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Medical Treatment Effects

Paper Session

Sunday, Jan. 6, 2019 10:15 AM - 12:15 PM

Atlanta Marriott Marquis, International B
Hosted By: American Economic Association
  • Chair: Scott Barkowski, Clemson University

Decision Fatigue in Physicians

Han Ye
,
National University of Singapore
Junjian Yi
,
National University of Singapore
Songfa Zhong
,
National University of Singapore

Abstract

We explore the consequences of physician’s excessive workload from the perspective of decision fatigue—the decline in decision quality due to an increased number of patients and decisions. Leveraging an administrative dataset of 240,000 emergency department visits, we find that increased number of patients decreases inpatient admission rates, task orders, and patient length of stay. Subsequently, both patient revisit rates and mortality rates increase. The results are robust if we use the number of ambulance arrivals as an instrumental variable. Furthermore, we find that the observed consequences in physician decision-making can be alleviated by taking a break and by accumulated medical experience.

Medical Marijuana Laws and Mental Health in the United States

Alois Stutzer
,
University of Basel
Reto Odermatt
,
University of Basel and London School of Economics
Jörg Kalbfuss
,
University of Cambridge

Abstract

The consequences of legal access to medical marijuana for individual welfare are amatter of controversy. We contribute to the ongoing discussion by evaluating the impactof the staggered introduction and extension of medical marijuana laws across US stateson self-reported mental health. Our main analysis is based on BRFSS survey data frommore than six million respondents between 1993 and 2015. On average, we find thatmedical marijuana laws lead to a reduction in the self-reported number of days with mental health problems. Reductions are largest for individuals with high propensitiesto consume marijuana for medical purposes and people who are likely to suffer from chronic pain. Moreover, the introduction of prescription drug monitoring programs leadto a reduction in bad mental health days only in states that allow medical marijuana.

The Effect of Maternal Education on Offspring’s Mental Health

Daniel Graeber
,
German Institute for Economic Research
Daniel Dominik Schnitzlein
,
Leibniz University Hannover

Abstract

Worldwide, mental health conditions are a leading cause of disability-adjusted life years and health costs. The sum of direct and indirect costs worldwide were estimated to amount to 2.5 trillion US Dollar in 2010 and projected to increase to 6 trillion US Dollar in 2030. Given that societal and economic burden, it becomes increasingly important to understand the determinants of mental health.
We estimate the effect of maternal education on the offspring's mental health in adulthood. Theoretical considerations are ambiguous about a causal effect of maternal education on the offspring’s mental health. To identify the causal effect of maternal education, we exploit exogenous variation in maternal years of schooling, caused by a compulsory schooling law (CSL) reform in Germany, which is completely unrelated to the offspring’s mental health. This CSL reform increased the years of compulsory years of education from 8 to 9 years. We exploit this CSL reform by means of a 2SLS strategy.
The data we use is the Socio-Economic Panel (SOEP) and the outcomes for the offspring’s mental health are the Mental Component Summary (MCS) score, based on answers to the SF-12 questionnaire included in the (SOEP), as well as life satisfaction and an indicator for being at risk of a depression based on the MCS score.
Our empirical results suggest a negative effect of maternal education on the daughters’ mental health. One year of additional schooling for the mother decreases the MCS score of the daughter by about 26 percent of a s.d. and the likelihood of being at risk of a depression by about 11 p.p.s. We find no effects for the sons. Moreover, we provide suggestive evidence that improvements in the maternal home environment, as a result of the CSL reform, are not able to explain our results. Thus, we can rule out these as potential channels.

Influenza Vaccines, Employee Health and Sickness Absence-A Field Experiment at the Workplace

Manuel Hoffmann
,
Texas A&M University
Roberto Mosquera
,
Texas A&M University
Adrian Chadi
,
University of Konstanz

Abstract

While flu vaccination increases individual immunity by generating antibodies, individual behavior can counter these benefits. Vaccination rates fall short of levels that could prevent costly epidemics, and moral hazard can counter the effectiveness of the vaccine. We study how economic factors affect the decision to vaccinate, and whether changes in behavior affect the effectiveness of the vaccine. We partnered with a bank in Ecuador that allowed us to experimentally modify its annual vaccination program. A rich dataset of administrative records and employee surveys allow us to discuss the mechanisms behind our results on both determinants and effectiveness of flu vaccination. We find that opportunity costs play an important role in vaccine take-up. Take-up doubles by assigning employees to get the flu shot during a workday compared to Saturday. Peers’ take-up also increases individual take-up in a meaningful way. With respect to the effectiveness of the vaccine, while the time-exact data shows there is a negative correlation between getting a flu shot and cases of flu-related illnesses, the effect of exogenous vaccination is a precise zero. We present evidence consistent with a change towards riskier behavior that suggests that vaccinated individuals expose themselves more to the virus, and rule out other potential mechanisms.
JEL Classifications
  • I0 - General