The heterogeneous impact of insurance on health care demand among young adults: a panel data analysis*

Success of the recently implemented Affordable Care Act hinges on previously uninsured young adults enrolling in coverage. How will increased coverage, in turn, affect health care utilization? This paper applies variable coefficient panel models to estimate the impact of insurance on health care utilization among young adults. The econometric setup, which accommodates nonlinear usage measures, attempts to address the potential endogeneity of insurance status. The main finding is that, for approximately one-fifth of young adults, insurance does not substantially alter health care consumption. On the other hand, another one-fifth of young adults have large moral hazard effects. Among that group, insurance increases the probability of having a routine checkup by 71–120%, relative to mean probabilities, and insurance increases the number of curative-based doctor office visits by 67–181%, relative to the mean number of visits.     

Variable selection approach for zero-inflated count data via adaptive lasso

This article proposes a variable selection approach for zero-inflated count data analysis based on the adaptive lasso technique. Two models including the zero-inflated Poisson and the zero-inflated negative binomial are investigated. An efficient algorithm is used to minimize the penalized log-likelihood function in an approximate manner. Both the generalized cross-validation and Bayesian information criterion procedures are employed to determine the optimal tuning parameter, and a consistent sandwich formula of standard errors for nonzero estimates is given based on local quadratic approximation. We evaluate the performance of the proposed adaptive lasso approach through extensive simulation studies, and apply it to analyze real-life data about doctor visits.     

ESTIMATING THE NUMBER OF VISITS TO THE DOCTOR

The frequency of doctor consultations has direct consequences for health care budgets, yet little statistical analysis of the determinants of doctor visits has been reported. We consider the distribution of the number of visits to the doctor and, in particular, we model its dependence on a number of demographic factors. Examination of the Australian 1995 National Health Survey data reveals that generalized linear Poisson or negative binomial models are inadequate for modelling the mean as a function of covariates, because of excessive zero counts, and a mean‐variance relationship that varies enormously over covariate values. A negative binomial model is used, with parameter values estimated in subgroups according to the discrete combinations of the covariate values. Smoothing splines are then used to smooth and interpolate the parameter values. In effect the mean and the shape parameters are each modelled as (different) functions of gender, age and geographical factors. The estimated regressions for the mean have simple and intuitive interpretations. However, the dependence of the (negative binomial) shape parameter on the covariates is more difficult to interpret and is subject to influence by extreme observations. We illustrate the use of the model by estimating the distribution of the number of doctor consultations in the Statistical Local Area of Ryde, based on population numbers from the 1996 census.     

Bounds on Average and Quantile Treatment Effects on Duration Outcomes Under Censoring,Selection, and Noncompliance

Abstract

We consider the problem of assessing the effects of a treatment on duration outcomes using data from a randomized evaluation with noncompliance. For such settings, we derive nonparametric sharp bounds for average and quantile treatment effects addressing three pervasive problems simultaneously: self-selection into the spell of interest, endogenous censoring of the duration outcome, and noncompliance with the assigned treatment. Ignoring any of these issues could yield biased estimates of the effects. Notably, the proposed bounds do not impose the independent censoring assumption—which is commonly used to address censoring but is likely to fail in important settings—or exclusion restrictions to address endogeneity of censoring and selection. Instead, they employ monotonicity and stochastic dominance assumptions. To illustrate the use of these bounds we assess the effects of the Job Corps (JC) training program on its participants’ last complete employment spell duration. Our estimated bounds suggest that JC participation may increase the average duration of the last complete employment spell before week 208 after randomization by at least 5.6 log points (5.8%) for individuals who comply with their treatment assignment and experience a complete employment spell whether or not they enrolled in JC. The estimated quantile treatment effects suggest the impacts may be heterogeneous, and strengthen our conclusions based on the estimated average effects.     

变量选择方法在医疗保险赔付评估中的应用

在广义线性模型假设下,采用Lin的医疗费用模型,运用LASSO和SCAD方法对影响医疗费用的因素进行选择,并对两种方法的有效性进行了对比分析,从而得出影响医疗保险赔付的重要因素,解决了高维变量带来的一系列问题。实例分析中,由于两种方法注重的统计性质不同,选择出的解释变量略微不同,但通过分析发现,两种结果都具有良好的解释性,反映了影响医疗保险赔付的重要信息。     

High dimensional variable selection with clustered data: an application of random multivariate survival forests for detection of outlier medical device components

In many medical studies patients are nested or clustered within doctor. With many explanatory variables, variable selection with clustered data can be challenging. We propose a method for variable selection based on random forest that addresses clustered data through stratified binary splits. Our motivating example involves the detection orthopedic device components from a large pool of candidates, where each patient belongs to a surgeon. Simulations compare the performance of survival forests grown using the stratified logrank statistic to conventional and robust logrank statistics, as well as a method to select variables using a threshold value based on a variable's empirical null distribution. The stratified logrank test performs superior to conventional and robust methods when data are generated to have cluster-specific effects, and when cluster sizes are sufficiently large, perform comparably to the splitting alternatives in the absence of cluster-specific effects. Thresholding was effective at distinguishing between important and unimportant variables.     

