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Health Economics Health Economics is the study of how resources are allocated to and within the market for health care. It combines the study of health as it relates to economics and the study of economics as it relates to health. The Economics Department at UNC-CH joins only a handful who have a field in Health Economics and two professors who have main research interests in health. A description of the faculty, the Health Economics field, our resources at UNC-CH, and our students is provided below. UNC Faculty
John S. Akin, Ph.D., Professor of Economics and Adjunct Professor of Health Policy and Administration, has primary interests in health economics and health care finance, especially with respect to developing countries. He and his colleagues have done extensive analysis of demand for health services and health insurance in the developing countries of the world. Akin was a coinvestigator in all phases of a Carolina Population Center’s Philippines health and nutrition survey and analysis project. He is interested in patterns and determinants of contraceptive use, particularly the role of economic factors, and has examined factors affecting the demand for types of contraceptives in Jamaica, the Philippines, and Thailand. As a principal investigator of the Evaluation of Family Planning Program Impact Project, he analyzed private sector effectiveness in family planning service delivery in the Philippines, using household, individual, and facility data from a large longitudinal survey conducted in urban and rural areas in Cebu, Philippines. As a consultant to the World Bank, he worked on a health usage and demand analysis for three Nigerian states. Akin was the external advisor to a World Bank-funded health provision and financing project in Sri Lanka that collected and analyzed survey data from health facilities and households in four areas of the country. With Barry Popkin (UNC Department of Nutrition) and medical anthropologist Gail Henderson (UNC Department of Social Medicine), he was coinvestigator of the National Institutes of Health (NIH) funded "Modeling the Health Transition" project. He and Henderson completed an analysis of causes of improved health in China. A follow-up project (with UNC Department of Health Policy and Planning Health Economist, William Dow) to examine changing health outcomes in China over time is in the beginning stages. Akin recently completed a two-year term on the Board of Trustees of the Southern Economic Association. From January 1996 through June 1997 he was on leave working in the World Bank's East Africa Department in Kampala, Uganda. He served as health economics advisor to the East Africa Department, and helped design and initiate projects in Tanzania, Kenya, and Uganda on health-sector reform and malaria control. He presently is principle investigator of a USAID funded research project (a sub-project of the Measure Project of the Carolina Population Center) on the impacts of decentralization of the health sector in Uganda.
Donna Gilleskie is a health economist whose research focuses on the health insurance and medical care utilization decisions of individuals and how these decisions impact health and employment issues. In a paper based on her dissertation work, Dr. Gilleskie models the dynamic medical care utilization and absenteeism decisions of employed males during an episode of acute illness in order to evaluate alternative health insurance and sick leave coverage policies. This paper (Econometrica, 1998) is the first application of structural estimation of dynamic programming models to consumer health care behavior. She is also estimating this model using a sample of employed women in order to compare the effects of different health insurance and sick leave coverage schemes across genders. In a related working paper, Drs. Gilleskie and Tom Mroz extend the scope of decision making to annual behavior and include all types of illness (acute and chronic) and consumption of several types of medical care (e.g., preventive, curative, hospital inpatient, outpatient, emergency room, and physician care). Modeling all medical care consumption decisions during an insurance year allows for evaluation of the dynamic effects of specific insurance characteristics, such as deductibles, coinsurance rates, and maximum deductible amounts, on utilization. In each of these papers, the estimation of structural parameters of the optimization problem allows for the evaluation of new and existing policies. Mroz and Gilleskie are also developing a semi-parametric conditional density estimation procedure for measuring covariate effects that differ along different parts of the distribution of the dependent variable. This work is applied to explaining variation in annual medical care expenditures. Dr. Gilleskie is working with Dr. David Blau on a series of NIH-funded papers explaining the relationship between health, health insurance, and work behavior of older individuals using the new Health and Retirement Survey (HRS). The first paper (forthcoming, Review of Economics and Statistics) models the dynamic employment decisions regarding entry, exit, and job switching and allows for endogenous health insurance coverage in order to study the impact of health insurance that often serves to fill the gap between separation from an employer prior to age 65 and the availability of universal coverage (Medicare) at age 65. A second paper (under review at Journal of Health Economics) provides a more detailed examination of the effects of multidimensional measures of health on the dynamic work transitions late in one's working life. A third paper (and the goal of this research) involves an exact solution of the dynamic programming problem that describes these employment decisions and estimation of the structural parameters of the theoretical model. Completion of this task will allow us to evaluate the effect of alternative policies regarding Medicare, Social Security, pension, and general health insurance coverage on employment behavior at older ages. She has also applied a similar model to young adults using the National Longitudinal Survey of Youth (NLSY) in order to study the issue of job lock, or restricted job mobility due to health and health insurance (under review at Journal of Human Resources). Her paper examining the productive and allocative effects of education on the production of health provides more accurate estimates than those found in the literature because she explicitly controls for illness severity during the year and models the endogenous consumption of curative, as well as preventive, medical care in assessing the link between health and education (Economics of Education Review, 1998). The link between non-medical and medical inputs to health is explored further in a paper with Dr. Sally Stearns and is estimated using data on Medicare beneficiaries from the National Survey of Self-Care and Aging. Other Triangle Health Economists
Frank Sloan is the J. Alexander McMahon Professor of Health Policy and Management and Professor of Economics at Duke University since 1993. He is also the Director of the Center for Health Policy, Law and Management at Duke that originated in 1998. Professor Sloan did his undergraduate work at Oberlin College and received his Ph.D. in economics from Harvard University. Before joining the faculty at Duke in July, 1993, he was a Research Economist at the Rand Corporation and on the faculties of the University of Florida and Vanderbilt University. He was Chair of the Department of Economics at Vanderbilt from 1986-89. His current research interests include alcohol use prevention, long-term care, medical malpractice, and cost-effectiveness analyses of medical technologies. Professor Sloan also has a long-standing interest in hospitals, health care financing, and health manpower. He has served on several national advisory public and private groups. He is a member of the Institute of Medicine of the National Academy of Sciences and was recently a member of the Physician Payment Review Commission.
Graduate Students
Recent Graduates
Triangle Health Economics Workshop About every two weeks we have a workshop with area health economists in which we discuss leading working papers in the field, call the authors on a speaker phone, or bring authors in for seminars. UNC Economics students do not register for or receive credit for attending the seminar, but are stongly encouraged to attend and participate. A description of the workshop can be found at: http://www.sph.unc.edu/hpaa/events/hpaa278/hpaa278.html Requirements of the Health Economics Field at UNC
Course Descriptions
Course Description of Class at Duke University
Other Resources
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