Notice bibliographique
Résumé
This thesis comprises three essays that empirically explore two important areas in health economics and policy: the valuation of medical innovations, and access to healthcare. The first essay explores the role of new medical technologies in improving labor market outcomes by conducting a case study of a class of drugs used in the treatment of arthritis called Cox-2 inhibitors. Cox-2 drugs make an excellent case study for investigating the labor supply effects of medical innovation because the potential labor supply effects are large, and the market introduction of these drugs generates plausibly exogenous variation in their use. Using data from the Health and Retirement Study (HRS) and applying a difference-in-differences approach that compares individuals with arthritis to individuals without arthritis, I find that the introduction of Cox-2 drugs had a positive and significant impact on the probability of working among individuals with long-term arthritis. The effects are stronger among older individuals, the less-educated, and those working in physical occupations. These results highlight the importance of evaluating economic outcomes such as labor supply as part of an assessment of the overall benefits of medical technology. The second essay builds on work by Allin et al. (2010) and Hurley et al. (2011) that systematically analyzes the relationship between subjective unmet need and healthcare utilization. However, unlike previous work that uses cross-sectional data, I use panel data from the National Population Health Survey (NPHS) to control for fixed unobserved individual heterogeneity. In addition, healthcare utilization is modeled using latent class models for panel data, which outperform traditional hurdle models. The results of this study confirm previous findings of different patterns of healthcare utilization among individuals with system-related unmet needs, personal-related unmet needs, and no unmet needs. Individuals with personal-related unmet needs tended to use the same amount of services as expected based on their needs. On the other hand, individuals with system-related unmet needs were found to not only be high users of GP and specialist visits, they were also higher-than-expected users. The third essay examines long-term changes in socioeconomic inequality and inequity in influenza immunization in Canada. The concentration index framework is applied using data from the following two Statistics Canada surveys: the cross-sectional component of the 1996/97 National Population Health Survey (NPHS), and the 2007/08 Canadian Community Health Survey (CCHS). The results show large variations in both coverage and inequity across provinces. In addition, increases in coverage levels across many provinces seem to have drawn disproportionately from those of higher socioeconomic status, contributing to a growing pro-rich inequity in utilization. These results highlight the need for more targeted efforts to help reduce inequities in vaccination.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,003 | 0,009 |
| Communication savante | 0,007 | 0,008 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,004 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,005 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».