Chung-Ping A. Loh

Medicaid Cost-Savings of Home- and Community-Based Service Programs for Older Persons in Florida:

This study is designed to address the estimated Medicaid cost-savings of selected home- and community-based service (HCBS) programs in the State of Florida. Utilizing Medicaid claim data for SFY 2000-2005, a propensity score matching procedure is used to simulate random assignment of seniors into matched treatment (HCBS users) and comparison (waitlist) groups. We then produce an algorithm that determines the differences in Medicaid expenditures between the two groups, producing an estimate of cost-savings. Some HCBS programs in Florida show evidence of Medicaid cost-savings. Median Medicaid cost-savings varied widely, ranging from a cost overage of US

Peer effects in adolescent bodyweight: Evidence from rural China

277 per member per month (PMPM) to a cost-savings of US

Potential and Actual Accessibility to Hospital and Hospital Services in Northeast Florida

229 PMPM. Cost-savings appears most consistently when analyzing nursing home costs. The results of this study provide further evidence that nursing home cost-savings can be achieved through home- and community-based services programs.

Measuring attitude toward social health insurance

Peer effect is a potential determinant of individual weight gain that has drawn considerable attention recently. The presence of peer effect implies that policies targeted at changing bodyweight can have enhanced effectiveness through a multiplier effect. This study aims to measure the peer effects on adolescent bodyweight in China. Using the small community nature of the rural sample of the wave 2000 of the China Health and Nutrition Survey, we define plausible peer groups and assess the effect of the average BMI of his/her peer group on the BMI of an adolescent. An instrumental variable (IV) approach is applied to control for potential endogeneity of the peer groups BMI. We find evidence supporting peer effect on BMI in general. The peer effect is around 0.3 with slight variation between two alternative peer definitions. Split sample analysis shows that the peer effect is significant for females (0.32-0.37), and insignificant for male adolescents. Furthermore, we find strong influence of same-gender peers (0.34-0.42) for female adolescents. Conditional quantile regressions show that the peer effect in weight gain is mainly present at or below the median in the conditional BMI distribution for girls, and at the higher end of the BMI distribution for boys. Multiple tests show strong identification, and strong instruments in our IV estimation. Placebo tests suggest that our results are reasonably robust to the correlated effect, due to unobserved community- and province-level factors.

Willingness to Pay for Home- and Community-Based Services for Seniors in Florida

This paper attempts to answer several questions addressing the provision of health care services in the Jacksonville, Florida MSA. Previous literature in the field of medical geography has focused on describing potential accessibility to hospitals and healthcare services, but this study also models actual use of such services by using a hospital patient database. Findings from a GIS-based analysis using ESRI ArcGIS and the Business Analyst extension suggests that distance to the nearest hospital is not the best measure of access to hospital care because of the lack of consideration of hospital capacity. This study demonstrates that health services delivery can be better understood and planned when the potential accessibilities to services and the actual utilization of such services are jointly considered.

The Role of Financial Wellbeing, Sociopolitical Attitude, Self-Interest, and Lifestyle in One's Attitude Toward Social Health Insurance

In order to understand the health care system a country chooses to adopt or the health care reform a country decides to undertake, one must first be able to measure a country’s attitude toward social health insurance. Our primary goal was to develop a construct that allows us to measure this “attitude toward social health insurance”. Using a sample of 724 students from the People’s Republic of China, Germany, and the United States and an initial set of sixteen items, we extract a scale that measures the basic attitude toward social health insurance in the three countries. The scale is internally consistent in each of the three countries. A secondary factor labeled “government responsibility” is marginally consistent for the total sample and for the German sample. German respondents have the most favorable attitude toward social health insurance, followed by China, and then the United States. Chinese respondents have the most favorable attitude toward government responsibility in health insurance. The scale developed here can be used to further investigate and understand which health care system will succeed and which will fail in a given country, which is important from both a political and an economic perspective.

Response to "critically reflecting on Loh's "trends and structural shifts in health tourism"".

States are increasingly interested in measuring the benefit of home- and community-based services (HCBS) programs in order to determine if continued provision of HCBS can be justified on a cost-benefit basis. This study attempts to assess the maximum dollar amount HCBS enrollees or eligible applicants are willing to pay as a measure of the value of the services to them. A contingent valuation survey was conducted on a random sample of 409 clients who were enrolled in or waitlisted for HCBS programs in Florida. Based on estimates from a random-effect model, the median and mean willingness to pay amounts are calculated to be

The Future of United States and Latin American Economic Relations

901 and

Is cigarette smoking in poorer nations highly sensitive to price? Evidence from Russia and China.

933 per month per person, respectively, with considerable variation across HCBS programs. The major determinants of willingness to pay include household income and individual functional status. The sizable values for willingness to pay reported in this study suggest that HCBS programs are perceived as a valuable resource for the elderly.

Valuing Short-Term Study Abroad in Business

BackgroundThere has been continuous debate in the United States, Germany, and China about their respective healthcare systems. While these three countries are dealing with their own unique problems, the question of how social a healthcare system should be is a topic in this debate.ObjectiveThis study examined how strongly college students’ attitudes toward a social healthcare system relate to ideological orientation and self-interest.MethodsWe used samples of college students in the People’s Republic of China, Germany, and the US, and extracted factors measuring “financial wellbeing,” “sociopolitical attitude,” “self-interest,” and “lifestyle” to explain the “attitude toward social health insurance” (ASHI) construct developed in recent literature (Loh et al. in Eur J Health Econ 13:707–722).ResultsThe results of regression analysis showed that sociopolitical attitude/progressivism is positively related to the ASHI, but the degree of association varies considerably from country to country. We also found that a self-interest factor, measured by health status, seems to be inversely related to an individual’s ASHI in the US, but not in China or Germany. Individuals with relatively healthy lifestyle choices were less likely to have a favorable ASHI in Germany, but no such relationship was found in China and the US. These results indicate that while some commonalities exist, there are also considerable differences in the structure of ASHI across these three countries.ConclusionUltimately, the results reported here could help to develop a predictive model that can be utilized to forecast a country’s ASHI. Such a predictive model could be used by politicians to gauge the popularity of a healthcare plan that is under consideration in a particular country.