APARC - AHPP Publications

Collage of the covers of three of AHPP books on the background of Encina Hall colonnade

Publications

High-quality, social science research on health policy and demographic change in the Asia-Pacific region

AHPP runs its own working paper series and regularly contributes edited volumes that are distributed through the Walter H. Shorenstein Asia-Pacific Research Center’s publishing program. Our faculty and researchers also publish extensively in peer-reviewed academic journals and in scholarly and trade presses. Browse our publications below.

Cover of the book Healthy Aging in Asia

Publication Spotlight

A new volume, 'Healthy Aging in Asia,' edited by Karen Eggleston, examines multiple aspects of policy initiatives for healthy longevity and economic research on chronic disease control in diverse health systems across Asia.

AHPP Working Paper Series

The AHPP working paper series is open to scholars and health policy experts around the world. We publish multiple papers each year and disseminate them to a broad international audience through the AHPP website and network and in collaboration with the Social Science Research Network.

Publications

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Working Paper

The Effects of India’s COVID-19 Lockdown on Critical Non-COVID Health Care and Outcomes

Radhika Jain, Pascaline Dupas
Asia Health Policy Program working paper # 60 , 2020

India’s COVID-19 lockdown is widely believed to have disrupted critical health services, but its effect on non-COVID health outcomes is largely unknown. Comparing mortality trends among dialysis patients in the eight months around the lockdown with the previous year, we document a 64% increase in mortality between March and May 2020 and an estimated 22-25% total excess mortality through July 2020. The mortality increase is greater among females and disadvantaged groups.

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Journal Article

Future Projection of the Health and Functional Status of Older People in Japan: A Multistate Transition Microsimulation Model with Repeated Cross‐sectional Data

Megumi Kasajima, Hideki Hashimoto, Sze‐Chuan Suen, Brian Chen, Hawre Jalal, Karen Eggleston, Jay Bhattacharya
Health Economics , 2020

Accurate future projections of population health are imperative to plan for the future healthcare needs of a rapidly aging population. Multistate‐transition microsimulation models, such as the U.S. Future Elderly Model, address this need but require high‐quality panel data for calibration. We develop an alternative method that relaxes this data requirement, using repeated cross‐sectional representative surveys to estimate multistate‐transition contingency tables applied to Japan's population.

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Working Paper

Intended and Unintended Consequences of a New Limit on Working Hours in South Korea: Implications for Precarious Employment

Sungchul Park, Hansoo Ko
Asia Health Policy Program working paper # 59 , 2020

Effective as of July 1, 2018, South Korea set a new cap on employees’ weekly working hours, decreasing the maximum number from 68 to 52. In this study, we comprehensively analyze the effectiveness of the law’s implementation by observing changes in work time, health status, health care utilization, health behavior, monthly expenses, and satisfaction between pre- and post-implementation periods (2014–2017 vs. 2019). We find evidence of both intended and unintended consequences—and, in this last category, some are beneficial and some not.

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Working Paper

COVID-19 Incidence and the Timing of Quarantine Measures and Travel Restrictions: A Cross-country Analysis

Marjorie Pajaron
Asia Health Policy Program working paper # 58 , 2020

COVID-19 presents humanity with not just a health crisis but also a governance crisis as leaders around the globe confront the challenges of stemming the spread of the virus. Various governments have responded in various ways to slow the transmission of the virus. Ideally, the leaders of a country should approach the crisis with a two-pronged attack. The first is to flatten the epidemic curve (epi curve), which is simply a graphical representation of the number of cases and date of onset of the illness, and the second is to raise or strengthen the capacity of the health system. 

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Book

Healthy Aging in Asia

Karen Eggleston
2020
Life expectancy in Japan, South Korea, and much of urban China has now outpaced that of the United States and other high-income countries. With this triumph of longevity, however, comes a rise in the burden of noncommunicable diseases (NCDs) like diabetes and hypertension, reducing healthy life years for individuals in these aging populations, as well as challenging the healthcare systems they rely on for appropriate care.  
 
