This dissertation comprises three chapters studying how the healthcare system and health policies work. Chapter 1 examines the effects of primary care physicians' (PCP) retirement on Medicare beneficiaries' medical costs and the quality care. By exploiting the random timing of PCPs' retirements with an event study model, I find that PCP retirements on average lead to a three percentage increase in total medical costs, mainly due to the shift from cheaper primary care towards more expensive specialty care, emergency care, and inpatient care. However, the effects on quality of care are mixed. On the one hand, the quality of ambulatory care decreases, as there is an increase in avoidable hospitalization rate. On the other hand, patients are more likely to be diagnosed with a new chronic condition, and patients tend to find a new PCP of higher quality, which may benefit them in a long run. Chapter 2 and 3 investigate the spillover effects of (public) health insurance policies. Chapter 2 analyzes whether providing public health insurance to rural population can incentivize more pharmaceutical innovation towards rural-prevalent diseases in the context of China. By exploiting the disease-level variation in expected market size change, I find that a disease with ten percent more rural patient share leads to a five to seven percent increase in its relevant patent applications after the implementation of the public health insurance. Chapter 3 estimates the effects of parents' health insurance expansion under the Affordable Care Act on children's well-being. Although in a three-year post-period, the only significant effect being detected on children is the increase in ADHD/ADD diagnosis, I find significant improvements in parents' well-being. Among the improvements for parents, two are especially relevant for child development. First, parents' mental health status improves tremendously. Second, parents' financial burden is relieved. Both improvements potentially benefit children in a longer term.
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Citation
Zhang, Xuan,
"Three Essays on Health Economics"
(2019).
Economics Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/c6z4-se04
