The focus of this research is the relationship between the supply of registered nurses and the rate of return on the educational investment to become a registered nurse. Is this rate of return a determining factor in the supply, past, present, and future? Since 98. 8 percent of all registered nurses are women, an integral part of this study is a survey of the data on women in the labor force. The empirical data, statistical, was obtained from government sources and non-government associations, The American Nurses Association, The American Hospital Association, and the educational institutions. The data indicates the following: the yearly average supply of active registered nurses has increased by 3.15 percent from 1966 through 1970; the demand for registered nurses has decreased from 41.1 percent of nursing personnel in 1966 to 36.8 percent in 1970; the average weekly wage of general duty nurses has increased $100.50 in 1966 to $141.00 in 1969; the number of graduates from registered nurse schools has been increasing in recent years. Of the three programs, the Associate Degree shows the largest increase in number of students and it is the one in which the present value of benefits from the investment, $10,414.00, exceeded the present value of the investment costs (education), $6,923.00, which yielded a private rate of return of five percent. In summary, the rate of return on the three registered nurse educational programs, Associate Degree, Diploma Degree, and Baccalaureate Degree, based on employment as a general duty nurse and calculated by both the present value of cost and benefit method and internal rate of return method indicated that only the Associate Degree program produced a positive rate of return. In addition, this is the program that has had the large increase in students and graduates in recent years. If this trend continues, the future supply of registered nurses will be adequate and may overshoot the demand. However, many questions remain unanswered which call for more research, particularly relating to the labor force participation of women.

In May 2021 the Swedish government decided to establish a trial period for an environmental bonus within the swedish reimbursement system, with the purpose to reduce the emissions of antibiotics and carbon dioxide from the pharmaceutical industry. This thesis examines the effect of the bonus on the pharmaceutical market and whether the goal set by the government can be met based on economic theory. By an in-depth analysis of the generic market, the implementation of the environmental premium is examined on the basis of the Bertrand model. The thesis finds that the environmental bonus will give different outcomes depending on the number of competing firms on the market. The main conclusion is that an environmental bonus will, in most cases, lead to higher prices for medicines. The thesis also finds that the bonus would probably give the best results in the substitution groups where many firms compete. / I maj 2021 beslutade regeringen att ett försök till miljöpremie ska implementeras i läkemedelsförmånssystemet. Syftet med miljöpremien är att minska utsläppen av främst restprodukter till antibiotika men även utsläppen av koldioxid vid produktionen. Denna uppsats undersöker vilka effekter denna miljöpremie kan tänkas ge på läkemedelsmarknaden utifrån nationalekonomisk teori samt om det mål som regeringen satt upp kan tänkas uppfyllas. Genom att djupgående analysera generikamarknaden undersöks implementeringen av miljöpremien utifrån Bertrandmodellen. Uppsatsen finner att miljöpremien troligtvis kommer ge olika utfall inom marknaden beroende på antal konkurrerande företag per utbytesgrupp. Analysens huvudsakliga slutsats är att en miljöpremien i de flesta fall kommer leda till högre priser på läkemedel samt att möjligheten för företag att upprätthålla tysta prissamordningar kan tänkas minska. Slutligen finner uppsatsen att en miljöpremie troligtvis får flest läkemedelsföretag att ställa om till grönt när den implementeras i utbytesgrupper med flera konkurrenter.

This thesis examines the relationship between gestational age and stillbirths, focusing on the effect of maternal age. Prolonged pregnancies have been associated with an increased risk of stillbirth, prompting the exploration of labor induction as a preventive measure. However, the existing literature suffers from limited sample sizes, leading to uncertainty in the findings.  This study utilizes regional variations in labor induction practices to in- crease the sample size substantially. Moreover, it incorporates the economical aspect by evaluating the cost of induction and how the current policy could be optimized. In Sweden, some regions modified their induction policies in 2019 while others did not, creating a quasi-experimental setting that is exploited in this thesis. The objective is to evaluate the impact of inducing labor before pregnancies are defined as prolonged on stillbirth rates. A panel from 2009 to 2021, comprising over 1.4 million laborers, is analyzed, focusing on approximately 13,500 prolonged pregnancies between 2019 and 2021.  The results suggest that implementing a new induction policy among mothers aged 30 or older would yield annual cost savings of 24.6 MSEK. Specifically, targeting this age group for induction reduces the number of inductions required in week 41 to prevent one stillbirth from 224 to 127, compared to inducing mothers of all ages. These findings contribute to understanding labor induction practices and their impact on stillbirth rates, especially how the current policy could be optimized from a monetary perspective, providing valuable insights to policymakers.

