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Aggregation and Insurance Mortality Estimation

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

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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File URL: http://www.nber.org/papers/w9827.pdf
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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
Note: HC HE
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  1. Hanushek, E-A & Rivkin, S-G & Taylor, L-L, 1995. "Aggregation and the Estimated Effects of School Resources," RCER Working Papers 397, University of Rochester - Center for Economic Research (RCER).
  2. 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.
  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 251-77, June.
  4. 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.
  5. 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.
  6. 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.
  7. Mesa-Lago, Carmelo, 1985. "Health care in Costa Rica: Boom and crisis," Social Science & Medicine, Elsevier, vol. 21(1), pages 13-21, January.
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