FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.
FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.
Supplier-induced Demand in Newborn Treatment: Evidence from Japan
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We measure the degree of supplier-induced demand in newborn treatment, by exploiting changes in reimbursement arising from the introduction in Japan of the partial prospective payment system (PPS). Under the partial PPS, neonatal intensive care unit (NICU) utilization became relatively more profitable than other procedures, since it was excluded from prospective payments. We find that hospitals respond to PPS adoption by increasing NICU utilization and more frequently manipulating infants' reported birth weights -- the latter of which is a measure that determines the infant's maximum allowable length of stay in NICU. This induced demand substantially increases hospitals' reimbursements.
Hitoshi Shigeoka received a B.A. (2001) and an MA (2003) in chemical engineering from University of Tokyo, and master of international affairs (2006) and PhD in economics (2012) from Columbia University. Hitoshi’s research interests include health, labor, public economics, and experimental economics. His current research involves estimating the demand elasticity of health care utilization, examining the degree of supplier-induced demand by physicians and hospitals, examining the effects of competition and peer-to-peer teaching on learning, and investigating how the long-term incentives of mothers affect the timing of births.
Philippines Conference Room
Hitoshi Shigeoka
Assistant Professor
Speaker
Simon Fraser University
Seminars
Information, Development, and Life-course Smoking Pattern in Mainland China and Taiwan over 50 Years
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We use retrospectively reported data on smoking behavior of residents of Mainland China and Taiwan to compare and contrast patterns in smoking behavior over the life-course of individuals in these two regions. Because we construct the life-history of smoking for all survey respondents, our data cover an exceptionally long period of time – up to fifty years in both samples. During this period, both societies experienced substantial social and economic changes. The two regions developed at much different rates and the political systems of the two areas evolved in very different ways. More importantly, governments in the two areas set policies that caused the flow of information about the health risks of smoking to differ across the regions and over time. We exploit these differences, using counts of articles in newspapers from 1951 to present, to explore whether and how the arrival of information affected life-course smoking decisions of residents in the two areas. We also present evidence that suggests how prices/taxes and key historical events might have affected decisions to smoke.
Dean Lillard received his PhD in economics from the University of Chicago in 1991. From 1991 to 2012, he was a faculty member and senior research associate in the Department of Policy Analysis and Management at Cornell University. In August 2012 he joined the Department Human Sciences at Ohio State University as an Associate Professor. He is Director and Project Manager of the Cross-National Equivalent File study that produces cross-national data. He is a member of the American Economics Association, the Population Association of America, the International Association for Research on Income and Wealth, the International Health Economics Association, the American Society for Health Economics, a Research Associate at the German Institute for Economic Research in Berlin, Germany, and a Research Associate of the National Bureau of Economic Research. He serves on the advisory board of the Danish National Institute for Social Research in Copenhagen, Denmark and the Cross-National Studies: Interdisciplinary Research and Training Program – a collaborative program run by the Polish Academy of Sciences (PAN), and together with the Mershon Centre at OSU.
Dean Lillard's current research focuses on health economics, the economics of schooling, and international comparisons of economic behavior. His research in health economics is primarily focused on the economics of the marketing and consumption of cigarettes and alcohol. His research on the economics of schooling includes studies of direct effects of policy on educational outcomes and on the role that education plays in other economic behaviors such as smoking, production of health, and earnings. His cross-national research ranges widely from comparisons of the role that obesity plays in determining labor market outcomes to comparisons of smoking behavior cross-nationally.
Philippines Conference Room
Dean R. Lillard
Associate Professor, Department Human Sciences
Speaker
Ohio State University
Seminars
Patient Copayments, Provider Incentives and Income Effects: Theory and Evidence from China’s Essential Medications List Policy
Paragraphs
How do demand- and supply-side incentives interact, when there are potentially large provider income effects? We develop a simple model and empirically test it with data from China’s Essential Medications List (EML) policy, which reduced patient copayments and changed provider incentives by removing a large source of revenue from primary care providers: drug dispensing revenues. Using a panel of patient-level spending and clinical data for Chinese patients with diabetes or hypertension over two and a half years, we find evidence of strategic provider response that dampened the impact of patient copayment reductions. Resource use and patient out-of-pocket spending did not change, when taking account of patient utilization outside primary care.
