Health Programme Evaluation by Propensity Score Matching: Accounting for Treatment Intensity and Health Externalities with an Application to Brazil
Most of the literature on health programme evaluation has estimated average programme impacts relying on either: (i) data on the presence or absence of an intervention in a particular locality, or (ii) data on individual participation in the health programme. By estimating an average health impact which is independent of the programme’s population coverage, the empirical approaches of these studies overlook the important fact that public health interventions create externalities whose magnitude depends crucially on the number of covered individuals in a locality. The main contributions of this paper are to suggest and apply an empirical approach for the impact evaluation of public health interventions which also takes into account treatment externalities, when non-experimental, routine data are available. The proposed framework involves the computation of average treatment effects by a propensity score matching-difference-in-differences estimator adapted to the case of multiple treatments, jointly evaluating the impact of different programme coverage levels. The methods are used to conduct an impact evaluation of the Family Health Programme (Programa Saude da Familia—PSF), the broadest health programme ever launched in Brazil, on adult and child health. I find that exposure to higher PSF coverage levels leads to improvements in individual health outcomes, with relatively small effects for adults but larger estimated impacts for children.
|Date of creation:|
|Contact details of provider:|| Postal: HEDG/HERC, Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom|
Phone: (0)1904 323776
Web page: https://www.york.ac.uk/economics/postgrad/herc/hedg/
More information through EDIRC
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- James J. Heckman & Hidehiko Ichimura & Petra E. Todd, 1997. "Matching As An Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," Review of Economic Studies, Oxford University Press, vol. 64(4), pages 605-654.
- Jalan, Jyotsna & Ravallion, Martin, 2003.
"Does piped water reduce diarrhea for children in rural India?,"
Journal of Econometrics,
Elsevier, vol. 112(1), pages 153-173, January.
- Jalan, Jyotsna & Ravallion, Martin, 2001. "Does piped water reduce diarrhea for children in rural India ?," Policy Research Working Paper Series 2664, The World Bank.
- James J. Heckman & Jeffrey A. Smith, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring.
- Eichler, Martin & Lechner, Michael, 2002. "An evaluation of public employment programmes in the East German State of Sachsen-Anhalt," Labour Economics, Elsevier, vol. 9(2), pages 143-186, April.
- Eichler, Martin & Lechner, Michael, 1999. "An Evaluation of Public Employment Programmes in the East German State of Sachsen-Anhalt," IZA Discussion Papers 94, Institute for the Study of Labor (IZA).
- Cameron,A. Colin & Trivedi,Pravin K., 2005. "Microeconometrics," Cambridge Books, Cambridge University Press, number 9780521848053, September.
- Armecin, Graeme & Behrman, Jere R. & Duazo, Paulita & Ghuman, Sharon & Gultiano, Socorro & King, Elizabeth M. & Lee, Nannette, 2006. "Early childhood development through an integrated program : evidence from the Philippines," Policy Research Working Paper Series 3922, The World Bank.
- Alberto Abadie & Guido W. Imbens, 2008. "On the Failure of the Bootstrap for Matching Estimators," Econometrica, Econometric Society, vol. 76(6), pages 1537-1557, November.
- Alberto Abadie & Guido W. Imbens, 2006. "On the Failure of the Bootstrap for Matching Estimators," NBER Technical Working Papers 0325, National Bureau of Economic Research, Inc.
- Imbens, Guido & Abadie, Alberto, 2008. "On the Failure of the Bootstrap for Matching Estimators," Scholarly Articles 3043415, Harvard University Department of Economics.
- Guido W. Imbens, 2004. "Nonparametric Estimation of Average Treatment Effects Under Exogeneity: A Review," The Review of Economics and Statistics, MIT Press, vol. 86(1), pages 4-29, February.
- Guido W. Imbens, 2003. "Nonparametric Estimation of Average Treatment Effects under Exogeneity: A Review," NBER Technical Working Papers 0294, National Bureau of Economic Research, Inc.
- Richard Blundell & Monica Costa Dias, 2000. "Evaluation methods for non-experimental data," Fiscal Studies, Institute for Fiscal Studies, vol. 21(4), pages 427-468, January.
- Gustavo Angeles & David Guilkey & Thomas Mroz, 2005. "The determinants of fertility in rural Peru: Program effects in the early years of the national family planning program," Journal of Population Economics, Springer;European Society for Population Economics, vol. 18(2), pages 367-389, 06.
- Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, 01.
- Kosuke Imai & Gary King & Elizabeth A. Stuart, 2008. "Misunderstandings between experimentalists and observationalists about causal inference," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 171(2), pages 481-502. Full references (including those not matched with items on IDEAS)