Socioeconomic inequity in long-term care use in Europe

We investigate the determinants of the use of long-term care services provided at home as well as the degree of horizontal inequity that may exist in the use of this type of services for a sample of dependent individuals living in Netherlands, Denmark, Sweden, Italy and Spain, using data from 2006/2007. The results suggest that there is not an equitable distribution of use of formal home care and informal care across the selected countries. Pro-poor inequity is found for formal home care in the Netherlands, Denmark and Sweden while Italy and Sweden shows a pro-rich distribution of use when analyzing nursing/personal home care exclusively. With respect to informal care no evidence of inequity was found for all the countries except Sweden. However, in the case of intensive informal care use pro-poor inequity was found in The Netherlands, Sweden and Italy.Se investigan los determinantes del uso de los servicios de cuidados paliativos brindados exclusivamente en el hogar, así como el grado de inequidad horizontal que puede existir en el uso de este tipo de servicios, para una muestra de personas dependientes residentes en los Países Bajos, Dinamarca, Suecia, Italia y España, utilizando datos de 2006/2007. Los resultados sugieren que no existe una distribución equitativa del uso de este tipo de servicios para el caso que sean proporcionados en el hogar por personal profesional; y mediante medios informales, en los países seleccionados. En particular, se encuentra que existe inequidad pro-pobre en la atención brindada en el hogar por personal profesional en los Países Bajos, Dinamarca y Suecia, mientras que Italia y Suecia muestran una distribución de uso pro rica al analizar exclusivamente la atención domiciliaria de enfermería y asistencia personal. Con respecto al cuidado informal, no se encontró evidencia de inequidad en todos los países, excepto Suecia. Sin embargo, en el caso del uso intensivo del cuidado informal, se encontró inequidad pro-pobre en los Países Bajos, Suecia e ItaliaThe SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812) and FP7 (SHARE-PREP: N°211909, SHARE-LEAP: N°227822, SHARE M4: N°261982). Additional funding from the German Ministry of Education and Research, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064) and from various national funding sources is gratefully acknowledged (see www.share-project.org)

Terrorist attacks, Islamophobia and newborns’health [WP]

Islamophobia has increased in recent years which can be partly attributed to terrorist attacks perpetrated by jihadist groups. Islamophobia might be a source of stress, being problematic for pregnant (Muslim) women. We examine how stress generated by the 2017 Catalonia (Spain) attacks affected the health of newborns whose mothers are from a Muslim country (as the perpetrators). We use a difference-in-differences-in-differences model comparing newborns whose mothers come from a Muslim country and are residing in a municipality directly affected by the attacks, to other newborns, before-after the attacks. Results show that the share of low-birth-weight babies and deliveries with complications raise significantly by 23.77%, and 13.02%. We document a significant increase in Islamophobia and in emotional distress in our treated group. We conclude that one of the channels contributing to the deterioration of those newborns health is the stress faced by their mothers that resulted from the increase in Islamophobia

Job competition in civil servant public examinations and sick leave behavior

In several countries the entry system to access public service positions is the traditional public examination procedure. In this setting, candidates have to take passing exams that require a huge load of material to study, and therefore time. Candidates who are working while preparing the public exam may find it difficult to devote enough time to both tasks. Thus, they might experience increased stress/anxiety related to high stakes civil service recruitment testing. In this paper, we investigate the impact of new openings of civil servant positions on sickness absences. Using a unique administrative dataset on the universe of sickness absences and civil servant positions offered in Spain from 2009 to 2015, we find a significant increase in health-related absences several months before the examination date. In particular, this effect is stronger for individuals working in the educational sector as well as for calls offering a large number of positions. This effect is mostly driven by stress related absences. Finally, using data on medical visits (GP and specialist) we find evidence consistent with a deterioration in public sector workers’ health. Our results are important from a policy perspective as they highlight the existence of important negative consequences of the civil service recruitment process that have been previously overlooked

Inequidades socioeconómicas en el uso de servicios sanitarios de atención primaria en Ecuador

