Three essays on development and health economics

Guzman Finol, Karelys Katina

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https://hdl.handle.net/2142/122040 Copy

Description

Title

Three essays on development and health economics

Author(s)

Guzman Finol, Karelys Katina

Issue Date

2023-11-30

Director of Research (if dissertation) or Advisor (if thesis)

Lyons, Angela

Doctoral Committee Chair(s)

Lyons, Angela

Committee Member(s)

• Arends-Kuenning, Mary
• McNamara, Paul
• Bardey, David

Department of Study

Agr & Consumer Economics

Discipline

Agricultural & Applied Econ

Degree Granting Institution

University of Illinois at Urbana-Champaign

Degree Name

Ph.D.

Degree Level

Dissertation

Keyword(s)

• rice yield
• temperature
• precipitation
• migration
• health expenses
• liquidity
• accounts receivable
• quality of care

Abstract

My dissertation consists of three chapters with studies on development in the context of Colombia, a developing country. The main topics approached are agricultural economics, public finances, and health economics. The first chapter evaluates the effects of climatic variables on one of the most important staples in the world. The second chapter analyzes the effects of one of the biggest migration shocks in recent years on the health expenses of the main recipient country. The third one studies the relationship between liquidity and quality of care. Each chapter used data at different granularity levels: The first chapter at the department level, the second at the municipality level, and the third at the hospital level. In the first chapter, my co-authors and I estimate the effects of annual temperature and precipitation on rice yields in Colombia from 1987 to 2016. The analysis explores the degree of variation in response to climate changes across the country’s diverse topography. Since there are two growing seasons in Colombia, the effects of the weather conditions for these two seasons are independently investigated. Additionally, rice yields are projected for two periods (2046-2065 and 2081-2100) based on the RCP 4.5, 6.5, and 8.0 of future climate scenarios. We found a positive effect of rainfall and temperature on yields, although one variable attenuates the effect of the other. The temperature was the main driver of yields in the early season, and precipitation was the main driver in the later season. Effects were larger in departments with higher altitudes. Projections show that temperature and precipitation changes will cause rice yields to increase by 10% over 2046-2065, and 2081-2100, with respect to the reference period 1987-2016. In the second chapter, my co-author and I evaluate the effects of Venezuelan migration on health expenditures for 23 main cities in Colombia between 2013 and 2019. Venezuelan migration to Colombia increased significantly since 2016 when the border between the two countries was re-opened after being closed for one year. In Colombia, local governments channel their health expenditures into four accounts: the subsidized regime, public health, services provided to the uninsured population, and other expenses. We investigate whether the migration effect differed for each account. The identification strategy is based on the 2SLS methodology. We found that total health expenditures, and public health expenditures specifically, increased with the number of migrants coming from Venezuela (Colombian returnees and Venezuelans). An increase in the number of migrants by 1,000 increased total health expenditures for the municipalities by 1.05%, and public health expenditures by 0.61%. However, migration did not significantly affect expenditures in the subsidized regime or the subaccount covering the uninsured population's attention (PPNA). This result suggests that local governments tried to contain the negative externalities of public health produced by the migration shock and that as the migration from Venezuela continues, local governments might need to secure resources to grant public health programs continuity. The third chapter estimates the effects of the accounts receivable to sales ratio, a liquidity indicator, on six quality of care indicators: waiting time for getting an appointment with a General Doctor, waiting time for emergency care, hospital readmission rate, satisfaction rate, number of General Doctors, and number of nurses. I also examine the effects of accounts receivable on the failure to pay staff, and the relationship between the former variable and other liquidity indicators, such as the percentage of assets in cash, the current liquidity ratio, and the cash ratio. The identification strategy is based on the 2SLS methodology, using information reported by public hospitals between 2009 and 2019. Results show that the accounts receivable to sales ratio had a positive effect on the number of General Doctors and nurses. Additionally, results suggest that even though public hospitals have faced severe delays in collecting payments they have assigned appointments with General Doctors and provided care for users at the emergency department in acceptable time windows. Moreover, accounts receivable did not influence the readmission rates and patient satisfaction either.

Graduation Semester

2023-12

Type of Resource

Thesis

Copyright and License Information

© 2023 Karelys Katina Guzman Finol  

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