Essays in the economics of health and ageing

• Main Author: TAN, Yi Jin
• Format: text
• Language: English
• Published: Institutional Knowledge at Singapore Management University 2018
• Subjects: Applied microeconomics; policy evaluation; non-contributory pensions; electricity consumptions; transitional care; Behavioral Economics; Health Economics
• Online Access: https://ink.library.smu.edu.sg/etd_coll/149; https://ink.library.smu.edu.sg/cgi/viewcontent.cgi?article=1149&context=etd_coll
• Institution: Singapore Management University

This dissertation consists of four papers in applied microeconomics / the economics of health and ageing that analyse the causal effect of public policies, or of events / issues amenable to policy intervention. Chapter 1 provides an overview of the papers in this dissertation. Chapter 2 investigates whether a major and growing environmental disamenity – dengue fever – leads to protective behavior that increases residential electricity consumption. Being near a dengue cluster leads to a persistent increase in electricity consumption in 4-room and 5-room/bigger flats (by 1.7% and 1.1% respectively). In addition, electricity consumption rises discontinuously when a dengue cluster’s risk classification is upgraded from yellow to red. This increased electricity consumption cost $11.9 to 16.3 million per annum (in 2015 Singapore dollars), or 7% – 12% of the overall costs of dengue in Singapore. Chapter 3 studies the effect of in-utero exposure to mild nutritional shocks during Ramadan on an individual’s later-life outcomes. In-utero exposure to Ramadan leads to poorer subjective well-being across a broad range of domains (overall life, social and family life, daily activities, economic, and health satisfaction), self-rated health condition, and poorer mental well-being. In addition, exposed individuals report higher rates of diagnosed cardiovascular conditions and higher body mass index (among women). We find no evidence that these results are driven by selective timing of pregnancies, differing survey participation rates, or seasonal effects. Chapter 4 examines the effect of an exogenous permanent income shock on subjective well-being. This permanent income shock is the introduction of Singapore’s first national non-contributory pension, the Silver Support Scheme. The pension improved the life satisfaction of recipients; this effect appears to be driven by social, household income, and economic satisfaction. Consistent with the predictions of the permanent income hypothesis, well-being improved at announcement, but did not improve significantly further at disbursement of the pension. Lastly, we find evidence that the marginal utility of income varies – recipients who reported being less financially prepared for retirement exhibited larger increases in well-being. Lastly, Chapter 5 reports results from a pragmatic, randomized controlled trial of CareHub, a new transitional care program (TCP) in Singapore’s National University Hospital that aims to contain costs, reduce re-hospitalizations, and improve patient quality of life. CareHub reduced unplanned cardiac-related readmissions by 39% and unplanned cardiac-related days in hospital by 56%. In addition, we found suggestive evidence that CareHub reduced patient anxiety and depression, and improved the quality of transitional care. In all, CareHub achieved net cost savings of about S$1,300 per patient over six months, suggesting that a carefully designed TCP can reduce resource utilization while improving quality of life.