Souvik Banerjee

Identifying the Mechanisms for Workplace Burden of Psychiatric Illness

Background:Although previous research indicates that mental disorders detract from labor market outcomes, little is known about which psychiatric symptoms are most important. Objective:The objective of this study was to identify the mechanisms, or most important symptoms, through which psychiatric disorders affect labor market outcomes. We focus on major depressive episode, panic attack, social phobia, and generalized anxiety disorder. Our approach builds on prior work in that we consider the effects of symptoms both among individuals meeting and among individuals not meeting the diagnostic criteria for mental disorders. Research Design:Data were obtained from the National Comorbidity Survey Replication and the National Latino and Asian American Study. We used a structural equation model with latent indices for mental disorders, where the indices are generated from the model using multiple indicators (symptoms) and multiple causes of the disorders. Measures:The outcomes were current employment/labor force participation, weeks worked in last year, and number of work absences in the last month among employed individuals. Results:We found that for major depressive episode, symptoms of insomnia/hypersomnia, indecisiveness, severe emotional distress, and fatigue are crucial for labor market outcomes. In the case of generalized anxiety disorder, the length of the episode, symptoms relating to difficulty controlling worry, and symptoms of worry/anxiety/nervousness causing significant emotional distress were most detrimental for work outcomes. Social phobia and panic attack were not associated with labor market outcomes. Conclusion:Our findings suggest that interventions targeting these particular symptoms may be most helpful in improving work functioning.

Effects of Psychiatric Disorders on Labor Market Outcomes: A Latent Variable Approach Using Multiple Clinical Indicators

In this paper, we estimate the effect of psychiatric disorders on labor market outcomes using a structural equation model with a latent index for mental illness, an approach that acknowledges the continuous nature of psychiatric disability. We also address the potential endogeneity of mental illness using an approach proposed by Lewbel (2012) that relies on heteroscedastic covariance restrictions rather than questionable exclusion restrictions for identification. Data come from the US National Comorbidity Survey - Replication and the National Latino and Asian American Study. We find that mental illness adversely affects employment and labor force participation and also reduces the number of weeks worked and increases work absenteeism. To assist in the interpretation of findings, we simulate the labor market outcomes of individuals meeting diagnostic criteria for mental disorder if they had the same mental health symptom profile as individuals not meeting diagnostic criteria. We estimate potential gains in employment for 3.5 million individuals, and reduction in workplace costs of absenteeism of

Prevalence of and Comorbid Health Conditions Associated With Pediatric Prescription Opioid Use in the US

21.6 billion due to the resultant improvement in mental health. Copyright

Disparities in Emergency Department Visits Among Collocated Racial/Ethnic Medicare Enrollees

ABSTRACT Prescription opioids are among the most effective analgesics to treat moderate to severe pain; however, little is known about the use of prescription opioids in children, particularly those receiving an extended-release formulation for the treatment of chronic pain. In this retrospective study, the authors determined the prevalence of prescription opioid use among 7–17-year-old children and associated comorbid health conditions from 2010 to 2013 using Truven Health MarketScan (MarketScan) and Optum Clinformatics DataMart (Optum). The primary end points were prevalence of using any prescription opioids, using only prescription short-acting opioids (SAOs), and at least one prescription of a long-acting opioid (LAO). The prevalence of prescription opioid use among children is non-negligible and has been trending downwards: 6.90% in 2010 and 5.93% in 2013 using MarketScan and a similar trend using Optum: 5.47% in 2010 and 4.51% in 2013. Very few children had claims for LAOs, with only 0.04% (4979 children) in MarketScan and 0.03% (1117 children) in Optum. Given the very small number of children, primarily in the 12–17 age group, who are prescribed LAOs, there is a need to focus on a better understanding of the patterns of SAO use in children.

Cost and Health Care Utilization Implications of Bariatric Surgery Versus Intensive Lifestyle and Medical Intervention for Type 2 Diabetes

Study objective: We estimate emergency department (ED) use differences across Medicare enrollees of different race/ethnicity who are residing in the same zip codes. Methods: In this retrospective cohort study, we stratified all Medicare fee‐for‐service beneficiaries aged 66 years and older (2006 to 2012) by residence zip code and identified zip codes with racial/ethnic diversity, defined as containing at least 1 enrollee from each of 3 racial/ethnic groups: Hispanics, (non‐Hispanic) blacks, and (non‐Hispanic) whites. Our primary study population consisted of a stratified random sample of approximately equal number of each racial/ethnic group from each zip code with racial/ethnic diversity (N=1,563,631). We identified ED visits, comorbidities, primary‐care‐treatable status, and patient disposition. We characterized socioeconomic status by zip code poverty rate. The main outcome measure was the ratio of ED visit rate (number of visits/100 person‐years) between each minority group and whites. Results: Of 38,423 zip codes nationally, 41% met the racial/ethnic diversity criterion; these zip codes contained 85% of the Medicare fee‐for‐service beneficiaries. Among enrollees from zip codes with racial/ethnic diversity, the ED visit rate among whites was 45.4 (95% confidence interval 45.1 to 45.6), and the ED visit rate ratio was 1.34 (95% confidence interval 1.33 to 1.36) among blacks and 1.23 (95% confidence interval 1.22 to 1.24) among Hispanics. ED visit rate ratios for both minority groups were greater than 1.00 among all subgroups by age, comorbidity, zip code poverty rate, urban/rural area, and primary‐care‐treatable and disposition status. Conclusion: Among Medicare enrollees, blacks and Hispanics had higher ED use rates than whites overall and among subgroups by demographics and socioeconomic status.

A Simple Model on Motherss Autonomy, Health Inputs, and Child Health

The aim of this study was to compare the cost and health care utilization of patients with obesity and type 2 diabetes mellitus (T2DM) randomized into either Roux‐en‐Y gastric bypass (RYGB) surgery or an intensive lifestyle and medical intervention (ILMI).

Effects of Psychiatric Disorders on Labor Market Outcomes: A Latent Variable Approach Using Multiple clinical Indicators

Using traditional health capital model of Grossman (1972) and Wagstaff (1986a) this paper attempts to fill in the theoretical missing link between mothers’ autonomy and household consumption behavior, particularly focusing on the consumption of child health inputs. It has been shown in this analysis that working mothers’ children should be of better health status. Further independent of working status of the mother, the autonomy parameter always induces consumption of more health inputs for the children. However, when autonomy is linked with mothers’ income, the basic results of the model are further strengthened. In fact, income induced autonomy may result in redefining the composite consumption good for the family as an inferior one.