scholarly journals Does compulsory schooling affect health? Evidence from ambulatory claims data

2021 ◽  
Author(s):  
Tatjana Begerow ◽  
Hendrik Jürges
Keyword(s):  
Claims Data ◽  
Regression Discontinuity ◽  
Causal Effect ◽  
West Germany ◽  
Health Conditions ◽  
Reduced Form ◽  
Compulsory Schooling ◽  
Positive Effects ◽  
Icd 10 ◽  
Form Effect

AbstractUsing claims data on more than 23 million statutorily insured, we investigate the causal effect of schooling on health in the largest and most comprehensive analysis for Germany to date. In a regression discontinuity approach, we exploit changes in compulsory schooling in West Germany to estimate the reduced form effect of the reforms on health, measured by doctor diagnoses in ICD-10 format covering physical as well as mental health conditions. To mitigate the problem that empirical results depend on subjective decisions made by the researcher, we perform specification curve analyses to assess the robustness of findings across various model specifications. We find that the reforms have, at best, very small impacts on the examined doctor diagnoses. In most of the specifications we estimate insignificant effects that are close to zero and often of the “wrong” sign. Therefore, our study questions the presence of the large positive effects of education on health that are found in the previous literature.

The Causal Effect of Polls on Turnout Intention: A Local Randomization Regression Discontinuity Approach

2021 ◽  
pp. 1-7
Author(s):  
Pablo Brugarolas ◽  
Luis Miller
Keyword(s):  
Political Science ◽  
Natural Experiment ◽  
Regression Discontinuity ◽  
Time Window ◽  
Causal Effect

Abstract This letter reports the results of a study that combined a unique natural experiment and a local randomization regression discontinuity approach to estimate the effect of polls on turnout intention. We found that the release of a poll increases turnout intention by 5%. This effect is robust to a number of falsification tests of predetermined covariates, placebo outcomes, and changes in the time window selected to estimate the effect. The letter discusses the advantages of the local randomization approach over the standard continuity-based design to study important cases in political science where the running variable is discrete; a method that may expand the range of empirical topics that can be analyzed using regression discontinuity methods.

Sibling Rivalry: Evidence from China’s Compulsory Schooling Reform

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Guanfu Fang ◽  
Yu Chen
Keyword(s):  
Labor Market ◽  
Causal Effect ◽  
Compulsory Education ◽  
Spillover Effects ◽  
Resource Reallocation ◽  
Compulsory Schooling ◽  
Market Outcomes ◽  
Geographical Variations ◽  
Negative Impacts ◽  
Older Siblings

AbstractThis study investigates the causal effect of older siblings’ schooling on their younger siblings’ schooling and labor market outcomes by exploiting the temporal and geographical variations in the implementation of compulsory schooling laws in China. Reform exposure is quantified as the number of years that an individual is eligible for compulsory education. We find that older siblings’ exposure to compulsory schooling reform had negative impacts on their younger siblings’ academic achievement and labor market performance. We provide some suggestive evidence for the mechanism of resource reallocation within households. These findings suggest that we may be overestimating the social benefits of compulsory schooling reforms by ignoring the resources constraints within households and the spillover effects on siblings.

The prevalence of pre-existing mental health, drug and alcohol conditions in major trauma patients

2017 ◽  
Vol 41 (3) ◽  
pp. 283 ◽  
Author(s):  
Tu Q. Nguyen ◽  
Pamela M. Simpson ◽  
Belinda J. Gabbe
Keyword(s):  
Mental Health ◽  
Medical Record ◽  
Major Trauma ◽  
Health Conditions ◽  
Trauma Patients ◽  
Discharge Data ◽  
Mental Health Conditions ◽  
Icd 10 ◽  
Record Review ◽  
Drug And Alcohol