This dissertation consists of three essays that study the role of information acquisition and processing in health decision-making. Each chapter underscores the ways in which new information shapes the choices of health providers and consumers. Understanding these responses sheds light on critical health policy problems, including the potential overuse of low-value health services, gaps between medical evidence and practice, and inequitable access to high-value health services. The first essay studies the role of a consumer’s family network in the formation of their risk perceptions. I assess whether people correctly interpret new risk information communicated through household health events and analyze how these responses impact household welfare. Individuals respond to new diagnoses in ways most consistent with individual reevaluations of health risk rather than other possible explanations. To assess welfare implications, I estimate a structural model of health choices in which individuals learn about risk after health events reveal information. I find that consumers over-respond to recent, salient health events by over-weighting their risks ex-post. This leads to individual and social welfare losses, and suggests that aiding consumers in interpreting health risk information should be an important aim of health literacy policies. The second essay explores how health providers respond to information about innovations in mental health treatments, paying particular attention to the heterogeneous adoption costs of different practices. I compare the impact of continuing education on takeup across innovations that incur learning costs (psychotherapy) and those that do not (psychopharmacology). I use a novel extension of an estimator proposed by Calvi et al. (2021) to estimate a dynamic treatment effect in the presence of classification error. Therapists respond more to education when learning costs are negligent, being about three percentage points more likely to write new prescriptions following a conference. The third essay assesses the tradeoff between adopting novel medical technologies and achieving health equity. I study the adoption of transcatheter valve replacement surgeries in Medicare patients; these surgeries disrupted the supply of medical interventions from cardiothoracic surgeons to interventional cardiologists. This transition led providers to adjust practice styles along two margins: medium-risk patients became more likely to receive surgery, and low-risk patients received fewer medical interventions overall. I incorporate these findings into a model of physician decision-making, showing that both the expansion of high-intensity intervention and the crowd-out of low-intensity treatment can be rationalized by the presence of technological spillovers. The model further highlights that crowd-out may be inequitably distributed across the patient population when treatment appropriateness is not directly observed. I validate these predictions in my setting, showing that technology adoption resulted in disproportionately high barriers to care for low-income patients.

<p dir="ltr">This study aims to predict the environmental, organizational, and managerial factors that determine the adoption of cloud computing in U.S. healthcare delivery systems. The premise of the analysis is that several internal and external factors determine a health provider’s transition to cloud computing. The U.S. government has funded healthcare providers through HITECH <a href="" target="_blank">(Health Information Technology for Economic and Clinical Health) </a>to implement electronic health records (EHR) which is considered as an important first step in transitioning to cloud computing. This study investigated whether there is a significant difference between hospitals and providers that received HITECH funding to enhance their EHR infrastructure and those that did not in terms of their external environmental complexities, internal organizational structure, and quality of healthcare services they provide. A stratified random sample was applied to select a cohort of 3,385 hospitals from the American Hospital Association (AHA) 2022 roster for the period 2018- 2021 to test the study hypothesis. The sampled hospitals were linked with claim, administrative, cost, and ICD-10 clinical data files to capture variables of interest repeatedly over the study period. The analysis modeled for selected external (location, market concentration as measured by Herfindahl Index), internal (number and composition of staff – physicians, nurses, technicians, etc.) demographic, clinical and financial factors. Quantitative methods such as generalized estimating equations (GEE), logistic regression, and generalized linear mixed model (GLMM) were applied within the framework of unified technology acceptance theory (UTAT), accounting for both discrete and continuous response variables while modeling for possible between-subject heterogeneity and within-subject correlations. The analysis is based on publicly available data sources that are systematically linked to address the research questions. The portion of the HITECH funding that is applied for cloud computing is calculated from the hospital’s EHR funding. This is one of the very few longitudinal time series studies of cloud computing in healthcare since almost all previous studies on American hospitals are cross-sectional. The findings of this study show statistically significant differences between hospitals that received government funding in terms of internal organizational structure, environmental complexity, and quality of healthcare provided. The analysis identified management and quality metrics that help to gauge continuously changing organizational needs and identify emerging trends. This study proposes specific topics that future researchers can consider promoting a successful implementation of cloud computing.</p>