The challenges and disparities are even more pressing in low- and middle-income economies, such as rural China and India.
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Working Paper

Intention to Pay for HPV Vaccination among Women of Childbearing Age in Vietnam

Xuan Thi Thanh Le, Phuong Thi Ngoc Nguyen, Toan Thi Thanh Do, Thang Huu Nguyen, Huong Thi Le, Cuong Tat Nguyen, Giang Hai Ha, Chi Linh Hoang, Bach Xuan Tran, Carl A. Latkin, Roger C.M. Ho, Cyrus S.H. Ho
Asia Health Policy Program working paper # 57 , 2020

The intention to pay for human papillomavirus (HPV) vaccination among women of childbearing age in Vietnam, where cervical cancer remains a significant public health concern, has been mostly lacking. To examine this issue, we conducted a cross-sectional study of 807 pregnant women in an urban and a rural district (Dong Da and Ba Vi) of Hanoi, Vietnam. The vast percentage of our respondents expressed a firm intention to vaccinate, especially women in rural areas (over 90.0%).

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Journal Article

Smoking, Life Expectancy, and Chronic Disease in South Korea, Singapore, and the United States: A Microsimulation Model

Daejung Kim, Cynthia Chen, Bryan Tysinger, Sungchul Park, Ming Zhe Chong, Lijia Wang, Michelle Zhao, Jian-Min Yuan, Woon-Puay Koh, Joanne Yoong, Jay Bhattacharya, Karen Eggleston
Health Economics , 2019

The substantial social and economic burden attributable to smoking is well‐known, with heavy smokers at higher risk of chronic disease and premature mortality than light smokers and nonsmokers. In aging societies with high rates of male smoking such as in East Asia, smoking is a leading preventable risk factor for extending lives (including work‐lives) and healthy aging.

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Journal Article

Healing One-Fifth of Humanity: Progress and Challenges for China's Health System

Karen Eggleston,
Milken Institute Review , 2019

In the 2019 fourth quarter edition of the Milken Institute Review, Asia Health Policy Program director Karen Eggleston discusses the progress China has made since the 2009 reforms to its healthcare, which brought basic coverage to all and reduced patients' share of costs, and explains the many challenges that remain, including increasing the system's efficiency to ensure its sustainability and addressing the disparities in healthcare that echo the "yawning gap in living standards between China's rising middle class and its poorest citizens."

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Working Paper

Healing One-fifth of Humanity: Progress and Challenges for China’s Health System

Karen Eggleston, Karen Eggleston
Asia Health Policy Program working paper # 56 , 2019

China’s national health reforms over the past two decades have brought the system closer to the modern, safe, reliable and accessible health system that is commensurate with China’s dramatic economic growth, improvement in living standards, and high hopes for the next generation.

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Book

Understanding "Value for Money" in Healthy Ageing (chapter in ebook)

Karen Eggleston,
2019

In Live Long and Prosper?, a new eBook edited by David Bloom, AHPP director Karen Eggleston contributes the chapter "Understanding 'Value for Money' in Healthy Ageing," in which she advocates for and explains the concept of "net value of medical care," a metric that helps quantify the social value of spending on healthcare.

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Journal Article

Enhancing Financial Protection under China’s Social Health Insurance to Achieve Universal Health Coverage

Hai Fang, Karen Eggleston, Kara Hanson, Ming Wu
BMJ , 2019
China started comprehensive health system reforms in 2009. An important goal of China’s health system reforms was to achieve universal health coverage through building a social health insurance system. Universal health coverage means that all individuals and communities should get the quality health services they need without incurring financial hardship.
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Journal Article

Financing Longevity: The Economics of Pensions, Health and Long-term Care Insurance

Anita Mukherjee, Karen Eggleston
The Journal of the Economics of Ageing , 2019

This special issue of The Journal of the Economics of Ageing, edited by Anita Mukherjee and APARC's Asia Health Policy Program Director Karen Eggleston, focuses on a key challenge around the world: financing the many needs that come with longer lives, lower fertility, and older population age structures. The triumph of longevity can pose a challenge to the fiscal integrity of public and private pension systems and other social support programs disproportionately used by older adults.

