Dollars and Performance: Treating Alcohol Misuse in Maine. Journal of Health Economics, vol 20 (4) pp 645-672, 2001.
If public funds are allocated efficiently, then an increase in funding should improve the performance of substance abuse treatment programs. In the data used in this paper, performance (measured as abstinence rates) and expenditures per patient are not positively correlated. One explanation is that funding is endogeneous, i.e. programs treating more difficult patients receive more funding. The data comes from all Maine’s outpatient drug-free programs that received public funding between 1991 and 1994. After controlling for endogeneity, this paper concludes that the marginal impact of expenditures per patient on abstinence rates is small and statistically insignificantly different from zero.
A Consistent Estimator for the Binomial Distribution in the Presence of Incidental Parameters, an Application to Patent Data. Journal of Econometrics, vol 119 (1) pp73-98, March 2004.
In this paper a consistent estimator for the Binomial distribution in the presence of incidental parameters, or fixed effects, when the underlying probability is a logistic function is derived. The consistent estimator is obtained from the maximization of a conditional likelihood function in light of Andersen's work. Monte Carlo simulations show its superiority relative to the traditional maximum likelihood estimator with fixed effects also in small samples, particularly when the number of observations in each cross-section, T, is small. Finally, this new estimator is applied to an original dataset that allows the estimation of the probability of obtaining a patent.
Substance Abuse Treatment: what do we know? An Economist's perspective, European Journal of Health Economics, Vol. 6 (1), pp 53-64, March 2005.
The literature on treating substance abuse has dealt basically with four important questions: (a) Is treatment effective? (b) Are all programs equally effective? (c) Why do programs differ in their effectiveness? (d) Which treatments are more cost-effective? This paper reviews the substance abuse treatment literature around these four questions and discusses methodological issues that hinder the interpretation and generalization of results to date. The answer to the first question is a sounding “yes,” treatment is effective but not all programs are equally effective. Researchers have moved beyond the “black box” literature that concentrated on patient and program characteristics as explanations for differences in effectiveness and search for the “active” ingredients of treatment. These include, for example, the treatment philosophy of the program’s director and staff attitudes towards patients. Cost-effectiveness studies are less common, and their conclusions are mixed. In general, it is probably safe to say that for the majority of patients, outpatient or shorter programs are more cost-effective.
Benchmarking for Productivity Improvement: a health care application (Daniel A. Ackerberg, Matilde P. Machado and Michael H. Riordan), International Economic Review, vol47 nº1, February 2006
A methodology is developed and applied to compare the performance of publicly funded agencies providing treatment for alcohol abuse in Maine. The methodology estimates a Wiener process that determines the duration of completed treatments, while allowing for agency differences in the effectiveness of treatment, costs of treatment, standards for completion of treatment, patient attrition, and the characteristics of patient populations. Notably, the Wiener process model separately identifies agency fixed effects that describe differences in the effectiveness of treatment (“treatment effects”), and effects that describe differences in the unobservable characteristics of patients (“population effects”). The estimated model enables hypothetical comparisons of how different agencies would treat the same populations. The policy experiment of transferring the treatment practices of more cost‐effective agencies suggests that Maine could have significantly reduced treatment costs without compromising health outcomes by identifying and transferring best practices.Literatu
Moral hazard and the demand for health services: a matching estimator approach (Pedro Pita Barros, Matilde P. Machado and Anna Sanz de Galdeano), Journal of Health Economics, Vol 27, pp 1006-1025, July 2008.
We estimate the impact of extra health insurance coverage beyond a National Health System on the demand for several health services. Traditionally, the literature has tried to deal with the endogeneity of the private (extra) insurance decision by finding instrumental variables. Since a priori instrumental variables are hard to find we take a different approach. We focus on the most common health insurance plan in Portugal, ADSE, which is given to all civil servants and their dependents. We argue that this insurance is exogenous, i.e., not correlated with the beneficiaries’ health status. This identifying assumption allows us to estimate the impact of having ADSE coverage on the demand for three different health services using a matching estimator technique. The health services used are number of visits, number of blood and urine tests, and the probability of visiting a dentist. Results show large positive effects of ADSE coverage for number of visits and tests among the young (18–30 years old) but only the latter is statistically significantly different from zero. The effects represent 21.8% and 30% of the average number of visits and tests for the young. On the contrary, we find no evidence of moral hazard on the probability of visiting a dentist.
Can We Infer Hospital Quality from Medical Graduates’ Residency Choices? (Matilde P. Machado, Ricardo Mora and Antonio Romero-Medina), Journal of the European Economic Association, 10-6, pp 1400-1424, December 2012.
