Essays in Health Economics: Empirical Studies on Employment-Based Health Insurance Plans and Hospice Care

dc.contributor.authorKicinger, Iwona M.
dc.creatorKicinger, Iwona M.
dc.description.abstractThis dissertation describes results of empirical studies addressing important issues in the field of health economics. The investigated problems include two major topic areas: employment-based health insurance plans and hospice care. In particular, we empirically examine the determinants of the employers’ contributions towards health insurance premiums, the price elasticity of demand in employer-provided self-insured health plans, and the effects of hospice ownership and certification on the length of hospice use. We extend previous empirical work on employment-based health insurance to self-insured health plans and show that union membership and self-insurance predict higher amounts of employer’s contribution to health insurance premiums. The obtained empirical evidence also indicates that several socioeconomic characteristics (i.e., family income, poverty level, and employer’s provision of fringe benefits) as well as other factors (i.e., sex, the place of residence, and family coverage) have impact on the employer’s contribution. The obtained estimates of the price elasticity of demand for self-insured health plans show it to be relatively inelastic. This agrees well with previous literature findings for traditional health insurance plans. The similarity of our results not only provides a relevant re-confirmation for these earlier measures but it also demonstrates that the demand responsiveness to changes in price for self-insured health plans does not differ from estimates of other types of health insurance. Our analysis of the effects of the ownership form and the certification status on hospice care shows a positive impact of the for-profit organizational form with respect to the length of hospice use as compared to their nonprofit counterparts. In particular, the obtained results suggest that among individuals with short expected length of hospice use, patients at nonprofit hospices have lower mortality while using hospice care. In contrast, among those with long expected length of hospice use, patients at for-profit hospices have longer survival times. There is, however, no evidence of systematic selection of long-stay patients by for-profit hospices or of short-stay patients by nonprofit hospices. Furthermore, the results of the impact of hospice certification show that the length of hospice use is shorter at certified hospices as compared to noncertified ones. All three problems investigated in this dissertation address key elements of the healthcare system in the US and hence the results reported should be relevant not only to policy makers, but also to parties directly involved in the healthcare system such as employers, insured and uninsured individuals, and insurance companies.
dc.subjectHealth insurance
dc.subjectPrice elasticity
dc.subjectHospice care
dc.subjectEmployer’s contribution
dc.titleEssays in Health Economics: Empirical Studies on Employment-Based Health Insurance Plans and Hospice Care
dc.typeDissertation Mason University of Philosophy in Economics


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