welfare Gains in Self-selection," The Review of Economics and Statistics, MIT Press, vol. 69(1), pages 42-49, February.
    35. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Achyuta Adhvaryu & Anant Nyshadham, 2011. "Labor Complementarities and Health in the Agricultural Household," Working Papers 996, Economic Growth Center, Yale University.
    2. Achyuta Adhvaryu & Anant Nyshadham, 2011. "Labor Supply, Schooling and the Returns to Healthcare in Tanzania," Working Papers 995, Economic Growth Center, Yale University.
    3. Achyuta R. Adhvaryu & Anant Nyshadham, 2012. "Schooling, Child Labor, and the Returns to Healthcare in Tanzania," Journal of Human Resources, University of Wisconsin Press, vol. 47(2), pages 364-396.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mwabu, Germano, 2007. "Health Economics for Low-Income Countries," Center Discussion Papers 10118, Yale University, Economic Growth Center.
    2. Fitzsimons, Emla & Malde, Bansi & Mesnard, Alice & Vera-Hernández, Marcos, 2016. "Nutrition, information and household behavior: Experimental evidence from Malawi," Journal of Development Economics, Elsevier, vol. 122(C), pages 113-126.
    3. Sylvain Chassang & Gerard Padro I Miquel & Erik Snowberg, 2012. "Selective Trials: A Principal-Agent Approach to Randomized Controlled Experiments," American Economic Review, American Economic Association, vol. 102(4), pages 1279-1309, June.
    4. William Easterly, 2009. "Can the West Save Africa?," Journal of Economic Literature, American Economic Association, vol. 47(2), pages 373-447, June.
    5. David M. Cutler & Adriana Lleras-Muney, 2012. "Education and Health: Insights from International Comparisons," NBER Working Papers 17738, National Bureau of Economic Research, Inc.
    6. Bolin, Kristian & Caputo, Michael R., 2020. "Consumption and investment demand when health evolves stochastically," Journal of Economic Dynamics and Control, Elsevier, vol. 114(C).
    7. Meredith, Jennifer & Robinson, Jonathan & Walker, Sarah & Wydick, Bruce, 2013. "Keeping the doctor away: Experimental evidence on investment in preventative health products," Journal of Development Economics, Elsevier, vol. 105(C), pages 196-210.
    8. Andrew M. Jones, 2007. "Identification of treatment effects in Health Economics," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1127-1131.
    9. Jones A.M & Rice N, 2009. "Econometric Evaluation of Health Policies," Health, Econometrics and Data Group (HEDG) Working Papers 09/09, HEDG, c/o Department of Economics, University of York.
    10. Andrew M. Jones, 2007. "Identification of treatment effects in Health Economics," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1127-1131, November.
    11. Achyuta R. Adhvaryu & Anant Nyshadham, 2012. "Schooling, Child Labor, and the Returns to Healthcare in Tanzania," Journal of Human Resources, University of Wisconsin Press, vol. 47(2), pages 364-396.
    12. Pascaline Dupas & Edward Miguel, 2016. "Impacts and Determinants of Health Levels in Low-Income Countries," NBER Working Papers 22235, National Bureau of Economic Research, Inc.
    13. Adhvaryu, Achyuta & Nyshadham, Anant, 2017. "Health, Enterprise, and Labor Complementarity in the Household," Journal of Development Economics, Elsevier, vol. 126(C), pages 91-111.
    14. Bénédicte Apouey & Gabriel Picone & Joshua Wilde & Joseph Coleman & Robyn Kibler, 2017. "Paludisme et anémie des enfants en Afrique subsaharienne : effet de la distribution de moustiquaires," Revue économique, Presses de Sciences-Po, vol. 68(2), pages 163-197.
    15. Okeke, Edward N. & Adepiti, Clement A. & Ajenifuja, Kayode O., 2013. "What is the price of prevention? New evidence from a field experiment," Journal of Health Economics, Elsevier, vol. 32(1), pages 207-218.
    16. Schultz, T. Paul, 2010. "Population and Health Policies," Handbook of Development Economics, in: Dani Rodrik & Mark Rosenzweig (ed.), Handbook of Development Economics, edition 1, volume 5, chapter 0, pages 4785-4881, Elsevier.
    17. Jacopo Bonan & Stefano Pareglio & Massimo Tavoni, 2014. "Access to Modern Energy: a Review of Impact Evaluations," Working Papers 2014.96, Fondazione Eni Enrico Mattei.
    18. Anja Sautmann & Samuel Brown & Mark Dean, 2016. "Subsidies, Information, and the Timing of Children’s Health Care in Mali," Working Papers 2016-2, Brown University, Department of Economics.
    19. Krämer, Marion & Kumar, Santosh & Vollmer, Sebastian, 2021. "Anemia, diet, and cognitive development: Impact of health information on diet quality and child nutrition in rural India," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 495-523.
    20. Abhijit V. Banerjee & Esther Duflo, 2009. "The Experimental Approach to Development Economics," Annual Review of Economics, Annual Reviews, vol. 1(1), pages 151-178, May.

    More about this item

    Keywords

    healthcare; information; child health; Tanzania;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O10 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - General
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:egc:wpaper:994. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Benjamin King (email available below). General contact details of provider: https://edirc.repec.org/data/egyalus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.