Objective Capturing information about mental health, drug and alcohol conditions in injury datasets is important for improving understanding of injury risk and outcome. This study describes the prevalence of pre-existing mental health, drug and alcohol conditions in major trauma patients based on routine discharge data coding. Methods Data were extracted from the population-based Victorian State Trauma Registry (July 2005 to June 2013, n = 16 096). Results Seventeen percent of major trauma patients had at least one mental health condition compared with the Australian population prevalence of 21%. The prevalence of mental health conditions was similar to the Australian population prevalence in men (19% v. 18%), but lower in women (14% v. 25%) and across all age groups. Mental health conditions were more prevalent in intentional self-harm cases (56.3%) compared with unintentional (13.8%) or other intentional (31.2%) cases. Substance use disorders were more prevalent in major trauma patients than the general population (15% v. 5%), higher in men than women (17% v. 10%) and was highest in young people aged 25–34 years (24%). Conclusions Under-reporting of mental health conditions in hospital discharge data appears likely, reducing the capacity to characterise the injury population. Further validation is needed. What is known about the topic? Medical record review, routine hospital discharge data and self-report have been used by studies previously to characterise mental health, drug and alcohol conditions in injured populations, with medical record review considered the most accurate and reliance on self-report measures being considered at risk of recall bias. The use of routinely collected data sources provides an efficient and standardised method of characterising pre-existing conditions, but may underestimate the true prevalence of conditions. What does this paper add? No study to date has explored the prevalence of Abbreviated Injury Scale and International Classification of Diseases and Health Related Problems, Tenth Revision, Australian Modification (ICD-10-a.m)-coded mental health, alcohol and drug conditions in seriously injured populations. The results of this study show the incidence of mental health conditions appeared to be under-reported in major trauma patients, suggesting limitations in the use of ICD-10-a.m. to measure mental health comorbidities. What are the implications for practitioners? In order to achieve improvements in measuring mental health, drug and alcohol comorbidities, we suggest the use of a series of different diagnostic systems to be used in conjunction with ICD-10-a.m., such as medical record review and self-reporting as well as linkage to other datasets. When applied simultaneously, diagnosis and outcomes of mental health may be compared and validated across diagnostic systems and deviations in diagnoses could be more readily accounted for.

scholarly journals Increasing the Willingness to Participate in Organ Donation Through Humorous Health Communication: (Quasi-)Experimental Evidence

2020 ◽  
Author(s):  
Cornelia Betsch ◽  
Nora Katharina Küpke ◽  
Leonie Otten ◽  
Eckart von Hirschhausen
Keyword(s):  
Health Communication ◽  
Organ Donation ◽  
Causal Effect ◽  
Control Group ◽  
Willingness To Participate ◽  
Entertainment Education ◽  
Positive Effects ◽  
Neutral Information ◽  
Willingness To Donate ◽  
Quasi Experimental

Increasing people’s willingness to donate organs after their death requires effective communication strategies. In two preregistered studies, we assessed whether humorous entertainment education formats on organ donation elicit positive effects on knowledge, fears, attitudes, and behavioral intentions – both immediately after the treatment and four weeks later. We test whether perceived funniness mediates expected effects on attitudes and intentions. Study 1 is a quasi-experiment which uses a live medical comedy show (N = 3,964) as an entertainment education format, which either contained or did not contain information about organ donation. Study 2, a lab experiment, tests humor’s causal effect in a pre-post design with a control group (N = 144) in which the same content was provided in either a humorous or non-humorous way in an audio podcast. Results showed that humorous interventions per se were not more effective than neutral information, but that informing people about organ donation in general increased donation intentions, attitudes, and knowledge. However, humorous interventions were especially effective in reducing fears related to organ donation. The findings are discussed regarding the opportunities for sensitive health communication through entertainment education formats, psychological processes that humor triggers, and humor’s role in health communication formats.

α-Lipoic Acid and its role on female Reproduction

2021 ◽  
Vol 22 ◽  
Author(s):  
Fiorella Di Nicuolo ◽  
Roberta Castellani ◽  
Carlo Ticconi ◽  
Giovanni Scambia ◽  
Alfredo Pontecorvi ◽  
...  
Keyword(s):  
Lipoic Acid ◽  
Polycystic Ovary ◽  
Antioxidant Properties ◽  
Reduced Form ◽  
Female Reproduction ◽  
Adhesion Protein ◽  
Positive Effects ◽  
Antioxidant Agents ◽  
Tnf Α ◽  
Cytokine Levels

