Meeting the Health-care Needs of the Rural Elderly: The Unique Role of Village Doctors
Despite their recent deterioration, village clinics have historically been an important source of health care for the poor and elderly in rural China. In this paper, we examine the current role of village clinics, the patients who use them and some of the services they provide. We focus specifically on the role of village clinics in meeting the health-care needs of the rural poor and elderly. We find that although clinics are continuing to decline financially, they remain a source of care for the rural elderly and poor. We estimate that the elderly are 10–15 percent more likely than young individuals to seek care at a clinic. We show that clinics provide many unique services to support the rural elderly (and the elderly poor), such asin-home patient care, the option for patients to pay on credit, and free and discounted services.
Migration, Poverty Alleviation and Wellbeing of the Elderly: Population Modeling for Rural Western China
The researchers developed models for the time course of the economic demography of remote Chinese villages that takes into account the migration, and sometimes return, of the villagers, the predicted remittances, the costs for maintenance of those remaining in the villages (mainly parents and children of the migrants), and the marriage squeeze on males, which is very pronounced in remote rural China. They constructed formal mathematical models that include the above-mentioned features, as well as the rate of migration (which is available from our data).
Socioeconomic Gradients in Health Among the Elderly in China
This project studied the patterns of health and health care disparities across elderly and non-elderly in China, including the impact of earlier educational and public health interventions on contemporary elderly.
Readmissions and Chronic Disease in the Elderly
This study aimed to expand knowledge regarding chronic disease and readmissions in the elderly The researchers conducted a retrospective analysis of California Office of Statewide Health Planning and Development Patient Discharge Data, 2000-2009, which includes all adults age 18 and older with a non-federal acute care hospital discharge (n= 29,009,966 discharges). We identified 7- and 30-day all cause readmissions (ACR) and potentially preventable readmissions (PPR), and then analyzed relationships between index and readmission hospitalizations for each metric.
Effect of Social Isolation and Loneliness on Health Care Utilization
The researchers assessed the effect of social isolation and loneliness on healthcare utilization (costs and frequency of care) using longitudinal survey data from the Health and Retirement Survey (HRS) linked to Medicare administrative claims data. This study provides the first representative picture of the correlation social isolation and loneliness have with total Medicare costs.
Margaret Triyana
Shorenstein APARC
Encina Hall C331
616 Serra Street
Stanford, CA 94305-6055
Margaret (Maggie) Triyana’s main research interests are inequality and human capital investments in developing countries. In particular, she is interested in the effects social policy changes on children’s health outcomes. As a Postdoctoral Fellow, she will analyze the effects of rural-urban migration in Indonesia and China, as well as the impact of health insurance expansion in Indonesia and Vietnam.
Triyana received a PhD in Public Policy from the University of Chicago in 2013.
Working Papers
“Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia“
“The Effects of Community and Household Interventions on Birth Outcomes: Evidence from Indonesia”
“The Longer Term Effects of the ‘Midwife in the Village’ Program in Indonesia”
“The Sources of Wage Growth in a Developing Country” (with Ioana Marinescu)
Region-based v. Distance-based Information in Emergency Health Risk Communication: Evidence from the Fukushima Daiichi Nuclear Disaster
A tremendous amount of radioactive products were discharged as a result of the accident at the Fukushima nuclear power plant in March 2011, which resulted in radioactive contamination of the plant and surrounding areas. While geographical distribution of radioactive iodine, tellurium, and cesium in the surface soils was smoothly (but not always systematically) widespread all over the region, health risk information by the government, media, and other organizations is most likely to be given in terms of administrative boundaries (cf. prefectures, municipalities, etc.) and/or distance from the radiation source.
This paper estimates the effect of such health risk information rather than the actual health risks of radiation on land and other prices in different locations. We find that the prefecture and municipality border effects – but not the distance effect from the nuclear power plant – are significantly related to a reduction in land and other prices after the accident. This shows that people responded to health risk information based on administrative boundaries rather than the actual health risk of radiation after the disaster. Although health risk information based on prefecture and municipality boundaries has an obvious advantage of distilling large and complex risk information into a simple one, the government, media, and other organizations need to recognize and carefully examine the potential of misclassifying non-contaminated areas into contaminated prefectures. Doing so will avoid unintentional consequences to the region’s economy.
Hiroaki Matsuura is currently Departmental Lecturer in the Economy of Japan in the School of Interdisciplinary Area Studies, University of Oxford and a Junior Research Fellow of St. Antony’s College. His main interests are health economics and demography, with a special interest in the relation between laws and population health. Hiroaki received his B.A. in Economics from Keio University, M.A. in Social Science from the University of Chicago, M.S. in Project Management from Northwestern University’s McCormick School of Engineering and Applied Science, and Sc.D. in Global Health and Population (Economics track) from Harvard University’s School of Public Health. In the past, he was affiliated with Institute of Quantitative Social Sciences, Human Rights in Development, and Takemi Program in International Health at Harvard University. He also worked as a research assistant at the National Bureau of Economic Research. His doctoral dissertation research explores a right to health or to health care in national constitutions of 157 countries and state constitutions of the 50 U.S. states and estimates the impact of introducing (or removing) a right to health or to health care into national and state constitutions on health system and population health outcomes. His most recent article, “The Right to Health in Japan: Challenges of a Super Aging Society and Implication from Its 2011 Public Health Emergency” (with Eriko Sase) will be appeared on “Advancing the Human Right to Health”, edited by José M. Zuniga, Stephen P. Marks, and Lawrence O. Gostin, Oxford University Press, 2013.
Daniel and Nancy Okimoto Conference Room