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Moral Hazard and Less Invasive Medical Treatment for Coronary Artery Disease: The Case of Cigarette Smoking

Author

Listed:
  • Margolis, Jesse

    (CUNY Graduate Center)

  • Hockenberry, Jason

    (Emory University)

  • Grossman, Michael

    (CUNY Graduate Center)

  • Chou, Shin-Yi

    (Lehigh University)

Abstract

Comparisons of the effectiveness of two common procedures for Coronary Artery Disease: Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG). Evidence indicates that CABG – the more invasive procedure – leads to superior long term outcomes for otherwise similar patients, though there is little consensus as to why. In this article, we propose a novel explanation: patient offsetting behavior. We hypothesize that patients who undergo the more invasive procedure, CABG, are more likely to improve their behavior – eating, exercise, smoking, and drinking – in a way that increases longevity. To test our hypothesis, we use Medicare records linked to the National Health Interview Survey to study one such behavior: smoking. We find that CABG patients are 12 percentage points more likely to quit smoking in the one-year period immediately surrounding their procedure than PCI patients, a result that is robust to alternative specifications.

Suggested Citation

  • Margolis, Jesse & Hockenberry, Jason & Grossman, Michael & Chou, Shin-Yi, 2014. "Moral Hazard and Less Invasive Medical Treatment for Coronary Artery Disease: The Case of Cigarette Smoking," IZA Discussion Papers 8492, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp8492
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    References listed on IDEAS

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    1. Stephen G. Donald & Kevin Lang, 2007. "Inference with Difference-in-Differences and Other Panel Data," The Review of Economics and Statistics, MIT Press, vol. 89(2), pages 221-233, May.
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    Cited by:

    1. Jorge M. Agüero & Trinidad Beleche, 2016. "Health Shocks and the Long-Lasting Change in Health Behaviors: Evidence from Mexico," Working papers 2016-26, University of Connecticut, Department of Economics.
    2. Antoine Marsaudon & Lise Rochaix, 2017. "Impact of acute health shocks on cigarette consumption
      [Impact d'un choc de santé sur la consommation de cigarette]      ," PSE Working Papers halshs-01626024, HAL.
    3. Jinhwan Park & Duk Bin Jun & Sungho Park, 2022. "The effect of epidemic outbreak on healthcare usage: Lessons from the 2015 Middle East respiratory syndrome outbreak in South Korea," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 185(3), pages 1319-1343, July.
    4. Shobande Olatunji Abdul, 2019. "Effects of Energy Use on Socioeconomic Predictors in Africa: Synthesizing Evidence," Studia Universitatis „Vasile Goldis” Arad – Economics Series, Sciendo, vol. 29(4), pages 21-40, December.
    5. Antoine Marsaudon & Lise Rochaix, 2010. "Impact of acute health shocks on cigarette consumption: A combined DiD-matching strategy to address endogeneity issues in the French Gazel panel data," Working Papers halshs-01626187, HAL.
    6. Manuel Hoffmann & Roberto Mosquera & Adrian Chadi, 2019. "Vaccines at Work," TWI Research Paper Series 116, Thurgauer Wirtschaftsinstitut, Universität Konstanz.
    7. Cristina Mazza & Eleonora Ricci & Marco Colasanti & Alessandra Cardinale & Francesca Bosco & Silvia Biondi & Renata Tambelli & Alberto Di Domenico & Maria Cristina Verrocchio & Paolo Roma, 2022. "How Has COVID-19 Affected Mental Health and Lifestyle Behaviors after 2 Years? The Third Step of a Longitudinal Study of Italian Citizens," IJERPH, MDPI, vol. 20(1), pages 1-16, December.
    8. Ali Moghtaderi & Avi Dor, 2016. "Immunization and Moral Hazard: The HPV Vaccine and Uptake of Cancer Screening," NBER Working Papers 22523, National Bureau of Economic Research, Inc.
    9. Agüero, Jorge M. & Beleche, Trinidad, 2017. "Health shocks and their long-lasting impact on health behaviors: Evidence from the 2009 H1N1 pandemic in Mexico," Journal of Health Economics, Elsevier, vol. 54(C), pages 40-55.

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    More about this item

    Keywords

    coronary artery disease; moral hazard; smoking;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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