I am an Associate Professor at the School of Government and the Institute of Economics at PUC-Chile. My research focuses on health economics, development economics, and program evaluation. I am also a constant collaborator of international agencies on projects in the LAC region. I hold affiliations with 3ieImpact, BFI-Latam, ISCI, and JPAL-Latam.
Download my CV here.
Email: pacelhay [at] uc.cl
Google scholar here.
[1] "Short-Term Effects of Cash Assistance for Migrants and Refugees in Colombia," (with S. Martinez, C. Huang, C. Alviar and A. Stamatiadi).
Economic Development and Cultural Change, accepted. [Link]
[2] "Stigma in Welfare Programs," (with N. Mittag and B. Meyer).
Review of Economics and Statistics, accepted.[Link][NBER w30307].
[3] "Schooling Mobility Across Three Generations in Six Latin American Countries," (with S. Gallegos).
Journal of Population Economics, accepted.[Link].
[4] "When a Strike Strikes Twice: Massive Student Mobilizations and Teenage Pregnancy in Chile," (with Emilio Depetris-Chauvin and Cristina Riquelme).
Journal of Development Economics, 2024. [Link]
[5] "What Leads to Measurement Errors? Evidence from Reports of Program Participation in Three Surveys," (with Nikolas Mittag and Bruce Meyer).
Journal of Econometrics, 2024. [Link] [NBER 29652]
[6] "Early Skill Effects on Parental Beliefs, Investments, and Children Long-Run Outcomes," (with Sebastian Gallegos).
Journal of Human Resources, 2022. [Link]
[7] "How Scheduling Systems with Automated Appointment Reminders Improve Health Clinic Efficiency," (with Claire Boone, Paul Gertler, Tadeja Gracner, and Josefina Rodriguez) .
Journal of Health Economics, 2022. [Link]
[8] "Location Preferences and Slums Formation: Evidence From a Panel of Residence Histories," (with Raimundo Undurraga).
Regional Science and Urban Economics. 2022. [Link]
[9] "Can Small Incentives Have Large Payoffs? Health Impacts of a Cash Transfer Program in Bolivia," (with Julia Johannsen, Sebastian Martinez, and Cecilia Vidal).
Economic Development and Cultural Change, 2021. [Link]
[10] "Long-Run Effects of Temporary Incentives on Medical Care Productivity," (with Paul Gertler, Paula Giovagnoli, and Christel Vermeersch).
American Economic Journal: Applied Economics, 2019. [Link] Press: Blog Nada es Gratis
[11] "Attitudinal effects of data visualizations and illustrations in data stories," (with Garretón, Manuela, Francesca Morini, Marian Dörk, and Denis Parra).
IEEE Transactions on Visualization and Computer Graphics, 2023. [Link]
[12] "Property rights and market behavior in the low-income housing sector: Evidence from Chile," (with Diego Gil).
Journal of Empirical Legal Studies, 2022. [Link]
[13] "Effects of Mindfulness-Based Stress Reduction on Psychological Distress in Health Workers: A Three-arm Parallel Randomized Controlled Trial," (with Antonia Errazuriz, Kristin Schmidt, Eduardo A. Undurraga, Sebastian Medeiros, Rene Baudrand, Diego Cussen, Marcela Henriquez, Rodrigo A. Figueroa).
Journal of Psychiatric Research, 2022. [Link]
[14] "The function and credibility of urban slums: Evidence on informal settlements and affordable housing in Chile," (with Diego Gil).
Cities, 2020. [Link]
[15] "Measuring socioeconomic gaps in nutrition and early child development in Bolivia," (with Sebastian Martinez and Cecilia Vidal).
International Journal for Equity in Health, 2020. [Link]
[16] "Long Run Effects of Universal Health Insurance for Children in Mexico" (with Sebastian Martinez, Matías Muñoz, Michelle Perez, and Ricardo Perez-Cuevas).
