The objective of this paper is to estimate the causal effect of coresidence with an adult child on depressive symptoms among older widowed women in South Korea. Data from the first and second waves of the Korea Longitudinal Study of Aging were used. Analysis was restricted to widowed women aged ≥ 65 years with at least one living child (N=2,449). We use an instrumental variable approach that exploits the cultural setting where number of sons predicts the probability of an elderly woman's coresidence with an adult child but is not directly correlated with the mother's depressive symptoms. Our models adjust for age, education, total assets, residence, functional limitations, self-rated health, and various illnesses. Our robust estimation results indicate that, among older widowed women, coresidence with an adult child has a significant protective effect on depressive symptoms, but that this effect does not necessarily benefit those with clinically relevant depressive symptoms. Future demographic and social transitions in South Korea portend that older women’s increasing vulnerability to poor mental health is an important though less visible public health challenge.
Keywords: living arrangements, coresidence, depressive symptomatology, elderly, KLoSA

Published: Do, Young Kyung, and Chetna Malhotra. "The effect of coresidence with an adult child on depressive symptoms among older widowed women in South Korea: an instrumental variables estimation." The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 67.3 (2012): 384-391.

Many Chinese express dissatisfaction with their healthcare system with the popular phrase Kan bing nan, kan bing gui (“medical treatment is difficult to access and expensive”). Critics have cited inefficiencies in delivery and poor quality of services.  Determining the pattern of patient satisfaction with health services in China—and the causes of patient dissatisfaction—may help to improve health care not only in China but in countries in similar predicaments throughout the world.

Using data from a sample of 5,036 residents from 17 provinces collected in a 2008 household survey by the National Bureau of Statistics of China, we analyze the patterns of patient preferences, concerns, and satisfaction among six social groups, classified by socioeconomic status including education level, income, and type of employment.

From regression results we conclude that the gap between what patients predict their service will entail and what they perceive the service actually did entail is the key determinant of lower satisfaction, especially for patients who care most about the quality of service and patients with higher social positions. Patients from lower social groups are more concerned with price and the attitudes of medical professionals, and generally express higher satisfaction with their health care experiences than their wealthier peers, despite receiving lower-level services. Patients with higher social positions are more concerned with the technical competence and quality of providers, and struggle with what they perceive as a lack of freedom to purchase and receive their desired services, as well as long waiting times and poor physician-patient interactions. These patterns of patient satisfaction appear to be the consequence of China’s unreliable basic delivery system, lack of advanced health service supply, and distorted health market. We discuss how what we have learned about patients’ dissatisfaction can be used to restructure the delivery system to better meet and shape patients’ needs.

Many researchers have concluded that longer life expectancies prompt increased investment in education, as a prolonged labor supply raises the rate of return on education. Besides explaining the empirical evidence behind this conclusion (at an absolute level), there is another issue to be discussed: does time spent in studying and working increase proportionally with higher longevity? Building on an extended life-cycle model with an assumption on a more realistic distribution of life cycle mortality rates, this article considers dynamic effects of prolonging longevity on economic development by directly introducing changes in longevity into the economy, which is more preferable than comparative static analysis that relies on changes in relevant parameters. It shows that prolonged life expectancy will cause individuals to increase their time in education but may not warrant rises in labor input. Later we show that higher improvement rate of longevity will also promote economic growth, even if we exclude the mechanism of human capital formation and only consider the growth effects of the higher improvement rate of life expectancy from physical capital investment.

Forthcoming in The Chinese Journal of Population, Resources and the Environment

Published: Qiong, Zhang. "Longevity, Capital Formation and Economic Development." Chinese Journal of Population Resources and Environment 10.1 (2012): 53-63.

The principal-agent problem in health care asserts that providers, being imperfect agents for patients, will act to maximize their profits at the expense of the patients’ interests. This problem applies especially where professional regulations are lacking and incentives exist to directly link providers’ actions to their profits, such as a fee-for-service payment system. The current analysis tests for the existence of the principal-agent problem in the private health market in Vietnam by examining the prescribing patterns of the private providers. We show that

1. private providers were able to induce demand by prescribing more drugs than public providers for a similar illness and patient profile;
   
2. private providers were significantly more likely to prescribe injection drugs to gain trust among the patients; and
   
3. patients’ education as a source of information and empowerment has enabled them to mitigate the demand inducement by the providers.
   

Our hypotheses were supported with evidence from Vietnam National Health Survey 2001 and 2002, the first and, so far, only comprehensive health survey in the country.