En América Latina existen escasos estudios sobre desigualdades socioeconómicas en variables de salud y pocos que analizan inequidades en el uso de servicios sanitarios. Este trabajo investiga los determinantes del uso de servicios sanitarios públicos de atención preventiva y curativa de atención primaria, además de la inequidad horizontal mediante el cálculo del índice de inequidad horizontal de la población adulta en Ecuador, utilizando datos del año 2012. Los resultados muestran que no existe evidencia de inequidad horizontal en el uso de estos servicios. Sin embargo, se encuentra que los grupos indígenas, individuos sin ningún tipo de seguro, sin educación y residentes en la región de la costa urbana muestran una menor probabilidad de uso de ambos tipos de servicios

Productividad Total de los Factores en el sector manufacturero ecuatoriano: Evidencia a nivel de empresas

Esta investigación fue presentada en el XXV Encuentro de Economía Pública desarrollado en Valencia, España en enero del 2018El objetivo de este trabajo es analizar la producción del sector manufacturero ecuatoriano y generar, a la vez, una medida de productividad empresarial, provincial, regional y de actividad industrial para el periodo 2007 – 2016. Para esto se estima una función de producción a nivel de empresa con la metodología tradicional en un marco empírico simple al estilo Cobb Douglas con los insumos tradicionales: capital, empleo y materias primas. Para esta estimación se utilizó un modelo dinámico como el GMM-SYS de tal manera que se minimizó el problema de simultaneidad y endogeniedad. Una vez estimada la función de producción se calculó la productividad total de los factores (PTF). Como principales conclusiones se obtienen que el insumo que más contribuye al ingreso por venta de las empresas es el consumo de materias primas, seguido del número de trabajadores y finalmente el de activo fijo netos, también se encuentra que la PTF presenta un patrón de crecimiento que coincide con los movimientos del PIB a lo largo del periodo, se encuentra evidencia a favor de una relación positiva entre la PTF y el tamaño de la firma y la región en la que se ubica, además se obtuvo las provincias y subsectores manufactureros más productivos del paísThe purpose of this research is to analyze the production of the Ecuadorian manufacturing sector and generate a measure of business productivity, provincial, regional and industrial activity in the period 2007 – 2016. As a result, it is estimated a production function at firm level with the traditional methodology in a simple empirical framework in Cobb Douglas style with traditional inputs: capital, employment and raw materials. For this estimation a dynamic model such as GMM-SYS was used in such a way that the problem of simultaneity and endogenity was minimized. Once the production function was estimated, the total factor productivity (TFP) was calculated. As main conclusions we obtained that the major input contribution to the firms sales revenue was the consumption of raw materials, followed by the number of workers and finally the net fixed assets, we also found that the TFP presents a growth pattern that coincides with GDP movements throughout the period; there is evidence in favor of a positive relationship between the TFP and firm size and the region in which it is located, in addition we obtained the most productive provinces and manufacturing subsectors of the countr

