Papers by Philip Merrigan
ABSTRACT This paper focuses on the determinants of the likelihood of a remarriage (marriage) for ... more ABSTRACT This paper focuses on the determinants of the likelihood of a remarriage (marriage) for female heads with children. Using retrospective data from Statistics Canada's 1990 Family History Survey, the study attempts to identify which socioeconomic characteristics of single mothers are conducive to conjugal union formation (formal or informal). Particular attention is given to external time-varying economic covariates, so as to disentangle the impact they exert on single mothers' propensity to start living with a (new) partner. The empirical analysis is carried out using a proportional hazards model which permits the estimation of the effects of various covariates on the hazard of exiting single parenthood. The most striking result is the strong effect of provincial welfare benefits on conjugal union formation. However, the analysis reveals that single motherhood, far from representing a final state, remains a transitory situation for a majority of women.
PubMed, Feb 1, 2018
Objectives: To develop and validate a predictive model for first severe chronic obstructive pulmo... more Objectives: To develop and validate a predictive model for first severe chronic obstructive pulmonary disease (COPD) exacerbation using health insurance claims data and to validate the risk measure of controller medication to total COPD treatment (controller and rescue) ratio (CTR). Study design: A predictive model was developed and validated in 2 managed care databases: Truven Health MarketScan database and Reliant Medical Group database. This secondary analysis assessed risk factors, including CTR, during the baseline period (Year 1) to predict risk of severe exacerbation in the at-risk period (Year 2). Methods: Patients with COPD who were 40 years or older and who had at least 1 COPD medication dispensed during the year following COPD diagnosis were included. Subjects with severe exacerbations in the baseline year were excluded. Risk factors in the baseline period were included as potential predictors in multivariate analysis. Performance was evaluated using C-statistics. Results: The analysis included 223,824 patients. The greatest risk factors for first severe exacerbation were advanced age, chronic oxygen therapy usage, COPD diagnosis type, dispensing of 4 or more canisters of rescue medication, and having 2 or more moderate exacerbations. A CTR of 0.3 or greater was associated with a 14% lower risk of severe exacerbation. The model performed well with C-statistics, ranging from 0.711 to 0.714. Conclusions: This claims-based risk model can predict the likelihood of first severe COPD exacerbation. The CTR could also potentially be used to target populations at greatest risk for severe exacerbations. This could be relevant for providers and payers in approaches to prevent severe exacerbations and reduce costs.
Professeure titulaire, Département de sciences économiques, ESG-UQAM Chercheuse et Fellow CIRANO ... more Professeure titulaire, Département de sciences économiques, ESG-UQAM Chercheuse et Fellow CIRANO Résultats d'analyses inédites sur les liens entre l'âge d' entrée à l' école et les diagnostics du TDAH chez les enfants québécois
Annals of the American Thoracic Society, Jul 1, 2016
Rationale: Current chronic obstructive pulmonary disease (COPD) exacerbation risk prediction mode... more Rationale: Current chronic obstructive pulmonary disease (COPD) exacerbation risk prediction models are based on clinical data not easily accessible to national quality-of-care organizations and payers. Models developed from data sources available to these organizations are needed. Objectives: This study aimed to validate a risk measure constructed using pharmacy claims in patients with COPD. Administrative claims data were used to construct a risk model to test and validate the ratio of controller (maintenance) medications to total COPD medications (CTR) as an independent risk measure for COPD exacerbations. The ability of the CTR to predict the risk of COPD exacerbations was also assessed. Methods: This was a retrospective study using health insurance claims data from the Truven MarketScan database (2006-2011), whereby exacerbation risk factors of patients with COPD were observed over a 12-month period and exacerbations monitored in the following year. Exacerbations were defined as moderate (emergency department or outpatient treatment with oral corticosteroid dispensings within 7 d) or severe (hospital admission) on the basis of diagnosis codes. Models were developed and validated using split-sample data from the MarketScan database and further validated using the Reliant Medical Group database. The performance of prediction models was evaluated using C-statistics. Measurements and Main Results: A total of 258,668 patients with COPD from the MarketScan database were included. A CTR of greater than or equal to 0.3 was significantly associated with a reduced risk for any (adjusted odds ratio [OR], 0.91; 95% confidence interval [CI], 0.85-0.97); moderate (OR, 0.93; 95% CI, 0.87-1.00), or severe (OR, 0.87; 95% CI, 0.80-0.95) exacerbation. The CTR, at a ratio of greater than or equal to 0.3, was predictive in various subpopulations, including those without a history of asthma and those with or without a history of moderate/severe exacerbations. The C-statistics ranged from 0.750 to 0.761 for the development set and 0.714 to 0.761 in the validation sets, indicating the CTR performed well in predicting exacerbation risk. Conclusions: The ratio of controller to total medications dispensed for COPD is a measure that can easily be calculated using only pharmacy claims data. A CTR of greater than or equal to 0.3 can potentially be used as a quality-of-care measurement for prevention of exacerbations.
