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Three essays on econometric evaluation of public health interventions

This dissertation consists of three independent essays evaluating the impact of public health interventions in two countries, Indonesia and Australia. The first two essays concern the national pro-poor health card program in Indonesia, which fully subsidises health care purchases by its recipients. In quantifying the impact of the program, the combination of propensity score matching and difference-in-differences techniques is used to address bias due to non-random assignment. Covariates to match include both variables affecting demand and eligibility and variables measuring local health care supply. Using data from the single, nationally-representative longitudinal study of Indonesian households, the program is found to have limited impact. The second essay evaluates the program??s impact on supply variables. In the absence of a wage revision or additional staff, the program lowers the incentives for health workers to maintain their public position. This is particularly true for those workers providing outpatient care as patients can not be controlled by waiting lists. The analysis finds some evidence of reduced number of full-time doctors in areas where the distribution of health cards were most extensive. The final essay uses Australian data to investigate changes in women??s preferences for cervical screening following a screening promotion campaign and a vaccination program. Discrete choice experiments were used to elicit preferences, and results from experiments conducted prior and after the interventions were compared. Several additional comparison groups were created based on spatial variations and by variation induced by randomisation. The study finds that the interventions have minor impact on how women valued various screening attributes. However, there was a general reduction in the willingness to screen, which was unexpected given the awareness campaign. Through simulation, it is shown that an effective way to increase the screening rate is through encouraging a more active role of the provider.

Identiferoai:union.ndltd.org:ADTP/258623
Date January 2009
CreatorsJohar, Meliyanni, Economics, Australian School of Business, UNSW
PublisherAwarded By:University of New South Wales. Economics
Source SetsAustraliasian Digital Theses Program
LanguageEnglish
Detected LanguageEnglish
Rightshttp://unsworks.unsw.edu.au/copyright, http://unsworks.unsw.edu.au/copyright

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