This paper has been published: Brian Chen, Y. Tony Yang, and Karen Eggleston, 2017. Patient Copayments, Provider Incentives and Income Effects: Theory and Evidence from the Essential Medications List under China’s 2009 Healthcare Reform,” World Medical & Health Policy 9(1): 24–44."
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Asia Health Policy Program working paper # 37
Gendengarjaa Baigalimaa
Shorenstein APARC
Encina Hall E332
616 Serra Street
Stanford, CA 94305-6055
0
baigal@stanford.edu
Developing Asia Health Policy Fellow
Gendengarjaa Baigalimaa joins the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) during the 2013-2014 acedemic year as the Asia Health Policy Program Fellow. She joins APARC from the Mongolian National Cancer Center, where she serves as a Gynecological Oncologist.
During her appointment as Health Policy Fellow, she will conduct a comparative study of how knowledge of cervical cancer risk factors has influenced behavior changes in Mongolia before and after the introduction of the National Cervical Cancer Program.
Baigalimaa is the Executive Director of Mongolian Society of Gynecological Oncologists and is also a member of the International Gynecological Cancer Society (IGCS) in Mongolia, Russia, and France.
Baigalimaa holds a MD from Minsk Belarussia Medical University. She also received a Masters in Health Science from Mongolian Medical University. She is fluent in both Russian and English.
Margaret Triyana
Shorenstein APARC
Encina Hall C331
616 Serra Street
Stanford, CA 94305-6055
0
mtriyana@stanford.edu
2013-2014 Asia Health Policy Postdoctoral Fellow
Margaret (Maggie) Triyana’s main research interests are inequality and human capital investments in developing countries. In particular, she is interested in the effects social policy changes on children’s health outcomes. As a Postdoctoral Fellow, she will analyze the effects of rural-urban migration in Indonesia and China, as well as the impact of health insurance expansion in Indonesia and Vietnam.
Triyana received a PhD in Public Policy from the University of Chicago in 2013.
Working Papers
“Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia“
“The Effects of Community and Household Interventions on Birth Outcomes: Evidence from Indonesia”
“The Longer Term Effects of the ‘Midwife in the Village’ Program in Indonesia”
“The Sources of Wage Growth in a Developing Country” (with Ioana Marinescu)
Region-based v. Distance-based Information in Emergency Health Risk Communication: Evidence from the Fukushima Daiichi Nuclear Disaster
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A tremendous amount of radioactive products were discharged as a result of the accident at the Fukushima nuclear power plant in March 2011, which resulted in radioactive contamination of the plant and surrounding areas. While geographical distribution of radioactive iodine, tellurium, and cesium in the surface soils was smoothly (but not always systematically) widespread all over the region, health risk information by the government, media, and other organizations is most likely to be given in terms of administrative boundaries (cf. prefectures, municipalities, etc.) and/or distance from the radiation source.
This paper estimates the effect of such health risk information rather than the actual health risks of radiation on land and other prices in different locations. We find that the prefecture and municipality border effects – but not the distance effect from the nuclear power plant – are significantly related to a reduction in land and other prices after the accident. This shows that people responded to health risk information based on administrative boundaries rather than the actual health risk of radiation after the disaster. Although health risk information based on prefecture and municipality boundaries has an obvious advantage of distilling large and complex risk information into a simple one, the government, media, and other organizations need to recognize and carefully examine the potential of misclassifying non-contaminated areas into contaminated prefectures. Doing so will avoid unintentional consequences to the region’s economy.
Hiroaki Matsuura is currently Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies, University of Oxford and a Junior Research Fellow of St. Antony’s College. His main interests are health economics and demography, with a special interest in the relation between laws and population health. Hiroaki received his B.A. in Economics from Keio University, M.A. in Social Science from the University of Chicago, M.S. in Project Management from Northwestern University’s McCormick School of Engineering and Applied Science, and Sc.D. in Global Health and Population (Economics track) from Harvard University’s School of Public Health. In the past, he was affiliated with Institute of Quantitative Social Sciences, Human Rights in Development, and Takemi Program in International Health at Harvard University. He also worked as a research assistant at the National Bureau of Economic Research. His doctoral dissertation research explores a right to health or to health care in national constitutions of 157 countries and state constitutions of the 50 U.S. states and estimates the impact of introducing (or removing) a right to health or to health care into national and state constitutions on health system and population health outcomes. His most recent article, “The Right to Health in Japan: Challenges of a Super Aging Society and Implication from Its 2011 Public Health Emergency” (with Eriko Sase) will be appeared on “Advancing the Human Right to Health”, edited by José M. Zuniga, Stephen P. Marks, and Lawrence O. Gostin, Oxford University Press, 2013.