The effects of exchange rate regimes on economic growth: evidence from propensity score matching estimates

This is the first study that employs the propensity score matching framework to examine the average treatment effect of exchange rate regimes on economic growth. Previous studies examining the effects of different exchange regimes on growth often apply time series or panel data techniques and provide mixed results. This study employs a variety of non-parametric matching methods to address the self-selection problem, which potentially causes a bias in the traditional linear regressions. We evaluate the average treatment effect of the floating exchange rate regime on economic growth in 164 countries. Time period of the quasi experiment starts in 1970, capturing the collapse of the Bretton Woods fixed exchange rate commitment system. Results show that the average treatment effect of floating exchange rate regimes on economic growth is statistically insignificant. Verifying the results with the Rosenbaum's bounds, our findings are strong and robust. The research states that there is no evidence that employing a floating exchange rate regime compared to a fixed one leads to a higher economic growth for the countries that use this particular policy.     

Education-related inequity in healthcare with heterogeneous reporting of health

Reliance on self-rated health to proxy medical need can bias estimation of education-related inequity in healthcare utilization. We correct this bias both by instrumenting self-rated health with objective health indicators and by purging self-rated health of reporting heterogeneity that is identified from health vignettes. Using data on elderly Europeans, we find that instrumenting self-rated health shifts the distribution of visits to a doctor in the direction of inequality favouring the better educated. There is a further, and typically larger, shift in the same direction when correction is made for the tendency of the better educated to rate their health more negatively.     

Nonparametric analysis of aggregate loss models

This paper describes a nonparametric approach to make inferences for aggregate loss models in the insurance framework. We assume that an insurance company provides a historical sample of claims given by claim occurrence times and claim sizes. Furthermore, information may be incomplete as claims may be censored and/or truncated. In this context, the main goal of this work consists of fitting a probability model for the total amount that will be paid on all claims during a fixed future time period. In order to solve this prediction problem, we propose a new methodology based on nonparametric estimators for the density functions with censored and truncated data, the use of Monte Carlo simulation methods and bootstrap resampling. The developed methodology is useful to compare alternative pricing strategies in different insurance decision problems. The proposed procedure is illustrated with a real dataset provided by the insurance department of an international commercial company.     

Criteria for Linear Model Selection Based on Kullback's Symmetric Divergence

Model selection criteria are frequently developed by constructing estimators of discrepancy measures that assess the disparity between the 'true' model and a fitted approximating model. The Akaike information criterion (AIC) and its variants result from utilizing Kullback's directed divergence as the targeted discrepancy. The directed divergence is an asymmetric measure of separation between two statistical models, meaning that an alternative directed divergence can be obtained by reversing the roles of the two models in the definition of the measure. The sum of the two directed divergences is Kullback's symmetric divergence. In the framework of linear models, a comparison of the two directed divergences reveals an important distinction between the measures. When used to evaluate fitted approximating models that are improperly specified, the directed divergence which serves as the basis for AIC is more sensitive towards detecting overfitted models, whereas its counterpart is more sensitive towards detecting underfitted models. Since the symmetric divergence combines the information in both measures, it functions as a gauge of model disparity which is arguably more balanced than either of its individual components. With this motivation, the paper proposes a new class of criteria for linear model selection based on targeting the symmetric divergence. The criteria can be regarded as analogues of AIC and two of its variants: 'corrected' AIC or AICc and 'modified' AIC or MAIC. The paper examines the selection tendencies of the new criteria in a simulation study and the results indicate that they perform favourably when compared to their AIC analogues.     

Zero-Inflated Poisson Regression for Longitudinal Data

Medical and public health research often involve the analysis of repeated or longitudinal count data that exhibit excess zeros such as the number of yearly doctor visits by a group of individuals over a number of years. Zero-inflated Poisson (ZIP) regression models can be used to account for excess zeros in count data. We propose an extension of the ZIP model that is appropriate for longitudinal data. Our extension includes a non stationary, observation-driven time series model based correlation structure. We discuss estimation of the model parameters and the inefficiency of the estimators when the correlation structure is mis-specified. The model's application to the analysis of health care utilization data is also discussed.     

跨方言区流动、自选择与劳动力收入

本文基于2012和2014年中国劳动力动态调查（CLDS）数据,采用内生转换回归模型考察劳动力跨方言区流动对收入的影响。实证结果表明,与在同一方言区流动的个体相比,跨方言区流动收入要高31.9%;对于跨方言区流动的劳动力而言,跨方言区流动对收入的平均处理效应为30.5%,如果在同一方言区流动的劳动力选择跨方言区流动,其收入反而会减少3.9%,说明不同个体在流入地的选择上是基于其比较优势做出的决策。进一步,本文还发现跨方言区流动的劳动力无论选择在同一方言区流动还是跨方言区流动,均能获得较高的收入,在流动决策上具有绝对优势。在考虑了测量误差和极端值以及排除其他干扰因素后,上述结论依然稳健。     

The determinants of price in online auctions: more evidence from unbalanced panel data

This study provides an alternative approach that takes account of the unobserved effects of each seller under a sample selection framework while using online auction data. We use data collected from Yahoo! Kimo Auction (Taiwan) to demonstrate that earlier empirical results of online auction studies may be biased due to violating the assumption of independence of the error terms between sample observations. Empirical findings show that seller reputation is no longer as the most important factor for buyers to bid on items, while the sample data confirm the unobserved heterogeneity of sellers and sample selection problem.     