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Journal Article

Economic Impact of Diabetes in South Asia: the Magnitude of the Problem

Kavita Singh, K.M. Venkat Narayan, Karen Eggleston
Current Diabetes Reports , 2019

With an estimated 84 million people suffering from diabetes in South Asia, the disease imposes substantial economic burdens on individuals, families, and society. Furthermore, since the disease burden increasingly occurs in the most productive midlife period, it adversely affects workforce productivity and macroeconomic development. Diabetes-related complications lead to markedly higher treatment costs, causing catastrophic medical spending for many households, thus underscoring the importance of preventing diabetes-related complications.

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Working Paper

The Impact of Adolescents’ Risky Health Behaviors on Their Later Economic Outcomes

Marjorie Pajaron
Asia Health Policy Program working paper # 52 , 2019

Risky health behaviors such as illicit drug use, smoking, overconsumption of alcohol, violence, and early sexual activity have contemporaneous and intertemporal adverse health and economic outcomes. The health-related and economic costs to individuals and to society overall are particularly pronounced when adolescents are the ones engaging in one or more of such behaviors.

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Working Paper

The Impact of Energy Access on Mothers’ Health, Labor, and Time Allocation

Marjorie Pajaron
Asia Health Policy Program working paper # 53 , 2019

This paper shows that, for mothers in Cebu, Philippines, access to electricity and the type of cooking fuel used at home affect both health outcomes and also how time is allocated, including for paid work. First, the use of fuelwood for cooking adversely affects the health of mothers, who are traditionally responsible for cooking and are often at home, taking care of their families. This result is consistent across different econometric specifications.

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Working Paper

How Individuals’ Birth Weight and Later Risk Factors Interact to Determine Their Risk of Cardiovascular Disease: A Longitudinal Study in the Philippines

Marjorie Pajaron
Asia Health Policy Program working paper # 54 , 2019

Cardiovascular diseases (CVDs), which are disorders of the heart and blood vessels, are the world’s leading cause of death (WHO, 2016). The transition from infectious diseases to non-communicable diseases (NCDs), primarily CVDs, as the primary cause of mortality and morbidity worldwide— combined with the economic burden associated with heart-related diseases—prompted the World Health Organization (WHO) and its regional offices to identify CVDs’ risk factors (WHO, 2016).

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Working Paper

Future Projection of the Health and Functional Status of Older People in Japan: A Pseudopanel Microsimulation Model*

Megumi Kasajima, Hideki Hashimoto, Sze-Chuan Suen, Brian Chen, Karen Eggleston, Jay Bhattacharya
Asia Health Policy Program working paper # 55 , 2019

Background: Precise future projection of population health distribution is imperative for designing an efficient healthcare system in rapidly aging countries. Multistate-transition microsimulation models such as the US Future Elderly Model have been developed based on panel data collection, but these data may not be always available. We proposed a pseudopanel method using repeated cross-sectional representative surveys as a complementary approach, and specifically applied the model to Japan's population.

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Working Paper

Weathering the Storm: Weather Shocks and International Migrants from the Philippines

Marjorie Pajaron
Asia Health Policy Program working paper # 51 , 2019

The growing literature on environmental migration presents conflicting results. While some find that natural disasters induce international migration, others discover a dampening effect. We aim to reconcile these differences by using a comprehensive list of weather shocks from the Philippines, a country prone to natural disasters and a major exporter of labor. We constructed a longitudinal provincial dataset (2005–2015) from an assemblage of administrative and survey datasets and tested linear, quadratic, and lagged models.

