Essays on the Determinants and Implications of Access to Health Care

Persistent Link:
http://hdl.handle.net/10150/556668
Title:
Essays on the Determinants and Implications of Access to Health Care
Author:
Hollingsworth, Alex
Issue Date:
2015
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
An understanding of both the determinants of health care access and the implications of that access is of crucial importance because it enables us to learn about policies and institutions that are welfare enhancing in health outcomes. The first chapter of my dissertation explores how access to sanitaria aided in tuberculosis control in the time before antibiotics. Results indicate that access to an additional sanitaria bed reduced the death rate from tuberculosis for white residents by nearly .695 per 100,000 and had no impact for black residents. The next two chapters investigate the retail health clinic. First, I construct a choice model of clinic location that accounts for both demand and competition effects. I find that clinics are more likely to locate in areas that are populous, wealthy, educated, and white, and that they are less likely to locate in traditionally underserved communities. Second, I combine the results of my predictive model with data on ED visits to determine if clinics help direct patients away from receiving treatment at expensive emergency rooms. I find that access to retail clinics causes a substantial decrease in the number of ED visits for bronchitis and upper respiratory infections. The savings associated with retail clinic induced ED diversion is conservatively estimated to be at least $88 million in 2012 alone. In California, counterfactual analysis suggests that relaxing the barriers to clinic entry would result in $10.5 million in annual health care savings.
Type:
text; Electronic Dissertation
Keywords:
Entry Model; Health Economics; Retail Clinics; Tuberculosis; Emergency Department Diversion
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Economics
Degree Grantor:
University of Arizona
Advisor:
Fishback, Price

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.titleEssays on the Determinants and Implications of Access to Health Careen_US
dc.creatorHollingsworth, Alexen
dc.contributor.authorHollingsworth, Alexen
dc.date.issued2015en
dc.publisherThe University of Arizona.en
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en
dc.description.abstractAn understanding of both the determinants of health care access and the implications of that access is of crucial importance because it enables us to learn about policies and institutions that are welfare enhancing in health outcomes. The first chapter of my dissertation explores how access to sanitaria aided in tuberculosis control in the time before antibiotics. Results indicate that access to an additional sanitaria bed reduced the death rate from tuberculosis for white residents by nearly .695 per 100,000 and had no impact for black residents. The next two chapters investigate the retail health clinic. First, I construct a choice model of clinic location that accounts for both demand and competition effects. I find that clinics are more likely to locate in areas that are populous, wealthy, educated, and white, and that they are less likely to locate in traditionally underserved communities. Second, I combine the results of my predictive model with data on ED visits to determine if clinics help direct patients away from receiving treatment at expensive emergency rooms. I find that access to retail clinics causes a substantial decrease in the number of ED visits for bronchitis and upper respiratory infections. The savings associated with retail clinic induced ED diversion is conservatively estimated to be at least $88 million in 2012 alone. In California, counterfactual analysis suggests that relaxing the barriers to clinic entry would result in $10.5 million in annual health care savings.en
dc.typetexten
dc.typeElectronic Dissertationen
dc.subjectEntry Modelen
dc.subjectHealth Economicsen
dc.subjectRetail Clinicsen
dc.subjectTuberculosisen
dc.subjectEmergency Department Diversionen
thesis.degree.namePh.D.en
thesis.degree.leveldoctoralen
thesis.degree.disciplineGraduate Collegeen
thesis.degree.disciplineEconomicsen
thesis.degree.grantorUniversity of Arizonaen
dc.contributor.advisorFishback, Priceen
dc.contributor.committeememberFishback, Priceen
dc.contributor.committeememberGowrisankaran, Gautamen
dc.contributor.committeememberJoiner, Keithen
dc.contributor.committeememberLanger, Ashleyen
dc.contributor.committeememberXiao, Moen
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