Essays in Health Economics [before doctoral defense]

Kivonat, rövid leírás

1. Women’s Bargaining Power and Household Budget Allocation to Human Capital: Evidence from The Indonesia Family Life Survey (IFLS) In this paper, we explore the association of women’s bargaining power with human capital investment within the household. Using data from the Indonesia Family Life Survey (IFLS), wave 5, we estimate the determinants of bargaining power with multinomial logit models and the association of bargaining power with food, bad goods, education, and health spending with OLS regression models. We find that the wife’s higher education level increases the probability of her sole bargaining power in food spending and of joint husband-wife decision-making in education and health spending. The share of food spending is largest in households with joint decision making, the share of spending on bad goods is largest in households where women have no bargaining power, while the association of bargaining power with education and child health spending is more heterogeneous and domain-specific. 2. The Geographic Variations In Utilization of Healthcare Services In China: Evidence From The China Health and Retirement Longitudinal Study (CHARLS) Background: This study examines the key drivers of geographic variation in healthcare utilization in China among adults aged 45 and older, with a focus on disparities in outpatient and inpatient services. Methods: Using nationally representative panel data, I apply econometric techniques, including fixed effects and difference-in-differences models, to analyze regional differences in healthcare use and the role of rural–urban mobility. Results: On the demand side, socioeconomic status, health condition, insurance type, gender, and age strongly influence access to care. Rural residents are more likely to use outpatient services, whereas urban residents have a higher probability of inpatient admission. In wealthier regions, inpatient utilization is significantly lower, while outpatient use remains stable. On the supply side, infrastructure capacity also shapes utilization patterns, though demand-side factors play a more dominant role. Migration between rural and urban areas does not independently affect utilization once fixed effects are considered. Instead, economic context, declining self-rated health, and broader temporal trends are the main drivers of increasing outpatient and inpatient use. Conclusions: Despite progress from recent health reforms in China, institutional frictions and structural imbalances continue to shape healthcare utilization. To promote equity and efficiency, future reforms should prioritize integrating insurance systems, improving benefit portability, and balancing investments between outpatient and inpatient care. 3. The Impact of Change in Health Insurance on Utilization of Healthcare Services in China: Evidence from the China Health and Retirement Longitudinal Study (CHARLS) In 2016, the government initiated a major reform to merge fragmented rural and urban resident schemes into a single program, namely the New Cooperative Medical Scheme (NCMS) and the Urban Resident Basic Medical Insurance (URBMI) into the unified Urban and Rural Resident Basic Medical Insurance (URRBMI). This paper evaluates the effects of the integration on healthcare utilization and rural–urban disparities using panel data from five waves (2011–2020) of the China Health and Retirement Longitudinal Study (CHARLS). The analysis combines pooled OLS regressions, an intention-to-treat (ITT) difference-in-differences framework, and event study models, exploiting Urban Employee Basic Medical Insurance (UEBMI) participants as a control group and NCMS participants in the pre-reform period as the treatment group. Results show no strong differences in utilization between NCMS and urban participants prior to integration, but uninsured individuals were clearly disadvantaged. During the transition period, NCMS participants experienced a temporary decline in outpatient and inpatient use relative to controls, consistent with short-term administrative frictions. By the post-integration period, however, these disparities narrowed, with NCMS participants comparable to UEBMI in both outpatient and inpatient utilization. The findings indicate that the integration contributed to reducing rural–urban disparities in healthcare utilization but has yet to deliver substantial improvements in financial protection.