This paper uses a novel approach to infer hospital technical quality from revealed preferences over residency programs. Specifically, we use Spanish medical graduates’ residency choices made from 1995 to 2000. We start by estimating a model of medical graduates preferences that controls for hospital, proximity, specialty, and gender effects. We interpret the coefficients on the hospital dummy variables as measures of medical graduates’ preferences over hospitals. Our results show that graduates do indeed discriminate between hospitals and that their preferences correlate with hospital-specific covariates arguably related to hospital training quality. We then show that preferences from medical graduates are positively and statistically significantly correlated with risk-adjusted hospital rankings based on five alternative outcome measures. Finally, we construct reputation scores for each hospital using news story counts in three media outlets and find that medical graduates’ preferences are especially valuable for inference of hospital technical quality of care as they do not simply reflect well known reputation.
Coverage of Infertility Treatment and Fertility Outcomes (Matilde P. Machado and Anna Sanz de Galdeano), SERIES (The journal of the Spanish Economic Association), 6(4), December 2015.
This article is among the top 50 most cited articles published in SERIES (see here and journal metrics here)
Policy interventions that increase insurance coverage for infertility treatments may affect fertility trends, and ultimately, population age structures. However, such policies have ignored the overall impact of coverage on fertility. We examine short-term and long-term effects of increased insurance coverage for infertility on the timing of first births and on women’s total fertility rates. Our main contribution is to show that infertility mandates enacted in the United States during the 80s and 90s did not increase the total fertility rates of women by the end of their reproductive lives. We also show evidence that these mandates induced women to put off motherhood.
Literacy and Primary School Expansion in Portugal: 1940-1962 (Pedro Gomes and Matilde P. Machado). Revista de Historia Economica/Journal of Iberian and Latin American Economic History, 38(1), Special Issue on Economic History of Portugal, March 2020.
Blog post about the article: Portuguese Economy Research Report
In 1940, the Portuguese government approved a massive primary school construction plan that projected a 60 per cent increase in the number of primary schools. Based on the collection of a new dataset, we describe literacy levels in Portugal prior to the plan as well as the plan's strategy regarding the location of schools. We then estimate the causal impact of the increase in the number of schools between 1940 and the early 60s on enrolment and literacy, all at the county level. We conclude the increase in the number of schools was responsible for 80 per cent of the increase in enrolment and 13 per cent of the increase in the literacy rate of the affected cohorts.
The Impact of a Permanent Income Shock on the Situation of Women in the Household: the case of a pension reform in Argentina (Inés Berniell, Dolores De la Mata and Matilde P. Machado). Economic Development and Cultural Change, 68 (4), 1295-1343, July 2020.
Blog and Press about the article: Lacea Vox part 1 and 2 (in English); Nada es Grátis and Blog de Cedlas (in Spanish)
Income transfers from social programs are often not gender neutral, according to the vast literature on intrahousehold decision-making and allocation, and should affect the distribution of bargaining power within the household. This result, however, was by and large established under the assumption of marriage stability. If this assumption does not hold (because of divorce or separation), then the positive response of bargaining power to income found in the empirical research may be the artifact of sample selection. In this paper, we prove that the marriage stability assumption is wrong, even when applied to seniors. We use a noncontributory pension reform in Argentina, which resulted in an unexpected and substantial increase in permanent income for at least 1.8 million women, to study its effects on outcomes related to both marital stability and women’s bargaining power within the household. We find that the reform increased the probability of divorce or separation among highly educated senior women but had no impact on those with less education. Instead, the latter gained considerable bargaining power within the household by decreasing the probability of being the only one in charge of household chores along with an increase in their husbands’ participation in these chores.
Motherhood, pregnancy or marriage effects? (Ines Berniell, Lucila Berniell, Dolores De la Mata, Maria Edo, Yarine Fawaz, Matilde P. Machado and Mariana Marchionni), Economics Letters, 214, May 2022.
The existence of large child penalties on women's labor market outcomes has been documented for multiple countries and time periods. In this paper, we assess the extent to which marriage decisions and pregnancies may partly explain these child penalties. Using data from 29 countries drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), we show that although marriage has a negative effect on women's employment (-3.3%), its magnitude is much smaller than that of the negative effect of a first child (-23%). Moreover, we find that pregnancies that end in non-live births have non-statistically significant effects on employment in the following years, supporting the exogeneity assumption underlying the identification in child penalty studies. These new results lend support to the hypothesis that child-rearing, rather than marriage or pregnancy, is responsible for women exiting the labor force upon motherhood.
The Role of Mothers on Female Labour Force Participation: An approach using historical parish records, Jesus Carro, Matilde P. Machado and Ricardo Mora, Empirical Economics, 65, 1345-1384, 2023.
Blog article: Working mothers, working daughters: looking back at a time when information was scarce (uc3nomics)
The existence of large child penalties on women's labor market outcomes has been documented for multiple countries and time periods. In this paper, we assess the extent to which marriage decisions and pregnancies may partly explain these child penalties. Using data from 29 countries drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), we show that although marriage has a negative effect on women's employment (-3.3%), its magnitude is much smaller than that of the negative effect of a first child (-23%). Moreover, we find that pregnancies that end in non-live births have non-statistically significant effects on employment in the following years, supporting the exogeneity assumption underlying the identification in child penalty studies. These new results lend support to the hypothesis that child-rearing, rather than marriage or pregnancy, is responsible for women exiting the labor force upon motherhood.