: α-lipoic acid (ALA), also known as thioctic acid, is a biological thiol present in all types of prokaryotic and eukaryotic cells. It has been shown that ALA or its reduced form, DHLA, have several positive effects on human health acting as biological antioxidant, metal chelator and as a detoxifying agent. It is able to reduce oxidation of several antioxidant agents like glutathione, vitamins C and E, and to modulate insulin and NF-kB signaling pathways. ALA’s pharmacological effects are not only related to its antioxidant properties but it shows an anti-inflammatory action. In particular, ALA is able to reduce inflammasome activity, the pro-inflammatory cytokine levels, such as TNF-α, IL-1β, IL-6, IL-18 and IL-17, interferon (INF)-γ as well as the production of Vascular and Intercellular cell adhesion protein (VCAM-1 and ICAM-1). In recent papers, ALA has been indicated as a possible therapeutic approach to several endocrine or inflammatory disorders affecting female reproduction. Aim of the current review was to assess whether ALA has an evidence-based beneficial role on gynecological and obstetrical diseases such as polycystic ovary syndrome (PCOS), endometriosis, and miscarriage.

scholarly journals Comorbidity profile of patients with concurrent diagnoses of asthma and COPD in Germany

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Manas K. Akmatov ◽  
Tatiana Ermakova ◽  
Jakob Holstiege ◽  
Annika Steffen ◽  
Dominik von Stillfried ◽  
...  
Keyword(s):  
Claims Data ◽  
Case Control Study ◽  
Fungal Infections ◽  
Multidisciplinary Care ◽  
Comorbid Disorders ◽  
Full Spectrum ◽  
Care Approach ◽  
Icd 10 ◽  
Control Study

Abstract The aim of this study was to estimate the prevalence of concurrent diagnoses of asthma/COPD and examine its full spectrum of comorbid disorders in Germany. We used nationwide outpatient claims data comprising diagnoses of all statutory health insurees (40+ years) in 2017 (N = 40,477,745). The ICD-10 codes J44 (COPD) and J45 (asthma) were used to identify patients. The odds of 1,060 comorbid disorders were examined in a case–control study design. Of all insurees, 4,632,295 (11%) were diagnosed with either asthma or COPD. Of them, 43% had asthma only, 44% COPD only and 13% both diseases. The prevalence of concurrent asthma/COPD was 1.5% with a slightly higher estimate among females than males (1.6% vs. 1.4%) and constant increase by age in both sexes. Comorbid disorders were very common among these patients. 31 disorders were associated with a strong effect size (odds ratio > 10), including other respiratory diseases, but also bacterial (e.g., mycobacteria, including tuberculosis) and fungal infections (e.g., sporotrichosis and aspergillosis). Patients with concurrent asthma/COPD suffer from comorbid disorders involving various body systems, which points to the need of a multidisciplinary care approach. Regular screening for common comorbid disorders may result in better clinical course and prognosis as well as improvement of patients’ quality of life.

scholarly journals Influence of COVID-19 confinement measures on appendectomies in Germany—a claims data analysis of 9797 patients

2020 ◽  
Author(s):  
Matthias Maneck ◽  
Christian Günster ◽  
Hans-Joachim Meyer ◽  
Claus-Dieter Heidecke ◽  
Udo Rolle
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Claims Data ◽  
Sickness Fund ◽  
Administrative Claims ◽  
The Social ◽  
Icd 10 ◽  
Abdominal And Pelvic Pain ◽  
Claims Data Analysis ◽  
Medical Situation

Abstract Purpose COVID-19 pandemic had multiple influences on the social, industrial, and medical situation in all affected countries. Measures of obligatory medical confinement were suspensions of scheduled non-emergent surgical procedures and outpatients’ clinics as well as overall access restrictions to hospitals and medical practices. The aim of this retrospective study was to assess if the obligatory confinement (lockdown) had an effect on the number of appendectomies (during and after the period of lockdown). Methods This retrospective study was based on anonymized nationwide administrative claims data of the German Local General Sickness Fund (AOK). Patients admitted for diseases of the appendix (ICD-10: K35-K38) or abdominal and pelvic pain (ICD-10: R10) who underwent an appendectomy (OPS: 5-470) were included. The study period included 6 weeks of German lockdown (16 March–26 April 2020) as well as 6 weeks before (03 February–15 March 2020) and after (27 April–07 June 2020). These periods were compared to the respective one in 2018 and 2019. Results The overall number of appendectomies was significantly reduced during the lockdown time in 2020 compared to that in 2018 and 2019. This decrease affects only appendectomies due to acute simple (ICD-10: K35.30, K35.8) and non-acute appendicitis (ICD-10: K36-K38, R10). Numbers for appendectomies in acute complex appendicitis remained unchanged. Female patients and in the age group 1–18 years showed the strongest decrease in number of cases. Conclusion The lockdown in Germany resulted in a decreased number of appendectomies. This affected mainly appendectomies in simple acute and non-acute appendicitis, but not complicated acute appendicitis. The study gives no evidence that the confinement measures resulted in a deterioration of medical care for appendicitis.

