NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

NBER Working Papers and Publications by Didem Bernard

Contact and additional information for this authorAll NBER papers and publicationsNBER Working Papers only

Working Papers and Chapters and Reporter Articles

February 2017The Distribution of Public Spending for Health Care in the United States on the Eve of Health Reform
with Thomas Selden, Yuriy Pylypchuk: w23150
U.S. health care spending in 2012 totaled $2.8 trillion or 17.2 percent of gross domestic product. Given the magnitude of health care spending, the large public sector role in health care, and the reforms being implemented under the Patient Protection and Affordable Care Act (ACA), we believe it useful to examine several basic questions: What was the public share of national spending on the eve of reform? How has the public share evolved over time? And how are the benefits of public spending on health care distributed within the population by age, poverty level, insurance coverage, health status, and ACA-relevant subgroups? The questions we pose, while basic, cannot be answered with commonly-available statistics due to the sheer complexity of health care financing in the U.S. The objective...

Forthcoming: The Distribution of Public Spending for Health Care in the United States on the Eve of Health Reform, Didem Bernard, Thomas Selden, Yuriy Pylypchuk. in Measuring and Modeling Health Care Costs, Aizcorbe, Baker, Berndt, and Cutler. 2017

October 2016The Distribution of Public Spending for Health Care in the United States on the Eve of Health Reform
with Thomas Selden, Yuriy Pylypchuk
in Measuring and Modeling Health Care Costs, Ana Aizcorbe, Colin Baker, Ernst Berndt, and David Cutler, editors
U.S. health care spending in 2012 totaled $2.8 trillion or 17.2 percent of gross domestic product. Given the magnitude of health care spending, the large public sector role in health care, and the reforms being implemented under the Patient Protection and Affordable Care Act (ACA), we believe it useful to examine several basic questions: What was the public share of national spending on the eve of reform? How has the public share evolved over time? And how are the benefits of public spending on health care distributed within the population by age, poverty level, insurance coverage, health status, and ACA-relevant subgroups? The questions we pose, while basic, cannot be answered with commonly-available statistics due to the sheer complexity of health care financing in the U.S. The objectiv...
January 2010Does Prescription Drug Adherence Reduce Hospitalizations and Costs?
with William Encinosa, Avi Dor: w15691
We estimate the impact of diabetic drug adherence on hospitalizations, ER visits, and hospital costs, using insurance claims from MarketScan® employer data. However, it is often difficult to measure the impact of drug adherence on hospitalizations since both adherence and hospitalizations may be correlated with unobservable patient severity. We control for such unobservables using propensity score methods and instrumental variables for adherence such as drug coinsurance levels and direct-to- consumer-advertising. We find a significant bias due to unobservable severity in that patients with more severe health are more apt to comply with medications. Thus, the relationship between adherence and hospitalization will be underestimated if one does not control for unobservable severity. Overall,...

Published: Does prescription drug adherence reduce hospitalizations and costs? The case of diabetes. Encinosa, W., Bernard, D., Dor, A. "Does prescription drug adherence reduce hospitalizations and costs? The case of diabetes." Advances in Health Economics and Health Services Research, Vol. 22 151-173. Emerald Group Publishing Limited, Apr 2010.

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