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CINCH - Health Economics Research Center

New CINCH Working Paper


A new working paper has been added to the CINCH working paper series: “The Human Capital Cost of Radiation: Long-run Evidence from Exposure outside the Womb” by Benjamin Elsner and Florian Wozny.

Abstract: This paper studies the long-term effect of radiation on cognitive skills. We use regional variation in nuclear fallout caused by the Chernobyl disaster in 1986, which led to a permanent increase in radiation levels in most of Europe. To identify a causal effect, we exploit the fact that the degree of soil contamination depended on rainfall within a critical ten-day window after the disaster. Based on unique geo-coded survey data from Germany, we show that people who lived in highly-contaminated areas in 1986 perform significantly worse in standardized cognitive tests 25 years later. This effect is driven by the older cohorts in our sample (born before 1976), whereas we find no effect for people who were first exposed during early childhood. These results are consistent with radiation accelerating cognitive decline during older ages. Moreover, they suggest that radiation has negative effects even when people are first exposed as adults, and point to significant external costs of man-made sources of radiation.

See all working papers.

Monday Health Economics Seminar


On Monday, February 18 2019, 14:00 - 15:30, Galina Besstremyannaya (CEFIR, NES Moscow) will present:

Physicians' altruism in incentives contracts: Medicare's quality race

The paper analyzes the impact of physicians' altruism and motivation on the outcomes of rank-order tournaments in healthcare, where a fixed price contract on quantity is supplemented with a relative performance contract on quality. Our theoretical model forecasts crowding out of most altruistic types owing to the effect of the participation constraint. In an empirical application to the Medicare's nationwide natural experiment with a relative performance contract on quality for acute inpatient care since 2013, we observe the proof of the model's predictions. Namely, the quality dimensions, which are linked to patient's benefit, demonstrate higher deterioration among top-performing hospitals than other incentivized dimensions. The unintended effects of altruism may be adjusted by the social planner through designing a revelation mechanism and subsidizing the altruistic types.

Room: WST-C.02.12, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.

Monday Health Economics Seminar


On Monday, February 4 2019, 14:00 - 15:30, Olivia Bodnar (DICE) will present:

Physician Dispensing and Drug Expenditures: Empirical Evidence from the NHS

While most OECD countries fully prohibit physician dispensing, there are some exceptions as, for example, in Japan, Switzerland, and the UK and lately also politically discussed in Germany. On the one hand, dispensing physicians may be incentivized to increase their profits through overprescribing or cost-inefficient prescribing. On the other hand, wholesale margins are higher for more competitive markets which could lead to a positive association between physician dispensing and the use of generic drugs. We evaluate drug dispensing by physicians in the National Health Service (NHS) in England between 2012 and 2017. We estimate average treatment effects (ATE), as well as marginal treatment effects (MTE) in order to identify a continuum of treatment effects along the distribution of individual unobserved characteristics that drive the treatment decision. We use quarterly prescription data from all general practitioners in the NHS from January 2012 to December 2017. Our first estimates suggest that drug dispensing increases expenditures per patient by 15,68 pounds sterling per year. This effect is mainly driven by an increase in the number of prescribed items. Furthermore, we observe substitution to smaller package sizes due to a fixed-fee payment for each dispensed item.

Room: WST-C.02.12, Weststadttürme Berliner Platz 6-8, Essen

To find more on upcoming seminars, click here.