Econometrics of health evolution and workforce planning

Lead Research Organisation: University of Manchester
Department Name: Medical and Human Sciences

Abstract

The research investigates two important issues in health economics: (1) the economic causes and consequences of mental health and wellbeing and (2) planning the supply of, and requirements for, health care workers.

The research on mental health and wellbeing will consist of three linked studies, all using data from a representative sample of individuals from across Great Britain followed-up over an 18-year period (1991-2008). These studies will consider:
(1) whether decisions to move to a different part of the UK are associated with improvements in wellbeing
(2) how the development of long-term health conditions influences the contribution that individuals and their households make to Government finances through income tax and benefit receipts
(3) how changes in mental wellbeing for one individual influence the mental wellbeing of the other individual in couples.

The workforce planning research will develop methods for forecasting the number of dentists that will be required which take account of changes in population needs, productivity and skill-mix, and levels of private sector provision.

Expertise and skills that will be developed through formal training courses, new collaborations and the undertaking of these studies will provide a firm grounding for a future career in economics of health research.

Technical Summary

The fellowship will involve four studies, covering two key areas in health econometrics - mental health/wellbeing and workforce planning.

The first three studies proposed for the research programme aim to increase understanding of the economic causes and consequences of ill-health, with a particular focus on mental health and wellbeing (using GHQ and life satisfaction scores). Each exploits the longitudinal nature of the British Household Panel Survey, and the ability to model intra-household interactions. The studies use different methodological approaches to analysing changes in health over time.

The first study, The pursuit of happiness: internal migration and wellbeing in Great Britain, aims to identify the association between migration (between regions and Local Authority Districts) and an individual‘s wellbeing. While there are studies of the effects of migration on employment and earnings, no study has focused on the effect of migration on wellbeing. The methodology will account for the potential endogeneity of the migration decision, and potential correlation between unobserved heterogeneity and the covariates.

The second study, The effect of long-term health conditions on households‘ net contributions to the State, investigates the impact of wellbeing and a range of long-term health conditions on financial contributions to the Exchequer through tax payments and benefits receipts. The longitudinal nature of the BHPS permits a focus on changes in these variables on development of these long-term conditions. Thus, selection bias caused by unobservables and persistence in health conditions can be considered. Influences will be considered on individual and household outcomes.

The third study, Understanding correlations in mental health within households, expands further the range and depth of the techniques used to investigate changes in health over time by modelling associations between the mental health of couples. Little has been researched in this area. The study will test three hypotheses about why the mental health of individuals within couples are correlated: (i) endogenous partnership formation on unobservable characteristics; (ii) common exogenous influences; and (iii) direct, causal influences.

The fourth study, Applying a needs-based approach to workforce planning, aims to identify the supply of, and requirements for, the health workforce. A number of high profile reports on workforce planning in the NHS have identified the need for methodological improvements to workforce planning. This study will generate a model that meets the deficit in current models, incorporating a dynamic systems based approach that focuses on changes in patient needs and variations in service delivery. The model uses dentistry as an example.

Publications

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