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Aggregation and Insurance Mortality Estimation

Author

Listed:
  • 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.

Suggested Citation

  • William H. Dow & Kristine A. Gonzalez & Luis Rosero-Bixby, 2003. "Aggregation and Insurance Mortality Estimation," NBER Working Papers 9827, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:9827
    Note: HC HE
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    File URL: http://www.nber.org/papers/w9827.pdf
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    References listed on IDEAS

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    1. 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.
    2. Hanushek, Eric A & Rivkin, Steven G & Taylor, Lori L, 1996. "Aggregation and the Estimated Effects of School Resources," The Review of Economics and Statistics, MIT Press, vol. 78(4), pages 611-627, November.
    3. 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 251-277, June.
    4. Mesa-Lago, Carmelo, 1985. "Health care in Costa Rica: Boom and crisis," Social Science & Medicine, Elsevier, vol. 21(1), pages 13-21, January.
    5. 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.
    6. 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 1263-1296, December.
    7. 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.
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    Cited by:

    1. Grant Miller & Diana Pinto & Marcos Vera-Hernández, 2013. "Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 61-91, October.
    2. Dhaval Dave, 2004. "Illicit Drug Use Among Arrestees and Drug Prices," NBER Working Papers 10648, National Bureau of Economic Research, Inc.
    3. Adriana Camacho & Emily Conover, 2008. "Effects of Subsidized Health Insurance on Newborn Health in Colombia," DOCUMENTOS CEDE 005007, UNIVERSIDAD DE LOS ANDES-CEDE.

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • J1 - Labor and Demographic Economics - - Demographic Economics

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