Author: Ioana Sofia Pacurar

Publisher:

Published: 2014

Total Pages:

ISBN-13:

This doctoral dissertation comprises essays in Applied Microeconomics with focus in Health and Regional Economics. The first investigates a neo-classical hospital production model for cost and quality implications by payment source in the context of the 2010 Affordable Care Act. The second essay demonstrates positive crime effects induced by Hurricane Katrina population migration. Specifically, the first essay evaluates hospital cost efficiecies emanating from changes in public reimbursement levels and/or shifts in hospital care demand or health care budgets. Using 2000-2008 data from Tennessee Joint Annual Reports of Hospitals, hybrid generalized translog multi-product cost functions were estimated with controls for multi-dimensional quality, diagnostic mix, and hopital heterogeneity. The production technology cost model, accounting for technological change and geographic effects, was estimated using the Iterative Seemingly Unrelated Regression methodology. Factor demand elasticities, alternative conceptual measures of the elasticites of substitution, scale and scope economies were evaluated. This is the first study to quantify opportunities for exploiting scope economies by payer type (e.g., Medicaid/Tenncare with private payers). Policy implications were explored. Using a natural experiment, the second essay tests an empirical link between the forced evacuation and crime types countrywide and in Houston, TX, while avoiding concerns of endogeneity due to selection or simultaneity. Few prior economic studies of Katrina probed impacts on host labor markets or on evacuees' labor and schooling outcomes, overlooking potential effects on local crime in spite of anecdotal evidence. To ensure identification with a Difference-in-Difference specification, the number of evacuees going to a metropolitan area was instrumented by its distance to New Orleans, LA. Katrina immigration was found to rise the incidence of murder and non-negligent manslaughter, robbery, and motor vehicle theft. The analysis of Houston post-shelter consequences of Katrina on crime showed increases murder, aggravated assault, illegal possession of weapons, and arson. While the regional analysis was based on the Current Population Survey and data from the Federal Bureau of Investigation, the Houston study used data provided by the Police Department. Robustness checks evaluating self-selection utilized the Displaced New Orleans Resident Pilot survey. It remained undetermined whether the crimes were committed by the evacuees, or triggered by their presence.