Inferences from DNA data: population histories, evolutionary processes and forensic match probabilities

Summary. We develop a flexible class of Metropolis–Hastings algorithms for drawing inferences about population histories and mutation rates from deoxyribonucleic acid (DNA) sequence data. Match probabilities for use in forensic identification are also obtained, which is particularly useful for mitochondrial DNA profiles. Our data augmentation approach, in which the ancestral DNA data are inferred at each node of the genealogical tree, simplifies likelihood calculations and permits a wide class of mutation models to be employed, so that many different types of DNA sequence data can be analysed within our framework. Moreover, simpler likelihood calculations imply greater freedom for generating tree proposals, so that algorithms with good mixing properties can be implemented. We incorporate the effects of demography by means of simple mechanisms for changes in population size and structure, and we estimate the corresponding demographic parameters, but we do not here allow for the effects of either recombination or selection. We illustrate our methods by application to four human DNA data sets, consisting of DNA sequences, short tandem repeat loci, single-nucleotide polymorphism sites and insertion sites. Two of the data sets are drawn from the male-specific Y-chromosome, one from maternally inherited mitochondrial DNA and one from the β -globin locus on chromosome 11.     

Selection of regressors in econometrics: parametric and nonparametric methods selection of regressors in econometrics

The present paper addresses the selection-of-regressors issue into a general discrimination framework. We show how this framework is useful in unifying various procedures for selecting regressors and helpful in understanding the different strategies underlying these procedures. We review selection of regressors in linear, nonlinear and nonparametric regression models. In each case we successively consider model selection criteria and hypothesis testing procedures.     

Selection of regressors in econometrics: parametric and nonparametric methods selection of regressors in econometrics

The present paper addresses the selection-of-regressors issue into a general discrimination framework. We show how this framework is useful in unifying various procedures for selecting regressors and helpful in understanding the different strategies underlying these procedures. We review selection of regressors in linear, nonlinear and nonparametric regression models. In each case we successively consider model selection criteria and hypothesis testing procedures.     

Bayesian ratemaking procedure of crop insurance contracts with skewed distribution

Over the years, crop insurance programs became the focus of agricultural policy in the USA, Spain, Mexico, and more recently in Brazil. Given the increasing interest in insurance, accurate calculation of the premium rate is of great importance. We address the crop-yield distribution issue and its implications in pricing an insurance contract considering the dynamic structure of the data and incorporating the spatial correlation in the Hierarchical Bayesian framework. Results show that empirical (insurers) rates are higher in low risk areas and lower in high risk areas. Such methodological improvement is primarily important in situations of limited data.     

Selection bias,investment decisions and treatment effect distributions

When making decisions regarding the investment and design for a Phase 3 programme in the development of a new drug, the results from preceding Phase 2 trials are an important source of information. However, only projects in which the Phase 2 results show promising treatment effects will typically be considered for a Phase 3 investment decision. This implies that, for those projects where Phase 3 is pursued, the underlying Phase 2 estimates are subject to selection bias. We will in this article investigate the nature of this selection bias based on a selection of distributions for the treatment effect. We illustrate some properties of Bayesian estimates, providing shrinkage of the Phase 2 estimate to counteract the selection bias. We further give some empirical guidance regarding the choice of prior distribution and comment on the consequences for decision-making in investment and planning for Phase 3 programmes.     

Empirical Bayes estimators in hierarchical models with mixture priors

We consider subgroup analyses within the framework of hierarchical modeling and empirical Bayes (EB) methodology for general priors, thereby generalizing the normal–normal model. By doing this one obtains greater flexibility in modeling. We focus on mixture priors, that is, on the situation where group effects are exchangeable within clusters of subgroups only. We establish theoretical results on accuracy, precision, shrinkage and selection bias of EB estimators under the general priors. The impact of model misspecification is investigated and the applicability of the methodology is illustrated with datasets from the (medical) literature.     

异质性企业的空间选择与地区生产率差距研究

 本文在融入企业异质性的空间经济学理论框架下,采用中国工业企业数据库微观数据,运用分位数回归的方法,检验异质性企业的空间选择与产业集聚效应对地区(企业)生产率差距的影响程度。结果表明：（1）异质性企业的定位选择行为在中国显著存在,并且是影响地区（企业）生产率差距的另一重要的微观机制;（2）在中国,地区产业集聚并没有对本地企业生产率产生正向影响,即集聚效应并不明显。