Journal of Human Capital, Mar 1, 2018
We evaluate the long-term eects of the Canadian province of Quebec $5 per day universal childcare... more We evaluate the long-term eects of the Canadian province of Quebec $5 per day universal childcare policy on child and youth well-being (health, behavior, motor and social development). Treated children are followed for more than 19 years. Estimates based on a nonexperimental evaluation framework show that the negative eects on preschoolers documented in previous studies persist over time for most outcomes. Once children enter school, only the impact on emotional disorder and anxiety persists, but the magnitude is smaller than for preschool children. For teens, aged 12 to 19 years old, our estimates do not suggest that the eects persist.
Au Québec, les enfants doivent avoir 5 ans avant le 1er octobre pour être admis en maternelle. Da... more Au Québec, les enfants doivent avoir 5 ans avant le 1er octobre pour être admis en maternelle. Dans une même classe, les plus jeunes ont donc jusqu’à un an de moins que les plus vieux. Dans cette étude, les auteurs montrent que les enfants nés fin septembre ont des taux de diagnostic et de médication du TDAH 35 % plus élevés que ceux nés début d’octobre. Le TDAH serait confondu avec des comportements d’inattention ou de plus grande turbulence. S’appuyant sur des données inédites de la RAMQ incluant les dossiers de services médicaux de près de 800 000 jeunes nés entre 1996 et 2005, les auteurs tirent des conclusions non équivoques sur l’ampleur du phénomène et sonnent l’alarme sur un enjeu extrêmement préoccupant.
RePEc: Research Papers in Economics, Oct 1, 2011
We investigate the impact of an ambitious provincial school reform in Canada on students' mathema... more We investigate the impact of an ambitious provincial school reform in Canada on students' mathematical achievements. This reform provides advantages for the purpose of evaluation and cuts across some of the methodological di¢ culties of previous research. First, the reform was implemented in every school across the province in both primary and secondary schools. Second, we can di¤erentiate impacts according to the number of years students are a¤ected by the reform. Third, our data set provides a longer observation period than typically encountered in the literature. We …nd negative e¤ects on students'mathematical achievements at all points of the skills distribution.
RePEc: Research Papers in Economics, 2011
We investigate the impact of an ambitious provincial school reform in Canada on students' mathema... more We investigate the impact of an ambitious provincial school reform in Canada on students' mathematical achievements. It is the first paper to exploit a universal school reform of this magnitude to identify the causal effect of a widely supported teaching approach on students' math scores. Our data set allows us to differentiate impacts according to the number of years of treatment and the timing of treatment. Using the changes-in-changes model, we find that the reform had negative effects on students' scores at al points on the skills distribution and that the effects were larger the longer the exposure to the reform.
RePEc: Research Papers in Economics, 2008
This paper tries to disentangle the relative importance of family and school inputs on a child's ... more This paper tries to disentangle the relative importance of family and school inputs on a child's cognitive achievement as measured by her percentile score on a mathematics test. We replicate a study by Todd and Wolpin (2007) in the United States with Canadian data. In contrast to their work that uses state-level indicators of school quality we estimate our model with data from Statistics Canada's National Longitudinal Survey of Children and Youth (NLSCY) which provides micro-level information on the family and school history of the child. The sample used for the analysis is based on the 7-to 15year-old longitudinal children who have completed at least two consecutive math tests. As in Todd and Wolpin, we conclude that cognitive outcomes are determined by current and past family inputs. Contrary to them, who find no impact of school inputs, we find that the quality of schools has a positive impact on achievement in mathematics.