scholarly journals Epidemiology and health care utilization of patients suffering from Huntington’s disease in Germany: real world evidence based on German claims data

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christoph Ohlmeier ◽  
Kai-Uwe Saum ◽  
Wolfgang Galetzka ◽  
Dominik Beier ◽  
Holger Gothe
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Claims Data ◽  
Routine Care ◽  
Care Utilization ◽  
Research Database ◽  
Cross Sectional ◽  
Case Identification ◽  
Starting Point ◽  
Icd 10

Abstract Background Huntington’s disease (HD) is a rare, genetic, neurodegenerative and ultimately fatal disease with no cure or progression-delaying treatment currently available. HD is characterized by a triad of cognitive, behavioural and motor symptoms. Evidence on epidemiology and management of HD is limited, especially for Germany. This study aims to estimate the incidence and prevalence of HD and analyze the current routine care based on German claims data. Methods The source of data was a sample of the Institute for Applied Health Research Berlin (InGef) Research Database, comprising data of approximately four million insured persons from approximately 70 German statutory health insurances. The study was conducted in a retrospective cross-sectional design using 2015 and 2016 as a two-year observation period. At least two outpatient or inpatient ICD-10 codes for HD (ICD-10: G10) during the study period were required for case identification. Patients were considered incident if no HD diagnoses in the 4 years prior to the year of case identification were documented. Information on outpatient drug dispensations, medical aids and remedies were considered to describe the current treatment situation of HD patients. Results A 2-year incidence of 1.8 per 100,000 persons (95%-Confidence interval (CI): 1.4–2.4) and a 2-year period prevalence of 9.3 per 100,000 persons (95%-CI: 8.3–10.4) was observed. The prevalence of HD increased with advancing age, peaking at 60–69 years (16.8 per 100,000 persons; 95%-CI: 13.4–21.0) and decreasing afterwards. The most frequently observed comorbidities and disease-associated symptoms in HD patients were depression (42.9%), dementia (37.7%), urinary incontinence (32.5%), extrapyramidal and movement disorders (30.5%), dysphagia (28.6%) and disorders of the lipoprotein metabolism (28.2%). The most common medications in HD patients were antipsychotics (66.9%), followed by antidepressants (45.1%). Anticonvulsants (16.6%), opioids (14.6%) and hypnotics (9.7%) were observed less frequently. Physical therapy was the most often used medical aid in HD patients (46.4%). Nursing services and speech therapy were used by 27.9 and 22.7% of HD patients, respectively, whereas use of psychotherapy was rare (3.2%). Conclusions Based on a representative sample, this study provides new insights into the epidemiology and routine care of HD patients in Germany, and thus, may serve as a starting point for further research.

The Effects of the Initial English Language Learner Classification on Students’ Later Academic Outcomes

2017 ◽  
Vol 40 (2) ◽  
pp. 175-195 ◽  
Author(s):  
Nami Shin
Keyword(s):  
Academic Achievement ◽  
English Language Learners ◽  
Language Learners ◽  
English Language ◽  
Regression Discontinuity ◽  
Language Learner ◽  
Elementary Grades ◽  
Regression Discontinuity Design ◽  
State Laws ◽  
Positive Effects

Despite federal and state laws and regulations that require states and local districts to provide English language learners (ELLs) with support services, prior research has indicated that ELLs are, in general, lagging behind non-ELLs in academic achievement. An unanswered question is whether the initial designation of students as ELL influences their later academic achievement and how. Using a regression discontinuity design, this study compares the outcomes for students near the cutoff for being initially classified as ELL and initially fluent English proficient (IFEP) students. Among students near the cutoff, the classification had significant positive effects on ELLs’ academic achievement in elementary grades and, to some extent, in the later grades.

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