Children's Health Care Utilization and Cost in the Last Year of Life: A Cohort Comparison with and without Regional Specialist Pediatric Palliative Care

Author(s):  
David L. Lysecki ◽  
Sumit Gupta ◽  
Adam Rapoport ◽  
Emily Rhodes ◽  
Sarah Spruin ◽  
...  
2016 ◽  
Vol 131 (2) ◽  
pp. 687-738 ◽  
Author(s):  
David Cesarini ◽  
Erik Lindqvist ◽  
Robert Östling ◽  
Björn Wallace

Abstract We use administrative data on Swedish lottery players to estimate the causal impact of substantial wealth shocks on players’ own health and their children’s health and developmental outcomes. Our estimation sample is large, virtually free of attrition, and allows us to control for the factors conditional on which the prizes were randomly assigned. In adults, we find no evidence that wealth impacts mortality or health care utilization, with the possible exception of a small reduction in the consumption of mental health drugs. Our estimates allow us to rule out effects on 10-year mortality one sixth as large as the cross-sectional wealth-mortality gradient. In our intergenerational analyses, we find that wealth increases children’s health care utilization in the years following the lottery and may also reduce obesity risk. The effects on most other child outcomes, including drug consumption, scholastic performance, and skills, can usually be bounded to a tight interval around zero. Overall, our findings suggest that in affluent countries with extensive social safety nets, causal effects of wealth are not a major source of the wealth-mortality gradients, nor of the observed relationships between child developmental outcomes and household income.


2020 ◽  
Vol 19 (3) ◽  
pp. 771-801
Author(s):  
Kathryn Freeman Anderson

Research has demonstrated health care consequences of racial/ethnic residential segregation. Here, I test one possible mechanism—the distribution of community health care organizations and service providers across urban communities. Using data from a 2013 survey on children's health care utilization in the Phoenix urbanized area combined with data on a 2013 census of health care organizations, I estimate a series of statistical models in order to test this relationship. I find that Latino and Native American segregation is related to a lower density of health care organizations. Furthermore, the lack of these resources increases the odds of a family using a clinic, versus a physician's office, which is a more ideal source of care. Finally, a higher rate of racial/ethnic clustering is also related to greater utilization of a clinic, as opposed to a physician's office, and this association is partially mitigated by distribution of health care organizations.


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