The Lancet Global Health, 2019. [Link] Press: Commentary on Lancet Global Health Podcast in Lancet Global Health
SUBMITTED WORK AND WORKING PAPERS
"The Importance of Preventive Medical Care for Managing Chronic Disease" (with C. Boone, P. Gertler, and T. Gracner). R&R American Economic Journal: Policy. [NBER w33738]
We study how preventive medical care use affects health behaviors and outcomes for patients with chronic diseases. Leveraging variation induced by a national appointment reminder program, rolled out across 315 public primary care clinics in Chile, we use an instrumental variables approach with patient-level administrative data from over 300,000 patients with type 2 diabetes and hypertension. We find that increased preventive visits lead to more screening tests and large increases in medication adherence. Preventive care also leads to earlier detection and treatment of cardiovascular complications: we document an increase in cardiovascular hospitalizations but a reduction in in-hospital mortality.
"Short-Term Cash, Long-Term Gains: Evidence from the Venezuelan Migration Crisis in Colombia" (with S. Martinez, N. Agudelo, and P. Held). R&R Journal of Development Economics. [Link]
We study whether temporary humanitarian cash assistance yields durable welfare gains by evaluating ADN Dignidad, an unconditional transfer program reaching over 370,000 Venezuelan migrants and Colombian returnees in Colombia. Using a regression discontinuity design, we track beneficiaries 1–3 and 16–20 months after the six-month payment stream ended. In the short run, the program raises per-capita income, expenditures, savings, and food security. After 20 months, income and savings gains fade, but expenditures, food security, and well-being remain higher, with no increase in onward migration. Qualitative evidence suggests consumption smoothing and reduced harmful coping strategies as mechanisms sustaining well-being.
"Errors in reporting and imputation of government benefits and their implications" (with N. Mittag and B. Meyer). R&R Journal of Human Resources. [NBER w29184]
We document the extent, nature, and consequences of survey errors for receipt of cash welfare and SNAP in three major U.S. household surveys linked to administrative program records. Our results confirm earlier evidence of frequent misreporting of program receipt, particularly failure to report receipt. The surveys poorly capture patterns of participation in multiple programs, even though there is not much evidence of program confusion. Error rates are higher among imputed observations, which also account for a large share of false positive errors. Many household characteristics have significant effects on errors in reporting receipt, both false positives and false negatives. Among others, we find large differences in survey error by race, ethnicity, and income. We provide evidence on the consequences of these errors for models of program receipt. Estimated effects of, among others, income and race are biased downward. On the positive side, our results confirm a tendency to attenuation in models with misclassified dependent variables that preserves many qualitative results in the survey estimates. We then examine error due to item non-response and imputation, as well as whether imputation improves estimates. Item non-respondents have higher receipt rates than the population, even conditional on many covariates. The joint distribution ofs program receipt and these covariates differs between item non-respondents and the entire population, but also between accurate and imputed receipt among item non-respondents. Thus, neither excluding item non-respondents nor using their imputed values yields consistent estimates. For binary choice models of program receipt, estimates from the linked data favor excluding item non-respondents over using their imputed values. The biases in each case are well predicted by the error patterns we document, so such analyses can help researchers make more informed decisions on the use of imputed values.
"An ounce of prevention for a pound of cure: Basic health care and efficiency in health systems" (with A. Bancalari, P. Bernal, S. Martinez and MD. Sanchez). R&R Journal of Health Economics. [Link]
We examine the efficiency gains in health systems generated after the national roll out of basic healthcare in El Salvador between 2010 and 2013. Using data from over 120 million consultations and five million hospitalizations, we demonstrate that the expansion of community health teams, comprising less-specialized health workers, increases preventive care and decreases curative care and preventable hospitalizations. We also estimate coverage improvements for previously unattended chronic conditions amenable to effective primary care. These results suggest that decentralization of tasks to less-specialized health workers improves efficiency, maintaining quality of care.