Daniel and Nancy Okimoto Conference Room
Hiroaki Matsuura
Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies
Speaker
University of Oxford
Seminars
Empirical Investigation of Declining Childbirth: Psychosocial and Economic Conditions in Japan
Paragraphs
Background: For the past two decades, more and more women in certain European countries, Japan, and the United States are giving birth to their first child at a considerably later age than ever before. It remains unclear as to what extent this age-related general fertility decline is affected by changing social and cultural norms.
Method: The Global Centers of Excellence Survey was conducted by Osaka University in Japan (n=5313) in 2009. Multivariate regression analyses were conducted to examine the impact of psychosocial norms, cultural differences, and economic conditions on the perception of childbearing.
Results: The findings suggest that a subjective measure of happiness has a significant influence on childbearing. A society with income inequalities between classes discourages childbearing. It is observed that women’s higher labor force participation generates a negative impact on mother-child relations which causes discouragement of childbearing. A higher female labor force participation stemmed from a transition of a traditional society into a modern and market-oriented society discourages childbearing.
Conclusions/implications: A woman’s decision to delay childbearing is based on her perception of psychosocial norms with surrounding economic environment and her own value of opportunity in the market oriented society. Childbearing also imposes psycho-economic burdens on the working population under mix of a traditional, patriarchal society, and a modern market oriented framework. Childbearing incentives could be a strategic policy to encourage positive attitudes of childbearing in general and proper welfare policy, labor law(s), employment conditions, and social security system for a working mother with a child or children.
Key words: Childbearing, socioeconomic factors, psychosocial norms, subjective happiness
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Asia Health Policy Program working paper # 36
NHI Reform in Taiwan: Recent Developments
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Co-sponsored by the Center of East Asian Studies, Stanford University
Prominent health policy expert—Rachel Lu from Taiwan—will share her view on recent health policy developments in the region, drawing on her extensive research and policy background.
Jui-fen Rachel Lu, Sc.D., is a Professor in the Department of Health Care Management, at Chang Gung University (CGU) in Taiwan, where she teaches comparative health systems, health economics, and health care financing and has served as department chair (2000-2004), Associate Dean (2009-2010) and Dean of College of Management (2010-2013). She earned her B.S. from National Taiwan University, and her M.S. and Sc.D. from Harvard University, and she was also a Takemi Fellow at Harvard (2004-2005) and is an Honorary Professor at Hong Kong University (2007-2014), a guest professor at Huazhong University of Science and Technology (2010-2013), and an adjunct professor at Xi’an Jiaotong University (2011-2014) in China. Her devotion to teaching driven by her firm belief in the value of education and investment in human minds was recognized by the Award of Excellence in Teaching conferred by CGU in both 2002 and 2013.
Her research focuses on 1) the equity issues of the health care system; 2) impact of the NHI program on health care market and household consumption patterns; 3) comparative health systems in Asia-Pacific region. She is a long-time and active member of Equitap (Equity in Asia-Pacific Health Systems) research network and is currently the coordinator for the catastrophic payment component of Equitap II research project which involves 21 country teams and is jointly funded by IDRC, AusAID, and ADB. Professor Lu has also been appointed to serve as a member on various government committees dealing with health care issues in Taiwan, such as National Health Insurance Supervisory Committee (DOH), Hospital Management Committee(DOH), and Hospital Global Budget Payment Committee (BNHI), etc. Dr. Lu received the Minister Wang Jin Naw Memorial Award for Best Paper in Health Care Management presented by Kimma Chang Foundation in 2002 and was the recipient of IBM Faculty Award in 2009. She has published papers in Health Affairs, Medical Care, Journal of Health Economics, Health Economics, Social Science and Medicine, Health Economics, Policy and Law, Osteoporosis International, Health and Quality of Life Outcomes, and Taiwan Economic Review etc, and is the author of “Health Economics”(a textbook in Chinese) and various book chapters.
Philippines Conference Room
Encina Hall 3rd Floor Central
616 Serra Street, CA 94305
Jui-fen Rachel Lu
Professor in the Department of Health Care Management
Speaker
Chang Gung University in Taiwan
Seminars