RePEc: Research Papers in Economics, Nov 1, 2018
Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch ge... more Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may be saved and copied for your personal and scholarly purposes. You are not to copy documents for public or commercial purposes, to exhibit the documents publicly, to make them publicly available on the internet, or to distribute or otherwise use the documents in public. If the documents have been made available under an Open Content Licence (especially Creative Commons Licences), you may exercise further usage rights as specified in the indicated licence. Research Group on Human Capital Working Paper Series L'héritage de l'éducation sur 25 ans : Une comparaison des tendances au Québec et dans le Reste du Canada Working Paper No. 18-02
RePEc: Research Papers in Economics, Oct 1, 2014
Exploiting unique administrative longitudinal data sets on medical services provided to mothers b... more Exploiting unique administrative longitudinal data sets on medical services provided to mothers before- and after- delivery, we estimate the causal effects of two major distinct parental leave reforms on maternal health outcomes, over a period of 5 years postpartum. The health outcomes are objective measures based on all types of medical services provided by physicians. For mothers publicly insured by the public prescription drug plan we can also identify all drugs used, in particular those associated with depressive symptoms. The long time span of the longitudinal administrative data sets allows an assessment of short-run and long-run effects of maternity leave on mothers? health. The empirical approach uses a strict regression discontinuity design based on the day of regime change. The large samples of mothers, who gave birth three months before and three months after the two policy changes (in 2001 and 2006), are drawn randomly from the population of delivering women, all covered by the universal public health care program. We do not find any evidence that the reforms had sizeable impacts on maternal health care costs, either of a physical or of a mental in nature, as measured by physicians? fee-for-service billing costs, prescription drug costs, or the number of hospitalizations. The second expansion has given rise to large fiscal costs over time as well as socioeconomic inequities.
RePEc: Research Papers in Economics, 2008
Effects of a low-fee universal childcare policy, initiated in Québec, the second most populous pr... more Effects of a low-fee universal childcare policy, initiated in Québec, the second most populous province in Canada, on the cognitive development of preschool children are estimated with a sample of 4-and 5-year-olds (N=8,875; N=17,154). In 1997, licensed and regulated providers of childcare services began offering daycare spaces at the reduced fee of $5 per day per child for children aged 4. By 2000, the low-fee policy applied to all children aged 0 to 59 months (not in kindergarten). The study uses 6 cycles of biennial data drawn from Statistics Canada's National Longitudinal Survey of Children and Youth (1994-2004) and quasi-experimental estimation methods to provide evidence that the policy had substantial negative effects on preschool children's Peabody Picture Vocabulary Test scores. The negative effects are found to be stronger for children with mothers who have lower levels of education.
RePEc: Research Papers in Economics, Mar 1, 2005
RePEc: Research Papers in Economics, Mar 1, 2005
Le CIRANO est un organisme sans but lucratif constitué en vertu de la Loi des compagnies du Québe... more Le CIRANO est un organisme sans but lucratif constitué en vertu de la Loi des compagnies du Québec. Le financement de son infrastructure et de ses activités de recherche provient des cotisations de ses organisations-membres, d'une subvention d'infrastructure du Ministère du Développement économique et régional et de la Recherche, de même que des subventions et mandats obtenus par ses équipes de recherche. CIRANO is a private non-profit organization incorporated under the Québec Companies Act. Its infrastructure and research activities are funded through fees paid by member organizations, an infrastructure grant from the Ministère du Développement économique et régional et de la Recherche, and grants and research mandates obtained by its research teams.
Social Science Research Network, 2011
CIRANO Le CIRANO est un organisme sans but lucratif constitué en vertu de la Loi des compagnies d... more CIRANO Le CIRANO est un organisme sans but lucratif constitué en vertu de la Loi des compagnies du Québec. Le financement de son infrastructure et de ses activités de recherche provient des cotisations de ses organisations-membres, d'une subvention d'infrastructure du Ministère du Développement économique et régional et de la Recherche, de même que des subventions et mandats obtenus par ses équipes de recherche. CIRANO is a private non-profit organization incorporated under the Québec Companies Act. Its infrastructure and research activities are funded through fees paid by member organizations, an infrastructure grant from the Ministère du Développement économique et régional et de la Recherche, and grants and research mandates obtained by its research teams.
The B.E. Journal of Economic Analysis & Policy
In this paper, we study the long-term impacts on parental health and behaviors of a low-fee unive... more In this paper, we study the long-term impacts on parental health and behaviors of a low-fee universal childcare program for children aged zero to five years old. We follow families for more than 10 years after the reform. For families with preschool children, we show that the adverse effects documented in previous studies on maternal depression and parental behaviors persist over time. However, once children enter school, most negative effects of the program on parental mental health and behaviors fade away. Only the negative effect on positive interactions may have persisted over time.
HAL is a multi-disciplinary open access archive for the deposit and dissemination of sci-entific ... more HAL is a multi-disciplinary open access archive for the deposit and dissemination of sci-entific research documents, whether they are pub-lished or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et a ̀ la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.
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Papers by Philip Merrigan