Empirical essays on the economics of healthcare and education

Thesis

This thesis consists of two chapters on healthcare and one chapter on education. Scholars and policy-makers have long recognised that health and education are important components of human capital, which in turn affect individual welfare and economic growth. This thesis aim to enhance our understanding of the drivers of healthcare quality, health outcomes, and educational performance.

The first two chapters focus on supply- and demand-side factors that affect healthcare quality and outcomes. In Chapter 1, I explore the impacts of a pay-for-performance scheme that creates asymmetric incentives for hospitals to provide quality care cross different patient groups. I find that these incentives improve outcomes for targeted patients and have positive spillover effects on patients for whom hospitals are not explicitly incentivised to improve quality, suggesting that there are complementarities in quality provision within hospitals. These results suggest that asymmetric incentives across groups need not disadvantage the group with "low-powered" incentives.

In Chapter 2, I explore the impacts of health insurance on hospital readmissions among heart attack patients, focusing on demand-side responses to changes in insurance characteristics. Using the age-65 eligibility threshold for Medicare as a source of variation in insurance coverage, I estimate discontinuities in 30 day readmissions and treatment intensity. Among men, there is evidence that eligibility for Medicare insurance increases 30-day readmission rates and that treatment intensity is smooth across the age threshold. These findings suggest that in addition to provider-side factors, the focus of the existing literature, patient side factors also matter for post-discharge outcomes.

In Chapter 3, co-authored with Sami Miaari, we examine the impact of conflict-related mobility restrictions on educational outcomes in the West Bank between 2000 to 2006 during the Israeli-Palestinian conflict. A prominent feature of this conflict is the system of mobility restrictions enforced through various physical barriers such as checkpoints. We find strong evidence that mobility restrictions in the form of checkpoints have adverse impacts on educational performance. There is evidence that three mechanisms could explain this effect: students lose time when crossing checkpoints on journeys to school, students’ psychological wellbeing is negatively impacted by exposure to conflict, and physical resources at schools are negatively affected by mobility restrictions.

Authors: Lee, I

• DOI: 10.5287/ora-jvkqzxzqy
• Type of award: DPhil
• Level of award: Doctoral
• Awarding institution: University of Oxford
• Language: English
• Keywords: Education; Conflict; Health insurance; Incentives; Health
• Subjects: Health economics; Economics; Economics of education