"The Effects of Intervening the Supply Side of Fraudulent Sick Leaves Market in Chile" (with N. Figueroa, C. Guadalupi, and B. Oteiza). [Slides][Draft]
This paper investigates the impact of an intervention in Chile's fraudulent sick leave market, where 176 physicians were sanctioned for excessive sick leave certificate issuance. Physician decisions are influenced by patient needs and their own incentives, often leading to suboptimal healthcare practices. The study aims to determine if audits and sanctions can alter physician behavior, whether non-sanctioned doctors experience spillover effects, and how these changes affect patient behavior. Using data from approximately 22 million sick leaves issued between January 2018 and October 2022, the study employs a difference-in-differences (DiD) approach alongside a regression discontinuity in time (RDiT) model. Results indicate a significant decline in sick leave issuance among sanctioned doctors, with a 40.49% decrease observed in the DiD model compared to matched physicians, while the RDiT model shows reductions between 50.12% and 34.46%. Additionally, evidence suggests spillover effects, as non-sanctioned doctors’ sick leave issuance decreased by 14.19% to 9.33% post-intervention. On the demand side, high-receiving patients exposed to sanctioned doctors experienced an 18.94% reduction in sick leaves, translating to estimated savings of approximately $12.6 million for the public insurer. However, the findings indicate that these patients may substitute sick leaves imperfectly, revealing potential unintended consequences of the intervention. The paper concludes by suggesting further research into the channels of information transmission and the broader impacts on firm productivity.
"Monitoring Physician Behavior to Prevent Overpresciption: Experimental Evidence from Sick in Chile" (with N. Figueroa and M. Muñoz). [Policy brief]
This study investigates the effectiveness of deterrence strategies in reducing moral hazard within healthcare systems. Specifically, it examines three primary research questions: (1) Does the threat of enforcement reduce moral hazard among gatekeeping physicians? (2) Can deterrence applied to the supply side (doctors) also mitigate moral hazard on the demand side (patients)? (3) What are the potential negative health effects on patients resulting from deterring high-prescription physicians? To address these questions, we conducted an experimental intervention involving deterrence messages directed at high-prescription doctors in Chile. The study analyzes changes in prescription behavior resulting from these messages. Additionally, we evaluate the behavior of both frequent and infrequent patients of these physicians, focusing on appointment patterns and search behaviors. Finally, we assess the impact of these deterrence measures on the ex-post health expenditures of patients treated by the targeted physicians. Our findings contribute to understanding the broader implications of deterrence in healthcare, including its effects on physician behavior and patient health outcomes.
"How Managers Can Use Purchaser Performance Information to Improve Procurement Efficiency" (with P. Gertler, M. Olivares, and R. Undurraga). [Link]
We examine the effect of performance monitoring in public procurement through the lens of organizational culture in a principal-agent model where the manager (principal) and buyers (agents) may have different beliefs about how much the government values efficiency. We show that the effect of performance information not only increases efficiency but is greater when the buyer’s belief is stronger than the manager’s belief. We leverage a new e-procurement system in Chile to test these ideas by randomizing monthly reports on the purchasing performance of buyers and further whether the individual performance reports were disclosed to managers. We find that the reports generated sizable reductions in overspending— with savings reaching a 15% reduction or 0.1% of GDP — but only when individual performance was observable to managers. This is consistent with extrinsic motivation rather than intrinsic motivation driving buyer behavior. Consistent with the theoretical model, we also find that the gain in efficiency is concentrated in procurement units where buyer belief that the government cares about efficiency is stronger than manager belief. Our results highlight the key role played by organizational culture in mediating the impact of purchasing performance information on preventing the misuse of public resources.
"Sharing is Caring: The Impact of Disseminating Results to Research Participants" (with S. Martinez, N. Agudelo, and I. Torres).
Economics research involving human subjects has expanded rapidly in recent decades. While research ethics supports informing research participants of study results, there is little empirical evidence on this practice. We conducted an information experiment with participants of a cash transfer program in Colombia. Messages containing select program impacts were shared with half the program participants in our study sample. We find that exposure to this information significantly increased participants’ perceptions of the program’s effectiveness, and treated subjects had more favorable views of the program. We find no evidence of contamination in the reporting of outcome measures related to the cash transfer program. These results support a proactive role for researchers and policymakers to share study findings with participants.
