On the Role of Health in the Labor Market

Do physicians respond to financial incentives? We address this question by analyzing the prescription behavior of physicians who are allowed to dispense drugs themselves through onsite pharmacies. Using administrative data comprising over 16 million drug prescriptions between 2008 and 2012 in Upper Austria, a naïve comparison of raw figures reveals that self-dispensing GPs induce 33.2% higher drug expenses than others. Our identification strategy rests on multiple pillars: First, we use an extensive array of covariates along with multi-dimensional fixed effects which account for patient and GP-level heterogeneity as well as sorting of GPs into onsite pharmacies. Second, we use a novel approach that allows us to restrict our sample to randomly allocated patient-GP matches which rules out endogenous sorting as well as principal-agent bargaining over prescriptions between patients and GPs. LAST UPDATED FEBRUARY 22, 2018 ALEXANDER AHAMMER · CURRICULUM VITAE 1 Contrary to our descriptive analysis, we find evidence that onsite pharmacies have a small negative effect on prescriptions. Although self-dispensing GPs seem to prescribe sligthly more expensive medication, this effect is absorbed by a much smaller likelihood to prescribe something in the first place, causing the overall effect to be negative. Ahammer, Alexander and Stefan Kranzinger (2017), ‘Poverty in Times of Crisis,’Working Paper No. 1703, University of Linz · Submitted · [Paper] Abstract This paper evaluates the impact of a largemacroeconomic shock on poverty. In particular, we use longitudinal data from the European Survey on Income and Living Conditions (EU-SILC) comprising almost two million individuals from 29 European countries in order to quantify changes in poverty transition patterns caused by the 2007 global financial crisis. Because the crisis was largely unforeseeable, it provides an appealing natural experiment allowing us to isolate the causal effect of a substantial macroeconomic shock on poverty. Employing semiparametric mixed discrete time survival analysis, we find that conditional poverty entry hazards increased temporarily by 13.4% during the crisis, while post-crisis they are estimated to be 15.7% lower than before. Not only entry hazards have decreased, also conditional exit hazards are estimated to be 31.4% lower post-crisis compared to before. Ceteris paribus, the crisis therefore hasmade it more difficult to slip into poverty, yet those whowere already poor face substantially lower prospects to escape. Exploring determinants of poverty transitions, we find that being retired, having a permanent job, owning one’s dwelling instead of renting it, age, marital status, and household size are themost important protective factors against poverty. Finally, we show that mostly a housing cost overburden seems to be responsible for the persistence of poverty.This paper evaluates the impact of a largemacroeconomic shock on poverty. In particular, we use longitudinal data from the European Survey on Income and Living Conditions (EU-SILC) comprising almost two million individuals from 29 European countries in order to quantify changes in poverty transition patterns caused by the 2007 global financial crisis. Because the crisis was largely unforeseeable, it provides an appealing natural experiment allowing us to isolate the causal effect of a substantial macroeconomic shock on poverty. Employing semiparametric mixed discrete time survival analysis, we find that conditional poverty entry hazards increased temporarily by 13.4% during the crisis, while post-crisis they are estimated to be 15.7% lower than before. Not only entry hazards have decreased, also conditional exit hazards are estimated to be 31.4% lower post-crisis compared to before. Ceteris paribus, the crisis therefore hasmade it more difficult to slip into poverty, yet those whowere already poor face substantially lower prospects to escape. Exploring determinants of poverty transitions, we find that being retired, having a permanent job, owning one’s dwelling instead of renting it, age, marital status, and household size are themost important protective factors against poverty. Finally, we show that mostly a housing cost overburden seems to be responsible for the persistence of poverty. Ahammer, Alexander and Thomas Schober (2017), ‘Exploring Variations in Healthcare Expenditures –What is the Role of Practice Styles? ,’Working Paper No. 1705, University of Linz · Submitted · [Paper] · [Slides] Abstract Variations in the use of medical resources, both across and within geographical regions, have been widely documented. Whenever these variations cannot be explained by differences in patient needs or preferences, they may result in some individuals being over-treated, while others are under-treated, thus raising questions on the equity and efficiency of healthcare systems. One explanation for these variations is differences inmedical practice styles; that is, physiciansmay develop their own treatment patterns based on their beliefs about the efficacy of medical interventions. We use a large administrative data set from Upper Austria to study the practice styles among primary care physicians. We decompose the use of healthcare services into patient characteristics, patient and physician fixed effects, and stochastic health shocks. Physician fixed effects are interpreted as a measure of practice styles, which are then related to observable physician characteristics and to attributes of the local healthcare sector.Variations in the use of medical resources, both across and within geographical regions, have been widely documented. Whenever these variations cannot be explained by differences in patient needs or preferences, they may result in some individuals being over-treated, while others are under-treated, thus raising questions on the equity and efficiency of healthcare systems. One explanation for these variations is differences inmedical practice styles; that is, physiciansmay develop their own treatment patterns based on their beliefs about the efficacy of medical interventions. We use a large administrative data set from Upper Austria to study the practice styles among primary care physicians. We decompose the use of healthcare services into patient characteristics, patient and physician fixed effects, and stochastic health shocks. Physician fixed effects are interpreted as a measure of practice styles, which are then related to observable physician characteristics and to attributes of the local healthcare sector. Ahammer, Alexander, Mario Lackner, and Jasmin Voigt (2018), ‘Does Confidence Enhance Performance? — Causal Evidence from Professional Biathlon,’Working Paper No. 1718, University of Linz · Submitted · [Paper] Abstract Weanalyze the effect of self-confidence onperformance using data from top-level professional biathlon competitions. Biathlon combines two independent tasks: cross-country skiing and rifle shooting. We exploit this dual nature of the sport by usingweather conditions affecting performanceon the skiing track as exogenous variation in confidenceon the shooting range. Using round-level data on 254 competitions between 2009 and 2013, we show that the less confident athletes are, theworse their performance is on the shooting range. In particular, we estimate an increase of 0.525 standard deviations in missed shots for every standard deviation increase in our inverse self-confidence measure. Effects for women are estimated to be generally smaller in magnitude and less robust.Weanalyze the effect of self-confidence onperformance using data from top-level professional biathlon competitions. Biathlon combines two independent tasks: cross-country skiing and rifle shooting. We exploit this dual nature of the sport by usingweather conditions affecting performanceon the skiing track as exogenous variation in confidenceon the shooting range. Using round-level data on 254 competitions between 2009 and 2013, we show that the less confident athletes are, theworse their performance is on the shooting range. In particular, we estimate an increase of 0.525 standard deviations in missed shots for every standard deviation increase in our inverse self-confidence measure. Effects for women are estimated to be generally smaller in magnitude and less robust.