tailieunhanh - Screening Tests, Information, and the Health-Education Gradient

Cross-country differences in efficiency results are associated with expenditure composition and institutional arrangements in education and health. In particular, wage spending is negatively associated with efficiency in education, while health efficiency tends to be lower in countries with more health workers (Tables 11 and 12). This finding indicates that reduced compensation spending may increase efficiency. However, it could also reflect the possibility that countries with poor past education and health outcomes are spending more on staffing. . | CSEF Centre for Studies in Economics and Finance Working Paper no. 187 Screening Tests Information and the Health-Education Gradient Ciro Avitabile Tullio Jappelli and Mario Padula January 2008 This version April 2008 Nil University of Naples Federico II University of Salerno Bocconi University Milan CSEF - Centre for Studies in Economics and Finance - University of Salerno 84084 FISCIANO SA - ITALY Tel. 39 089 96 3167 3168 - Fax 39 089 96 3167 - e-mail csef@ CSiF Centre for Studies in Economics and Finance Working Paper no. 187 Screening Tests Information and the Health-Education Gradient Ciro Avitabile Tullio Jappelli Mario Padula Abstract The association between health outcomes and education - the health-education gradient - is widely documented but little is known about its source. Using microeconomic data on a sample of individuals aged 50 in eight European countries we find that education and cognitive skills such as verbal fluency are associated with a greater propensity for standard screening tests mammography and colonoscopy . In order to study the role of information on the decision to screen we test whether the health-education gradient varies with the quality of the information provided by the health care system as proxied by the quality of the General Practitioner. Using an Instrumental Variable approach to control for the potential endogeneity of the GP quality score we find evidence of a strong and significant complementarity between education and quality of primary care. We interpret this result as evidence that health-education gradient can be explained at least in part by the fact that better educated individuals are more able to process and internalize health related information as provided by GPs. JEL Classification I0 I1 I2. Keywords Health education information general practitioners. Acknowledgements We thank James Banks and Jim Smith for comments and the Italian Ministry of University and Research for financial support. University .

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