Across multiple countries, primary school reforms have been implemented with the goal of improving school attendance and accessibility. Failing to account for spillover effects from the children directly targeted by these reforms to their siblings may underestimate the reforms’ full impact. Using a regression discontinuity design and data from six countries, I compare women whose younger siblings were exposed to an education reform with those whose younger siblings were not. I find that, across several countries, there is a significant younger-to-older sibling spillover effect on an older sister’s probability of enrolling in secondary school and on her fertility. These findings demonstrate the broad impact of education reforms, and contribute to the understanding of the links between education and fertility, and the role played by parental reallocation of resources. / Dans de nombreux pays, des réformes de l’éducation primaire ont été implanté dans le but d’améliorer l’accès et les taux d’inscription aux écoles. Nous risquons de sous-estimer l’impact de ces réformes si nous ne considérons pas les retombées de celles-ci des enfants ciblés à leurs frères et sœurs. J’utilise une approche de régression par discontinuité et des données provenant de six pays pour comparer les femmes dont les frères et sœurs cadets ont été affectés par une réforme de l’éducation à celles dont les frères et sœurs cadets ne l’ont pas été. Je constate que, dans plusieurs pays, il y a des retombées significatives sur l’éducation secondaire et sur la fertilité des sœurs ainées. Ces résultats mettent en évidence les vastes impacts des réformes de l’éducation, et permettent de mieux comprendre les liens entre l’éducation et la fertilité, ainsi que l’importance de la réallocation des ressources par les parents.

This thesis seeks to investigate the 2014 Medicaid expansion’s effect on maternal mortality rates for New York and California. The CDC reported in 2019 that maternal mortality rates have been increasing. These findings are concerning for mothers and are a problem for developed nations like the United States with improved healthcare. Furthermore, women of color are disproportionately affected relative to white women. Previous research has indicated that healthcare expansions positively affect decreasing death rates among pregnant women. In this study, I investigate how increased access to healthcare through the 2014 Medicaid expansion under the Affordable Care Act affects maternal mortality for New York and California. I utilize the publicly available CDC Wonder Underlying Cause of Death 1999-2020 data to conduct my research for this analysis. For my analysis, I chose to observe the years 2006-2016. I plotted each state’s mortality rates by year to observe any visual trends or changes in reported data and then after ran regressions of each race on deaths. The results exhibited that women of color tend to experience higher maternal mortality ratios. When observing how deaths have changed post-expansion, the coefficients were not statically significant to a degree that would allow me to make confident conclusions that mortality rates had improved. This study contributes to the literature that women of color are more likely to suffer worse maternal health outcomes than white women. It brings to light the importance of attaining a solution to this issue.

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This dissertation consists of three empirical essays on labor, health, and real estate economics. The first essay theoretically and empirically analyzed the effects of the costs of firing an employee and hiring a replacement in a labor market with imperfect information. The theory suggested that increased expected firing or replacement costs contributed to a ``lemons effect" for the fired worker through the negative signal received in the labor market regarding the worker's ability. To test this theory, data from the Displaced Worker's Supplement to the Current Population Survey from 2004 to 2014 was used. The results were mixed, but suggested that workers in the United States who were displaced from their job experienced decreased probabilities of finding reemployment as firing costs increased. The essay also examined whether this ``lemons effect" contributed to larger wage decreases, but the estimates did not support this conclusion. The second essay estimated the impacts of the 2001 elimination of the Medicare 24-month waiting period for non-elderly Amyotrophic Lateral Sclerosis (ALS) patients. Using data from the National Hospital Discharge Survey, this essay estimated the effects of the elimination on health insurance coverage and utilization of health care services. By applying a difference-in-difference OLS estimation technique, it was estimated that, as a result of the waiting period elimination, non-elderly ALS patients were more likely to be insured, but there was a significant crowd-out of private insurance. These non-elderly patients who were admitted to the hospital with serious symptoms were also more likely to be transferred to long- or short-term care facilities while non-serious patients were more likely to receive a high (four or more) number of medical services while hospitalized. In the third essay, the effects of a new suburban casino on local housing prices were evaluated. Similar to the second essay, a difference-in-difference approach was applied, but it was combined with a spatial hedonic pricing model. Using data from a GIS product from the Maryland Department of Planning and local-area data from the American Community Survey, the effects that the opening of Maryland Live! Casino had on home sales prices of properties located in primary (one-mile radius) and secondary (one to three miles) impact areas were estimated. The results of the estimations indicated that the opening of the casino had a positive impact on housing prices in the primary impact area and this impact likely began during the construction period. No impacts, however, were evident in the secondary impact area. / Economics