Essays in Health Economics

[eng] Health across the life cycle is an important component of well-being and quality of life. Bad health is linked to negative child and adulthood socioeconomic outcomes such as educational achievement, future health, and earnings (Almond et al., 2005; Black et al., 2007; Almond and Currie, 2011; Currie and Vogl, 2013). This thesis contributes to two research lines in the field of health economics. The first line, with two chapters, focuses on health at birth outcomes, and the second one, also with two chapters, explores changes in workers' health and how health shocks can affect women’s labor market outcomes. With respect to the first research line, health outcomes at all stages of life are of relevance both for individuals and societies. There is vast literature showing that good health, especially health at birth, is associated with better outcomes in terms on wages, education attainment and human capital development. Health at birth can be influenced by many factors, for instance, stress during pregnancy that, according to the medical literature, has been demonstrated to have detrimental effects on newborns’ health (Rondó et al., 2003; Beydoun and Saftlas, 2008; Torche, 2011; Khashan et al., 2008). Economic literature assessing the effects of exogenous sources of stress (earthquakes, bombs, terrorist attacks) on birth outcomes is not very rich and has focused only on the general pregnant women population. The second chapter of this thesis focuses on assessing the effect of in-utero exposure to stress, generated by terrorist attacks, on the health of newborns of Muslim mothers. Another factor that can affect health at birth is mother's substance use/abuse. Chapter 3 explores how a public policy aimed at not criminalizing drug use may be linked to increased women's drug use and bad newborn's health. The results from these two chapters point to detrimental health at birth. Thus, Chapter 2 finds that in-utero exposure to stress is linked to low birth weight and complications during pregnancy. Likewise, Chapter 3 finds that the share of low birth weight and very low birth weight newborns raises significantly in provinces initially more exposed to drugs as a possible consequence of a policy that established maximum permissible amounts of possession of illicit substances for personal consumption in Ecuador. In addition, this chapter shows evidence that supports an increase in neonatal hospitalizations to medical conditions related to maternal drug use/abuse. With respect to the second research line, in Chapter 4, this dissertation explores how the traditional civil servant recruitment process, that uses public examinations as means of access, may affect workers sick leave behavior. In this setting, candidates have to take passing exams that require a huge load of material to study, and therefore time. Candidates working while preparing for public exams may find it difficult to spend enough time on both tasks. Thus, they might experience increased stress/anxiety related to public service entrance exams. Using novel administrative data, this chapter finds a significant increase in health-related work absences several months before the examination date. This effect is stronger for individuals working in the education sector as well as for calls offering a large number of positions. This effect is mostly driven by stress-related absences. This chapter also finds evidence consistent with a deterioration in public sector workers’ health. Finally, the last empirical chapter of this dissertation examines whether lockdown policies during the first wave of the Covid-19 pandemic differently hit formal employment for women as compared to those of men in the Ecuadorian labor market. The results show that the lockdown policy is associated with an increase in the number of unemployment spells of women working in the restricted economic activities, during the first wave of the Covid-19. In sum, this dissertation contributes to the literature studying the impact that exogenous events may have on health, with a particular focus on newborn's and worker's health

Essays in Health Economics

Programa de Doctorat en Economia[eng] Health across the life cycle is an important component of well-being and quality of life. Bad health is linked to negative child and adulthood socioeconomic outcomes such as educational achievement, future health, and earnings (Almond et al., 2005; Black et al., 2007; Almond and Currie, 2011; Currie and Vogl, 2013). This thesis contributes to two research lines in the field of health economics. The first line, with two chapters, focuses on health at birth outcomes, and the second one, also with two chapters, explores changes in workers' health and how health shocks can affect women’s labor market outcomes. With respect to the first research line, health outcomes at all stages of life are of relevance both for individuals and societies. There is vast literature showing that good health, especially health at birth, is associated with better outcomes in terms on wages, education attainment and human capital development. Health at birth can be influenced by many factors, for instance, stress during pregnancy that, according to the medical literature, has been demonstrated to have detrimental effects on newborns’ health (Rondó et al., 2003; Beydoun and Saftlas, 2008; Torche, 2011; Khashan et al., 2008). Economic literature assessing the effects of exogenous sources of stress (earthquakes, bombs, terrorist attacks) on birth outcomes is not very rich and has focused only on the general pregnant women population. The second chapter of this thesis focuses on assessing the effect of in-utero exposure to stress, generated by terrorist attacks, on the health of newborns of Muslim mothers. Another factor that can affect health at birth is mother's substance use/abuse. Chapter 3 explores how a public policy aimed at not criminalizing drug use may be linked to increased women's drug use and bad newborn's health. The results from these two chapters point to detrimental health at birth. Thus, Chapter 2 finds that in-utero exposure to stress is linked to low birth weight and complications during pregnancy. Likewise, Chapter 3 finds that the share of low birth weight and very low birth weight newborns raises significantly in provinces initially more exposed to drugs as a possible consequence of a policy that established maximum permissible amounts of possession of illicit substances for personal consumption in Ecuador. In addition, this chapter shows evidence that supports an increase in neonatal hospitalizations to medical conditions related to maternal drug use/abuse. With respect to the second research line, in Chapter 4, this dissertation explores how the traditional civil servant recruitment process, that uses public examinations as means of access, may affect workers sick leave behavior. In this setting, candidates have to take passing exams that require a huge load of material to study, and therefore time. Candidates working while preparing for public exams may find it difficult to spend enough time on both tasks. Thus, they might experience increased stress/anxiety related to public service entrance exams. Using novel administrative data, this chapter finds a significant increase in health-related work absences several months before the examination date. This effect is stronger for individuals working in the education sector as well as for calls offering a large number of positions. This effect is mostly driven by stress-related absences. This chapter also finds evidence consistent with a deterioration in public sector workers’ health. Finally, the last empirical chapter of this dissertation examines whether lockdown policies during the first wave of the Covid-19 pandemic differently hit formal employment for women as compared to those of men in the Ecuadorian labor market. The results show that the lockdown policy is associated with an increase in the number of unemployment spells of women working in the restricted economic activities, during the first wave of the Covid-19. In sum, this dissertation contributes to the literature studying the impact that exogenous events may have on health, with a particular focus on newborn's and worker's health