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Journal Article

The Impact of Social Pensions on Intergenerational Relationships: Comparative Evidence from China

Xi Chen, Karen Eggleston, Ang Sun
The Journal of the Economics of Ageing , 2018

China launched a new rural pension scheme (NRPS) for rural residents in 2009, now covering almost all counties with over 400 million people enrolled.

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Journal Article

How Do Type 2 Diabetes Mellitus (T2DM)-Related Complications and Socioeconomic Factors Impact Direct Medical Costs? A Cross-Sectional Study in Rural Southeast China

Haibin Wu, Karen Eggleston, Jieming Zhong, Ruying Hu, Chunmei Wang, Kaixu Xie, Yiwei Chen, Xiangyu Chen, Min Yu
BMJ Open , 2018
Objective To evaluate type 2 diabetes mellitus (T2DM)-related direct medical costs by complication type and complication number, and to assess the impacts of complications as well as socioeconomic factors on direct medical costs.
 
Design A cross-sectional study using data from the region’s diabetes management system, social security system and death registry system, 2015.
 
Setting Tongxiang, China.
 
Participants Individuals diagnosed with T2DM in the local dia
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Journal Article

Direct Medical Cost of Diabetes in Rural China Using Electronic Insurance Claims Data and Diabetes Management Data

Haibin Wu, Karen Eggleston, Jieming Zhong, Ruying Hu, Chunmei Wang, Kaixu Xie , Yiwei Chen, Xiangyu Chen, Min Yu
Journal of Diabetes Investigation , 2018
Aims/Introduction
To evaluate the annual direct medical cost attributable to type 2 diabetes mellitus according to socioeconomic factors, medical conditions and complications categories.
 
Materials and Methods
We created uniquely detailed data from merging datasets of the local diabetes management system and the social security system in Tongxiang, China.
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Book

Poisonous Pandas: Chinese Cigarette Manufacturing in Critical Historical Perspectives

Matthew Kohrman, Gan Quan, Liu Wennan, Robert Proctor
2018
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Working Paper

Dual Practice of Public Hospital Physicians in Vietnam

Ngan Do, Young Kyung Do
Asia Health Policy Program working paper # 49 , 2018

Although many public hospital physicians in Vietnam offer private service on the side, little is known about the magnitude and nature of the phenomenon of so-called dual practice, let alone the dynamics between the public and private health sectors. This study investigates how and to what degree public hospital physicians engage in private practice. It also examines the commitment of dual practitioners to the public sector. The analysis is based on a hospital-based survey of 483 physicians at 10 public hospitals in four provinces of Vietnam.

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Working Paper

Selective Mortality and the Long-term Effects of Early-life Exposure to Natural Disasters

Margaret Triyana, Xing Xia
Asia Health Policy Program working paper # 50 , 2018

We analyze the effects of early-life shocks with varying degrees of severity on mortality and human capital outcomes in the Philippines. We exploit variations in typhoon exposure and the introduction of a short-term post-disaster relief policy. Severe
typhoons are associated with increased mortality and adverse long-term outcomes. Before the disaster relief policy, mortality from in utero exposure to severe typhoons was 10 percent, and survivors exhibited similar levels of human capital as the unaffected.

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Working Paper

Economic Dimensions of Personalized and Precision Medicine in Asia: Evidence from Breast Cancer Treatment in Taiwan

Jui-fen Rachel Lu, Karen Eggleston
Asia Health Policy Program working paper # 48 , 2018

High costs of precision medicine raise concerns about exacerbating income-related disparities in healthcare utilization and health outcomes. One approach to expanding coverage in Asia has been to cover the precision therapy but require the pharmaceutical firm to cover the costs of the companion diagnostic test. Taiwan’s National Health Insurance (NHI) adopted this approach for lung cancer, colorectal cancer and leukemia, but not for the first target therapy covered by NHI, trastuzumab for the treatment of HER2-positive breast cancer.

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