Motherhood and the Allocation of Talent, Ines Berniell, Lucila Berniell, Dolores De la Mata, Maria Edo, Yarine Fawaz, Matilde P. Machado, and Mariana Marchionni, Applied Economics, 1-17, 2024.
In this paper we show that motherhood triggers changes in the allocation of talent in the labor market beyond the well-known effects on gender gaps in employment and earnings. Based on an event study approach around the birth of the first child and retrospective panel data for 28 European countries and Israel, we assess the labor market responses to motherhood across “talent” groups—i.e., groups with different educational attainment, Math performance at age 10, and personality traits associated to entrepreneurial ability. We show that even the most talented women—both in absolute terms and relative to their husbands—leave the labor market or uptake part-time jobs after the birth of the first child. We also find that motherhood induces a negative selection of female talents into self-employment. Overall, our results suggest relevant changes in the allocation of talent associated to gender differences in non-market responsibilities that can have sizable impacts on aggregate market productivity.
A Ecolarização em Portugal no principio dos anos 40: Uma análise quantitativa (Pedro Gomes and Matilde P. Machado). Ler História, vol 79, 135-164, 2021
Em 1940, o Governo Português aprovou um plano nacional de construção de escolas primárias denominado “Plano dos Centenários” que projectava um aumento de 60% do número de estabelecimentos de ensino primário. Através de uma análise estatística e após uma exaustiva recolha de dados, identificam-se vários factos relativos à escolarização em Portugal a nível geográfico, de género, e de tipo de escola à data do início do Plano dos Centenários e descreve-se a distribuição das novas escolas primárias por distritos, concelhos e freguesias previstas pelo plano. Em 1940, a distribuição de escolas e o aproveitamento dos recursos escolares era muito desigual a nível geográfico, e existiam grandes diferenças entre os géneros. O plano delineava uma maior expansão em termos relativos nas áreas mais desfavorecidas do sul e interior do país. Finalmente, utiliza-se o caso do distrito de Évora para demostrar o atraso na execução do plano.
2022: Asymmetric Information with multiple risks: the case of the Chilean Private Health Insurance Market (Dolores De la Mata, Matilde P. Machado, Pau Olivella and Nieves Valdés). Working paper UC3M 22-10. Revise and Resubmit.
.We extend Rothshild and Stiglitz (1976) model to two sources of risk to better proxy real-world health insurance markets. This extension produces an interesting theoretical possibility: Take individuals A and B, who are low risks in one dimension but A is riskier in the other dimension. Then, A may enjoy less coverage than B in the former dimension (coverage reversal). The existence of this reversal determines which individuals are more likely to suffer adverse selection. We adapt Chiappori and Salanié (2000) positive correlation test to account for this multi-dimensionality and apply it to individual-level claims data for the privately insured in Chile.
2021: Intergenerational transmission of teen childbearing in Latin America, Matilde P. Machado, Ricardo Mora and Karen Olivo. CAF WP 16, 2021 . [First circulated under the title: Teen chilbearing in Latin America: the mother-daughter link]
Post about the paper: Breaking the Cycle: Unraveling Intergenerational Teen Childbearing in Latin America (with Ricardo Mora)
Abstract: Latin America has experienced high rates of teen childbearing for decades. Using DHS data for six Latin American countries, we estimate the relation between a mother's teenage childbearing status and that of her daughter. Restricting the estimating sample to mother-daughter matches in the data leads to a large negative selection bias in the estimated effect because missing matches are nonrandom and affected by the teen childbearing status of mothers and daughters. We deal with this selection bias by developing a maximum likelihood estimation using all available data, including incomplete mother-daughter pairs, and allowing missing observations to be endogenous. Our results show that being the daughter of a teen mother increases the chances of being a teen mother between 9.1 and 23.7 percentage points (75 and 123% relative to the mean incidence of teen childbearing). podemos quizás añadir aqui una frase “A related outcomes, early initiation to sex, also shows high inertia across generations. “We conclude that the prevalence of such high intergenerational transmission is at the core of persistent high teenage childbearing rates in Latin America.
The Spanish electricity spot market is highly concentrated both on the seller and the buyer side. Furthermore, unlike electricity spot markets in other deregulated electricity systems, large buyers and sellers are typically vertically integrated. This allows both large net sellers and large net buyers to strategically influence the spot market price. We develop a supply function model of this market to analyse the impact of market power on prices and productive efficiency and use it empiricially to detect such bilateral market power. Our estimates suggest that market power has had little impact on spot market prices but that substantial productive inefficiencies may have arisen from the exercise of bilateral market power.