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义务教育对健康有影响吗?来自门诊索赔数据的证据。

Does compulsory schooling affect health? Evidence from ambulatory claims data.

机构信息

Schumpeter School of Business and Economics, University of Wuppertal, Rainer-Gruenter-Str. 21 (FN), 42119, Wuppertal, Germany.

出版信息

Eur J Health Econ. 2022 Aug;23(6):953-968. doi: 10.1007/s10198-021-01404-y. Epub 2021 Nov 15.

Abstract

Using claims data on more than 23 million statutorily insured, we investigate the causal effect of schooling on health in the largest and most comprehensive analysis for Germany to date. In a regression discontinuity approach, we exploit changes in compulsory schooling in West Germany to estimate the reduced form effect of the reforms on health, measured by doctor diagnoses in ICD-10 format covering physical as well as mental health conditions. To mitigate the problem that empirical results depend on subjective decisions made by the researcher, we perform specification curve analyses to assess the robustness of findings across various model specifications. We find that the reforms have, at best, very small impacts on the examined doctor diagnoses. In most of the specifications we estimate insignificant effects that are close to zero and often of the "wrong" sign. Therefore, our study questions the presence of the large positive effects of education on health that are found in the previous literature.

摘要

利用超过 2300 万法定参保人的索赔数据,我们在迄今为止德国最大、最全面的分析中研究了教育对健康的因果影响。在回归不连续性方法中,我们利用西德义务教育的变化来估计改革对健康的简化效应,这是通过 ICD-10 格式的医生诊断来衡量的,涵盖了身体和心理健康状况。为了缓解实证结果取决于研究人员主观决策的问题,我们进行了规范曲线分析,以评估各种模型规范下发现结果的稳健性。我们发现,这些改革对所检查的医生诊断的影响充其量是非常小的。在我们估计的大多数规范中,效应不显著,接近于零,而且往往是“错误”的。因此,我们的研究质疑了之前文献中发现的教育对健康的巨大积极影响的存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0ca/9304067/308b4bb6b9c7/10198_2021_1404_Fig1_HTML.jpg

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