Biomedical subjects

John Mullahy

Publications and source records attributed to John Mullahy.

6 recordsLinked to original sources

PubMed2006

Willingness to pay for reducing fatal risk by improving air quality: a contingent valuation study in Chongqing, China.

In China, 76% of all energy comes from coal consumption, which is the major cause of air pollution. One of the major barriers to developing sound policies for controlling air pollution is the lack of information related to the value of the health consequences of air pollution. We conducted a willingness-to-pay (WTP) study using contingent valuation (CV) methods in Chongqing, China to estimate the economic value of saving one statistical life through improving air quality. A sample of 500residents was chosen based on multistage sampling methods. A face-to-face household interview was conducted using a series of hypothetical, open-ended scenarios followed by bidding game questions designed to elicit the respondents' WTP for air pollution reduction. The Two-Part Model was used for estimations. The results show that 96% of respondents were able to express their WTP. Their mean annual income is $490. Their WTP to save one statistical life is $34,458. Marginal increases for saving one statistical life is $240 with 1year age increase, $14,434 with 100yuan monthly income increase, and $1590 with 1year education increase. Unlike developed country, clean air may still be considered as a "luxury" good in China based on the estimation of income elasticity.

Air↗

PubMed2005

Variation in Chinese population health related quality of life: results from a EuroQol study in Beijing, China.

The purpose of this study is to measure Chinese population health related quality of life (HRQoL) using European quality of life (EQ-5D) instrument, to examine the validity of EQ-5D in measuring Chinese population HRQoL, to explore the relationships between EQ-5D and other health determinants, and to display the similarities and differences of HRQoL between the Chinese population and the populations of other countries. The data used in this study includes 2994 respondents whose age are 12 years and older, which is from the 2000 Beijing Household Health Survey. Univariate and bivariate analyses have been used to examine the level of HRQoL and the relationships between HRQoL and other variables. Multi-variate analyses have been used to explore the relationships between the EQ-5D Visual Analogue Scale (VAS) and the EQ-5D five dimension indicators. There are four principal findings from this study. First, the EQ-5D instrument is a valid measure for Chinese HRQoL, but with a significant ceiling effect. Second, Pain/ Discomfort and Anxiety/Depression are the major Chinese HRQoL problems and the extents of these problems differ in subgroup populations. Third, typically mean scores are lower for older age group; this is observed at lower ages in the Chinese population than in populations from developed countries. Fourth, Chinese HRQoL has strong association relationship with population socio-economic status (SES), which might imply that issues brought on by the rapid economic transition have both positive and negative impacts on Chinese HRQoL.

Adult↗

PubMed2005

Generalized modeling approaches to risk adjustment of skewed outcomes data.

There are two broad classes of models used to address the econometric problems caused by skewness in data commonly encountered in health care applications: (1) transformation to deal with skewness (e.g., ordinary least square (OLS) on ln(y)); and (2) alternative weighting approaches based on exponential conditional models (ECM) and generalized linear model (GLM) approaches. In this paper, we encompass these two classes of models using the three parameter generalized Gamma (GGM) distribution, which includes several of the standard alternatives as special cases-OLS with a normal error, OLS for the log-normal, the standard Gamma and exponential with a log link, and the Weibull. Using simulation methods, we find the tests of identifying distributions to be robust. The GGM also provides a potentially more robust alternative estimator to the standard alternatives. An example using inpatient expenditures is also analyzed.

Models, Statistical↗

PubMed2004

Comparing alternative models: log vs Cox proportional hazard?

Health economists often use log models (based on OLS or generalized linear models) to deal with skewed outcomes such as those found in health expenditures and inpatient length of stay. Some recent studies have employed Cox proportional hazard regression as a less parametric alternative to OLS and GLM models, even when there was no need to correct for censoring. This study examines how well the alternative estimators behave econometrically in terms of bias when the data are skewed to the right. Specifically we provide evidence on the performance of the Cox model under a variety of data generating mechanisms and compare it to the estimators studied recently in Manning and Mullahy (2001). No single alternative is best under all of the conditions examined here. However, the gamma regression model with a log link seems to be more robust to alternative data generating mechanisms than either OLS on ln(y) or Cox proportional hazards regression. We find that the proportional hazard assumption is an essential requirement to obtain consistent estimate of the E(y|x) using the Cox model.

Health Services Research↗

PubMed2003

Services integration and cost-effectiveness.

Alcohol treatment services are increasingly combined with other health and social services to address the needs of multiple-problem clients. Hence, it has been of growing policy interest to find the most effective and the most cost-effective ways of linking these services. This symposium presents some recent studies in this area. The small but growing body of studies in this area has great potential to inform public policy debates.

Alcoholism↗

PubMed2002

Factors influencing decisions regarding influenza vaccination and treatment: a survey of healthcare workers.

Surveys conducted in our healthcare facility evaluated factors associated with acceptance of influenza vaccination and opinions regarding influenza prevention and treatment and willingness to pay. Avoiding lost work and low risk were primary reasons for vaccine recipients and non-recipients, respectively. One-third of vaccine recipients would refuse vaccination if asked to pay at least $10.

Adolescent↗