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The Quality of Medical Care, Behavioral Risk Factors, and Longevity Growth

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Frank R. Lichtenberg

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Abstract

The rate of increase of longevity has varied considerably across U.S. states since 1991. This paper examines the effect of the quality of medical care, behavioral risk factors (obesity, smoking, and AIDS incidence), and other variables (education, income, and health insurance coverage) on life expectancy and medical expenditure using longitudinal state-level data. We examine the effects of three different measures of the quality of medical care. The first is the average quality of diagnostic imaging procedures, defined as the fraction of procedures that are advanced procedures. The second is the average quality of practicing physicians, defined as the fraction of physicians that were trained at top-ranked medical schools. The third is the mean vintage (FDA approval year) of outpatient and inpatient prescription drugs. Life expectancy increased more rapidly in states where (1) the fraction of Medicare diagnostic imaging procedures that were advanced procedures increased more rapidly; (2) the vintage of self- and provider-administered drugs increased more rapidly; and (3) the quality of medical schools previously attended by physicians increased more rapidly. States with larger increases in the quality of diagnostic procedures, drugs, and physicians did not have larger increases in per capita medical expenditure.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 15068.

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Date of creation: Jun 2009
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Handle: RePEc:nbr:nberwo:15068

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Find related papers by JEL classification:
I1 - Health, Education, and Welfare - - Health
J1 - Labor and Demographic Economics - - Demographic Economics
O3 - Economic Development, Technological Change, and Growth - - Technological Change

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  1. Hulten, Charles R, 1992. "Growth Accounting When Technical Change Is Embodied in Capital," American Economic Review, American Economic Association, vol. 82(4), pages 964-80, September. [Downloadable!] (restricted)
  2. Charles R. Hulten, 1992. "Growth Accounting When Technical Change is Embodied in Capital," NBER Working Papers 3971, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Bartel, Ann P & Lichtenberg, Frank R, 1987. "The Comparative Advantage of Educated Workers in Implementing New Technology," The Review of Economics and Statistics, MIT Press, vol. 69(1), pages 1-11, February. [Downloadable!] (restricted)
  4. Baltagi, Badi H. & Rich, Daniel P., 2005. "Skill-biased technical change in US manufacturing: a general index approach," Journal of Econometrics, Elsevier, vol. 126(2), pages 549-570, June. [Downloadable!] (restricted)
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  5. Mark G. Duggan & William N. Evans, 2008. "Estimating the Impact of Medical Innovation: A Case Study of HIV Antiretroviral Treatments," Forum for Health Economics & Policy, Berkeley Electronic Press, vol. 11(2). [Downloadable!]
  6. Plutarchos Sakellaris & Daniel J. Wilson, 2001. "The production-side approach to estimating embodied technological change," Finance and Economics Discussion Series 2001-20, Board of Governors of the Federal Reserve System (U.S.). [Downloadable!]
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  7. Plutarchos Sakellaris & Daniel J. Wilson, 2004. "Quantifying Embodied Technological Change," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 7(1), pages 1-26, January. [Downloadable!] (restricted)
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