María E. Dávalos

Economic evaluation of telemedicine: review of the literature and research guidelines for benefit-cost analysis.

Telemedicine programs provide specialty health services to remote populations using telecommunications technology. This innovative approach to medical care delivery has been expanding for several years and currently covers various specialty areas such as cardiology, dermatology, and pediatrics. Economic evaluations of telemedicine, however, remain rare, and few of those conducted have accounted for the wide range of economic costs and benefits. Rigorous benefit-cost analyses of telemedicine programs could provide credible and comparative evidence of their economic viability and thus lead to the adoption and/or expansion of the most successful programs. To facilitate more advanced economic evaluations, this article presents research guidelines for conducting benefit-cost analyses of telemedicine programs, emphasizing opportunity cost estimation, commonly used program outcomes, and monetary conversion factors to translate outcomes to dollar values. The article concludes with specific recommendations for future research.

Easing the pain of an economic downturn: macroeconomic conditions and excessive alcohol consumption.

Individuals can react to financial stress in a variety of ways, such as reducing discretionary spending or engaging in risky behaviors. This article investigates the effect of changing macroeconomic conditions (measured by the unemployment rate in the state of residence) on one type of risky behavior: excessive alcohol consumption. Using unique and recent panel data from waves 1 and 2 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) and estimating fixed-effects models, we find that changes in the unemployment rate are positively related to changes in binge drinking, alcohol-involved driving, and alcohol abuse and/or dependence. Some differences are present among demographic groups, primarily in the magnitude of the estimated effects. These results contradict previous studies and suggest that problematic drinking may be an indirect and unfortunate consequence of an economic downturn.

Back to work : growing with jobs in Europe and Central Asia

Creating more and better jobs is perhaps the most critical challenge to boosting shared prosperity in Europe and Central Asia (ECA). This report examines the role of reforms, firms, skills, incentives and barriers to work, and labor mobility through the lens of two contextual factors: the legacy of centralized planned economies and the mounting demographic pressures associated with rapid aging in some countries and soaring numbers of youth entering the workforce in others. The main findings of the report are: 1) market reforms pay off in terms of jobs and productivity, although with a lag; 2) a small fraction of superstar high-growth firms, largely young, account for most of new jobs created in the region; 3) skills gaps hinder employment prospects, especially of youth and older workers, due to the inadequate response of the education and training systems to changes in the demand for skills; 4) employment is hindered by high implicit taxes on work for those transitioning to formal jobs from inactivity or unemployment and barriers that affect especially women, minorities, youth, and older workers; and 5) low internal labor mobility prevents labor relocation to places with greater job creation potential.

Moldova: A Story of Upward Economic Mobility

During the early 2000s, Moldova experienced strong economic growth and poverty and inequality reductions. This paper aims at uncovering the patterns behind these poverty trends by looking at economic mobility and its associated factors in Moldova. The findings build on the synthetic panel approach and allow for a non-anonymous view of the process of poverty reduction. The data used for this country study on Moldova come from the Household Budget Survey, which is conducted on a yearly basis. The paper presents transition matrices to look at the patterns of economic mobility across selected consumption thresholds, as well as descriptive statistics and a linear probability model aimed at identifying correlates of economic mobility. The findings show that the observed poverty reductions happened with little churning, and highlight the importance of education and employment on upward economic mobility in Moldova in the 2000s, as well as the role of public and private transfers.

Why so gloomy ? perceptions of economic mobility in Europe and Central Asia

Despite significant improvements in per capita expenditures and a marked decline in poverty over the 2000s, a large fraction of Eastern Europe and Central Asias population reports their economic situation in the late 2000s to be worse than in 1989. This paper uses data from the Life in Transition Survey to document the gap between objective and subjective economic mobility and investigate what may drive this apparent disconnection. The paper aims at identifying some of the drivers behind subjective perceptions of economic mobility, focusing on the role of perceptions of fairness and trust in shaping peoples perceptions of their upward or downward mobility. The results show that close to half of the households in the region perceive to have experienced downward economic mobility, that is, that their position in the income distribution has deteriorated. The results also show that perceptions of higher inequality, unfairness, and distrust in public institutions are associated with downward subjective economic mobility. The findings from this study confirm that factors beyond objective well-being are associated with the perceptions of mobility observed in Europe and Central Asia and may explain why the region has had such a pessimistic view of economic mobility during the past two decades. Understanding what drives peoples perceptions of their living standards and quality of life is important, because regardless of objective measures, perceptions could influence peoples behavior, including support for reforms and labor market decisions. For Eastern Europe and Central Asia, a region that has undergone substantive transformations and which is still going through a reform process, accounting for these aspects is critical.