Skip to main content


CINCH - Health Economics Research Center

New CINCH working paper


A new working paper has been added to the CINCH working paper series: “The long-term consequences of the global 1918 influenza pandemic: A systematic analysis of 117 IPUMS international census data sets” by Sebastian Vollmer and Juditha Wójcik.

Several country-level studies, including a prominent one for the United States, have identified long-term effects of in-utero exposure to the 1918 influenza pandemic (also known as the Spanish Flu) on economic outcomes in adulthood. In-utero conditions are theoretically linked to adult health and socioeconomic status through the fetal origins or Barker hypothesis. Historical exposure to the Spanish Flu provides a natural experiment to test this hypothesis. Although the Spanish Flu was a global phenomenon, with around 500 million people infected worldwide, there exists no comprehensive global study on its long-term economic effects. We attempt to close this gap by systematically analyzing 117 Census data sets provided by IPUMS International. We do not find consistent global long-term effects of influenza exposure on education, employment and disability outcomes. A series of robustness checks does not alter this conclusion. Our findings indicate that the existing evidence on long-term economic effects of the Spanish Flu is likely a consequence of publication bias.

See all working papers.

Monday Health Economics Seminar


On Monday December 11, 2017, 14:00 - 15:30 Katja Grasic (CHE, York) will present:

How should hospital reimbursement be refined to support the concentration of complex care services?

The English National Health Service is promoting the concentration of the treatment of patients with relatively rare and complex conditions into a limited number of specialist centres. If these patients are more costly to treat, the prospective payment system based on Healthcare Resource Groups (HRGs) may need refinement because these centres will be financially disadvantaged. To assess the funding implications of this concentration policy, we estimate the cost differentials associated with caring for patients that receive complex care and examine the extent to which complex care services are concentrated across hospitals and HRGs. We estimate random effects models using patient-level activity and cost data for all patients admitted to English hospitals construct different measures of the concentration of complex services. Payments for complex care services need to be adjusted if they have large cost differentials and if provision is concentrated within a few hospitals.


Room: WST-C.02.11, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.

New CINCH working paper


A new working paper has been added to the CINCH working paper series: “Learning Intensity Effects in Students’ Mental and Physical Health – Evidence from a Large Scale Natural Experiment in Germany” by Sarah Hofmann and Andrea Mühlenweg.

In this study, we analyze health effects of a recent education reform in Germany exposing students to increased schooling intensity. The reform shortened the higher secondary education track by one year. As the overall curriculum required for graduation was held constant, this led to an increase in instruction hours in the remaining school years. The reform has been introduced at different points in time across federal states, providing us with a difference-in-difference setup for analysis. Based on data from the German Socio-Economic Panel Study (SOEP), our results imply that the reform significantly reduced adolescents’ self-rated mental health status. The overall effect on the mental component summary score (MCS) is about a quarter of a standard deviation. Examining MCS sub-dimensions, we find detrimental effects of the reform on vitality and on emotional balance. We also observe significant impacts on self-assessed general physical health.

See all working papers.