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私人健康投资的竞争风险:来自塞内加尔疟疾控制的证据。

Private health investments under competing risks: Evidence from malaria control in Senegal.

机构信息

University of Amsterdam, office E6.21, Roeterstraat 11, 1018WB Amsterdam, Netherlands.

University of Namur (UNamur), CRED, office 633, Remparts de la Vierge 8, 5000 Namur, Belgium.

出版信息

J Health Econ. 2020 Sep;73:102330. doi: 10.1016/j.jhealeco.2020.102330. Epub 2020 Apr 27.

Abstract

This study exploits the introduction of high subsidies for anti-malaria products in Senegal in 2009 to investigate whether malaria prevents parents from investing in child health. A simple model of health investments under competing mortality risks predicts that private expenses to fight malaria and other diseases should increase in response to anti-malaria public interventions. We test and validate this prediction using original panel data from a household expenditure survey combined with geographical information on malaria prevalence. We find that health expenditures in malarious regions catch up with non-malarious regions. The same result holds for parental health-seeking behavior against other diseases like diarrhea. These patterns cannot be explained by differential trends between regions. Our results suggest that behavioral responses to anti-malaria campaigns magnify their impact on all-cause mortality for children.

摘要

本研究利用 2009 年塞内加尔引入的高额抗疟产品补贴,调查疟疾是否会阻碍父母投资于儿童健康。一个关于在竞争死亡风险下进行健康投资的简单模型预测,针对疟疾和其他疾病的私人支出应随着抗疟公共干预措施的增加而增加。我们使用家庭支出调查的原始面板数据以及疟疾流行的地理信息,对这一预测进行了检验和验证。我们发现,疟疾流行地区的卫生支出赶上了非疟疾流行地区。针对腹泻等其他疾病的父母寻医行为也是如此。这些模式不能用地区之间的差异趋势来解释。我们的结果表明,对抗疟运动的行为反应放大了它们对儿童全因死亡率的影响。

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