Hong Son Nghiem

Child health and the income gradient: Evidence from Australia

The positive relationship between household income and child health is well documented in the child health literature but the precise mechanisms via which income generates better health and whether the income gradient is increasing in child age are not well understood. This paper presents new Australian evidence on the child health-income gradient. We use data from the Longitudinal Study of Australian Children (LSAC), which involved two waves of data collection for children born between March 2003 and February 2004 (B-Cohort: 0-3 years), and between March 1999 and February 2000 (K-Cohort: 4-7 years). This data set allows us to test the robustness of some of the findings of the influential studies of Case et al. [Case, A., Lubotsky, D., Paxson, C., 2002. Economic status and health in childhood: the origins of the gradient. The American Economic Review 92 (5) 1308-1344] and Currie and Stabile [Currie, J., Stabile, M., 2003. Socioeconomic status and child health: why is the relationship stronger for older children. The American Economic Review 93 (5) 1813-1823], and a recent study by Currie et al. [Currie, A., Shields, M.A., Price, S.W., 2007. The child health/family income gradient: evidence from England. Journal of Health Economics 26 (2) 213-232]. The richness of the LSAC data set also allows us to conduct further exploration of the determinants of child health. Our results reveal an increasing income gradient by child age using similar covariates to Case et al. [Case, A., Lubotsky, D., Paxson, C., 2002. Economic status and health in childhood: the origins of the gradient. The American Economic Review 92 (5) 1308-1344]. However, the income gradient disappears if we include a rich set of controls. Our results indicate that parental health and, in particular, the mothers health plays a significant role, reducing the income coefficient to zero; suggesting an underlying mechanism that can explain the observed relationship between child health and family income. Overall, our results for Australian children are similar to those produced by Propper et al. [Propper, C., Rigg, J., Burgess, S., 2007. Child health: evidence on the roles of family income and maternal mental health from a UK birth cohort. Health Economics 16 (11) 1245-1269] on their British child cohort.

Marginal costs of hospital-acquired conditions: information for priority-setting for patient safety programmes and research

Objective To estimate the relative inpatient costs of hospital-acquired conditions. Methods Patient level costs were estimated using computerized costing systems that log individual utilization of inpatient services and apply sophisticated cost estimates from the hospitals general ledger. Occurrence of hospital-acquired conditions was identified using an Australian ‘condition-onset’ flag for diagnoses not present on admission. These were grouped to yield a comprehensive set of 144 categories of hospital-acquired conditions to summarize data coded with ICD-10. Standard linear regression techniques were used to identify the independent contribution of hospital-acquired conditions to costs, taking into account the case-mix of a sample of acute inpatients (n 5 1,699,997) treated in Australian public hospitals in Victoria (2005/ 06) and Queensland (2006/07). Results The most costly types of complications were post-procedure endocrine/metabolic disorders, adding AU

Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?

21,827 to the cost of an episode, followed by MRSA (AU

The effect of incentive reforms upon productivity: Evidence from the Vietnamese rice industry

19,881) and enterocolitis due to Clostridium difficile (AU

Research on injury compensation and health outcomes: ignoring the problem of reverse causality led to a biased conclusion

19,743). Aggregate costs to the system, however, were highest for septicaemia (AU

The impact of childhood malnutrition on schooling: Evidence from Bangladesh

41.4 million), complications of cardiac and vascular implants other than septicaemia (AU

Using ICD-10-AM codes to characterise hospital-acquired complications.

28.7 million), acute lower respiratory infections, including influenza and pneumonia (AU

What Roles Do Contemporaneous And Cumulative Incomes Play In The Income–Child Health Gradient For Young Children? Evidence From An Australian Panel

27.8 million) and UTI (AU

Are road traffic crash fatality rates converging among OECD countries

24.7 million). Hospital-acquired complications are estimated to add 17.3% to treatment costs in this sample. Conclusions Patient safety efforts frequently focus on dramatic but rare complications with very serious patient harm. Previous studies of the costs of adverse events have provided information on ‘indicators’ of safety problems rather than the full range of hospital-acquired conditions. Adding a cost dimension to priority-setting could result in changes to the focus of patient safety programmes and research. Financial information should be combined with information on patient outcomes to allow for cost-utility evaluation of future interventions.

Impact of microfinance on household income and consumption in Bangladesh: empirical evidence from a quasi-experimental survey

Since the beginning of 1980s, the Iranian health care system has undergone several reforms designed to increase accessibility of health services. Notwithstanding these reforms, out-of-pocket payments which create a barrier to access health services contribute almost half of total health are financing in Iran. This study aimed to provide a greater understanding about the inequality and determinants of the out-of-pocket expenditure (OOPE) and the related catastrophic expenditure (CE) for hospital services in Iran using a nationwide survey data, the 2003 Utilisation of Health Services Survey (UHSS). The concentration index and the Heckman selection model were used to assess inequality and factors associated with these expenditures. Inequality analysis suggests that the CE is concentrated among households in lower socioeconomic levels. The results of the Heckman selection model indicate that factors such as length of stay, admission to a hospital owned by private sector or Ministry of Health and Medical Education, and living in remote areas are positively associated with higher OOPE. Results of the ordered-probit selection model demonstrate that length of stay, lower household wealth index, and admission to a private hospital are major factors contributing to the increase in the probability of CE. Also, we find that households living in East Azarbaijan, Kordestan and Sistan and Balochestan face a higher level of CE. Based on our findings, the current employer-sponsored health insurance system does not offer equal protection against hospital expenditure in Iran. It seems that a single universal health insurance scheme that covers health services for all Iranian—regardless of their employment status—can better protect households from catastrophic health spending.