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Aggregation and Insurance Mortality Estimation

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  • William H. Dow
  • Kristine A. Gonzalez
  • Luis Rosero-Bixby

Abstract

One goal of government health insurance programs is to improve health, yet little is known empirically about how important such government interventions can be in explaining health transitions. We analyze the child mortality effects of a major health insurance expansion in Costa Rica. In contrast to previous work in this area that has used aggregated ecological designs, we exploit census data to estimate individual-level models. Theoretical and empirical econometric results indicate that aggregation can introduce substantial upward biases in the insurance effects. Overall we find a statistically significant but quite small effect of health insurance on child mortality in Costa Rica.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 9827.

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Date of creation: Jul 2003
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Handle: RePEc:nbr:nberwo:9827

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  1. Keeler, Emmett B. & Rolph, John E., 1988. "The demand for episodes of treatment in the health insurance experiment," Journal of Health Economics, Elsevier, vol. 7(4), pages 337-367, December.
  2. Katherine A. Guthrie & Lianne Sheppard, 2001. "Overcoming biases and misconceptions in ecological studies," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 164(1), pages 141-154.
  3. Eric A. Hanushek & Steven G. Rivkin & Lori L. Taylor, 1996. "Aggregation and the Estimated Effects of School Resources," NBER Working Papers 5548, National Bureau of Economic Research, Inc.
  4. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June.
  5. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December.
  6. Mesa-Lago, Carmelo, 1985. "Health care in Costa Rica: Boom and crisis," Social Science & Medicine, Elsevier, vol. 21(1), pages 13-21, January.
  7. Jimenez, Emmanuel, 1995. "Human and physical infrastructure: Public investment and pricing policies in developing countries," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 43, pages 2773-2843 Elsevier.
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Cited by:
  1. Grant Miller & Diana M. Pinto & Marcos Vera-Hernández, 2009. "Risk Protection, Service Use, and Health Outcomes Under Colombia’s Health Insurance Program for the Poor," NBER Working Papers 15456, National Bureau of Economic Research, Inc.
  2. Dhaval Dave, 2004. "Illicit Drug Use Among Arrestees and Drug Prices," NBER Working Papers 10648, National Bureau of Economic Research, Inc.

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