Publications

Job loss, disability insurance and health expenditure (Bíró, Elek 2020)

Labour Economics, DOI: 10.1016/j.labeco.2020.101856 We analyse the causal effect of job loss on disability insurance enrolment on a five-year horizon and the implications on health expenditure. Using administrative panel data from Hungary, we follow individuals displaced due to a mass lay-off and compare their labour force status to non-laid-off individuals with similar employment and health history. According to our estimates, being laid off increases the transition probability to disability 1.5-fold (or by 1.4% points) in four years, and half of the excess transitions occur within the first year. The four-year mortality rate increases 1.7-fold (or by 0.4% point). Total outpatient, inpatient...

Transition shocks during adulthood and health a few decades later in post-socialist Central and Eastern Europe (Bíró, Branyiczki 2020)

BMC Public Health, DOI: 10.1186/s12889-020-08839-7 Background Health of the population of post-socialist Central and Eastern European (CEE) countries lags behind the European Union average. Our aim in this paper is to analyse the link between transition shocks and health two-three decades later. Methods We use retrospective data from the Survey of Health, Ageing and Retirement in Europe. We estimate the implications of stressful periods, financial hardships and job loss occurring around the transition (1987–1993) on subjective and objective measures of health in 2017. We compare these implications across groups of CEE countries and with the health implications of similar difficulties reported...

Caesarean delivery and the use of antidepressants (Bíró, Elek 2020)

European Journal of Public Health, DOI: 10.1093/eurpub/ckaa047 Background The high ratio of caesarean sections (C-sections) is a major public health issue in the developed world; but its implications on maternal mental health are not well understood. Methods We use individual-level administrative panel data from Hungary between 2010 and 2016 to analyze the relationship between caesarean delivery and antidepressant consumption, an objective indicator of mental health. We focus on low-risk deliveries of mothers without subsequent birth in 3 years, and include around 135 000 observations. Results After controlling for medical and socio-economic variables, antidepressant use before delivery is associated with an elevated...

Healthcare spending inequality: Evidence from Hungarian administrative data (Bíró, Prinz 2020)

Health Policy, DOI: 10.1016/j.healthpol.2020.01.006 Using administrative data on a random 50% of the Hungarian population, including individual-level information on incomes, healthcare spending, and mortality for the 2003–2011 period, we develop new evidence on the distribution of healthcare spending and mortality in Hungary by income and geography. By linking detailed administrative data on employment, income, and geographic location with measures of healthcare spending and mortality we are able to provide a more complete picture than the existing literature which has relied on survey data. We compute mean spending and 5-year and 8-year mortality measures by geography and income quantiles, and also present...

The effect of primary care availability on antibiotic consumption in Hungary: a population based panel study using unfilled general practices (Bíró, Elek 2019)

BMJ Open; 9:e028233. doi: 10.1136/bmjopen-2018-028233 Objective We analyse the effect of primary care availability on antibiotic consumption and on the quality of antibiotic prescribing behaviour. Design Retrospective panel design, secondary analysis of settlement-level administrative panel data (n=2320 settlements, T=72 months). Participants and setting We analyse antibiotic consumption of the population of villages in Hungary, over years 2010 to 2015. We exploit the geographical and time variation in unfilled (mainly single-handed) general practices as a source of exogenous variation in the availability of primary care. We control for socioeconomic characteristics and settlement fixed effects in a panel regression framework. Outcome measures Antibiotic expenditures and days of therapy (DOT);...

Health Differences at Birth between Roma and non‐Roma Children in Hungary: Long‐run Trends and Decomposition (Hajdu, Kertesi, Kézdi, 2019)

Population and Development Review, DOI: 10.1111/padr.12276 This paper uses birth records linked to census data to document health differences at birth between Roma and non-Roma children in Hungary between 1981 and 2010. It focuses on differences in average birth weight and average gestational age, as well as the likelihood of low birth weight and the likelihood of preterm birth. The paper shows large gaps in all indicators over the 30 years, with a small narrowing of the gap in absolute terms but not in relative terms. Roma mothers are twice as likely to give birth to babies with low birth weight...

Reduced user fees for antibiotics under age 5 in Hungary: Effect on antibiotic use and imbalances in the implementation (Anikó Bíró, 2019)

PLoS ONE, 14(6): e0219085. DOI: 10.1371/journal.pone.0219085   Objectives In August 2016, new prescription guidelines were introduced in Hungary to reduce the co-payments for antibiotics among children aged 0-4. This study aims at analysing the implementation of this policy and its effect on the use of antibiotics. Methods The analysis is based on administrative prescription records between January 2010—February 2018, covering the entire population of Hungary aged 0-7. Spatial autocorrelation indices are calculated and settlement level regression models are estimated to analyse the spatial variation in the application of the new guidelines. The effect of reduced co-payments on antibiotic use is...

Health gap in post-socialist Central and Eastern Europe: A life-course perspective (Anikó Bíró, Réka Branyiczki, 2019)

in: Börsch-Supan, Axel; Bristle, Johanna; Andersen-Ranberg, Karen; Brugiavini, Agar; Jusot, Florence; Litwin, Howard; Weber, Guglielmo (eds.) (2019): Health and socio-economic status over the life course. First results from SHARE Waves 6 and 7. De Gruyter, Berlin/Boston.   ► The origins of the health gap between post-socialist central and eastern Europe and western Europe are analysed ► Health disparities existed even before the transition ► Stressful periods, financial difficulties and job losses around the transition are associated with worse health at older ages

The closer the better: does better access to outpatient care prevent hospitalization? (Péter Elek, Balázs Váradi, 2019)

The European Journal of Health Economics, https://doi.org/10.1007/s10198-019-01043-4 In 2010–2012, new outpatient service locations were established in poor Hungarian micro-regions. We exploit this quasi-experiment to estimate the extent of substitution between outpatient and inpatient care. Fixed-effects Poisson models on individual-level panel data for years 2008–2015 show that the number of outpatient visits increased by 19% and the number of inpatient stays decreased by 1.6% as a result, driven by a marked reduction of potentially avoidable hospitalization (PAH) (5%). In our dynamic specification, PAH effects occur in the year after the treatment, whereas non-PAH only decreases with a multi-year lag. The instrumental variable...