State and self investments in health

► State investments can crowd out or reinforce self investments in health. ► The UK NHS invested substantially in better care of cardiovascular disease (CVD). ► CVD patients receiving lipid-lowering drugs are more likely to quit smoking. ► Results robust to controlling for direct effect of smoking c...

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Bibliographic Details
Published in:	Journal of health economics Vol. 30; no. 6; pp. 1164 - 1173
Main Authors:	Fichera, Eleonora, Sutton, Matt
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 01.12.2011 Elsevier Elsevier Sequoia S.A
Subjects:	Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - diagnosis Cardiovascular Diseases - drug therapy Cessation Correlation Crowding-out Directive Counseling - economics Directive Counseling - methods Disease Drug Prescriptions - economics Drugs Drugs prescription Economic models Economics Empirical Research England Female Gesundheitsvorsorge Health Health economics Health insurance Health policy Health Surveys Humans Hypolipidemic Agents - economics Hypolipidemic Agents - therapeutic use Insurance Insurance, Health - economics Investment Investments Male Medical decision making Medical treatment Middle Aged Models, Theoretical Pharmaceuticals Practice Patterns, Physicians' - economics Practice Patterns, Physicians' - statistics & numerical data Prescriptions Preventative behaviour Prevention probability Public health Smoking Smoking - adverse effects Smoking cessation Smoking Cessation - economics Smoking Cessation - methods State State Medicine Studies surveys Theorie Verdrängungseffekt England United Kingdom > UK I18 C35 D01 C25 I12 Preventative behaviour Crowding-out Drugs prescription
ISSN:	0167-6296, 1879-1646, 1879-1646
Online Access:	Get full text
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Summary:	► State investments can crowd out or reinforce self investments in health. ► The UK NHS invested substantially in better care of cardiovascular disease (CVD). ► CVD patients receiving lipid-lowering drugs are more likely to quit smoking. ► Results robust to controlling for direct effect of smoking cessation advice. ► Doctors compensate for patients’ attitude to health with medical treatment. In this paper we consider how State investments can crowd out or reinforce self-investments in health using a theoretical model of insurance and protection. We apply this model to the smoking cessation decision made by individuals diagnosed with a cardiovascular disease using data from the 1998, 2003 and 2006 waves of the Health Survey of England. Prescription of lipid-lowering drugs, which increased substantially over this period, is used as the measure of State investment. Using bivariate and trivariate probit models, we allow for the endogeneity of the doctor's decision to prescribe and offer smoking cessation advice. We find that unobservable characteristics affecting the prescription of drugs are positively correlated with those affecting smoking advice and negatively correlated with those affecting the propensity to quit. Our results indicate that prescription of lipid-lowering drugs to individuals with cardiovascular disease increases the probability of smoking cessation by 20–28 percentage points.
Bibliography:	SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2
ISSN:	0167-6296 1879-1646 1879-1646
DOI:	10.1016/j.jhealeco.2011.09.002