Evaluación de la competencia en el sector de la banca privada en Ecuador: Un enfoque econométrico con el modelo Panzar-Rosse

This paper assesses empirically the competitive conditions in the private banking sector in Ecuador from 2000 to 2015. First, we measure the competition in the private banking sector, using the Panzar-Rosse H-statistic by the total revenue equation; we apply POLS, year fixed effects, bank fixed effects, and random effects. Second, we determine whether there is equilibrium in the long run in this sector by ROA regression equation and finally we aim to identify evidence of economies of scale in the private banking sector. In this path, we analyze three different panels, 2000 – 2015, 2000 – 2006 and 2007 – 2015. The main results indicate that private banks in Ecuador operate under monopolistic competition. In addition, this competition increased during the 2007 – 2015 period; other result shows that there is no equilibrium in the long run for this sector. Finally, there are not economies of scale, therefore we can argue that small banks do not operate with disadvantages compared to medium and large banksEste documento evalúa empíricamente las condiciones de competencia en el sector de la banca privada en Ecuador de 2000 a 2015. Primero, medimos la competencia en el sector de la banca privada, utilizando el estadístico H de Panzar-Rosse por la ecuación de ingresos totales; aplicamos POLS, efectos fijos de año, efectos fijos de bancos y efectos aleatorios. En segundo lugar, determinamos si hay equilibrio a largo plazo en este sector mediante la ecuación de regresión del ROA y, finalmente, buscamos identificar evidencia de economías de escala en el sector de la banca privada. En este camino, analizamos tres paneles diferentes, 2000 - 2015, 2000 - 2006 y 2007 - 2015. Los principales resultados indican que los bancos privados en Ecuador operan bajo competencia monopólica. Además, esta competencia aumentó durante el período 2007 - 2015; otro resultado muestra que no hay equilibrio a largo plazo para este sector. Finalmente, no hay economías de escala, por lo tanto, podemos argumentar que los bancos pequeños no operan con desventajas en comparación con los bancos medianos y grande

Inequidades socioeconómicas en el uso de servicios sanitarios de atención primaria en Ecuador

En América Latina existen escasos estudios sobre desigualdades socioeconómicas en variables de salud y pocos que analizan inequidades en el uso de servicios sanitarios. Este trabajo investiga los determinantes del uso de servicios sanitarios públicos de atención preventiva y curativa de atención primaria, además de la inequidad horizontal mediante el cálculo del índice de inequidad horizontal de la población adulta en Ecuador, utilizando datos del año 2012. Los resultados muestran que no existe evidencia de inequidad horizontal en el uso de estos servicios. Sin embargo, se encuentra que los grupos indígenas, individuos sin ningún tipo de seguro, sin educación y residentes en la región de la costa urbana muestran una menor probabilidad de uso de ambos tipos de servicios