Working Papers

The Impact of Epidemic on Infant Health and Maternal Health Care Utilization: Evidence from the 2014-16 Ebola Outbreak

(Job market paper)

Abstract: Health condition at birth is a strong indicator of health and socioeconomic status later in life. Birth weight predicts health later in life, affects adult schooling attainment, and correlates among generations. The literature on the effect of in utero exposure to stressful shocks on infant health is not conclusive. I analyze the effect of the 2014-2016 Ebola epidemic on birth weight and health care utilization using the 2017 Multiple Indicator Cluster Surveys for Sierra Leone. I examine the effect of Ebola fatalities on birth weight through maternal stress. Using the variation in the number of Ebola fatalities in each trimester across the provinces of Sierra Leone as a measure of the severity of maternal stress, I find an increase in Ebola fatalities in the first trimester is associated with a decrease in birth weight. I also find that an increase in Ebola fatality during the second trimester is associated with a decrease in the use of prenatal care.

The Effects of Physician-Hospital Integration on Health Care Spending and Use

(with Laurence Baker, Kate M. Bundorf, and Anne Royalty)

Abstract: We analyze whether physician practices that are vertically integrated with hospitals produce health care for Medicare patients at a higher cost than non-integrated practices, studying patients who switch from non-integrated to integrated practices. We use Medicare claims from 1999-2014 to identify individuals who move from one Hospital Referral Region (HRR) to another, and among the movers, those who switch from a non-integrated to integrated practice and those who are in a non-integrated practice both before and after the move. We use difference-in-difference and event study models to investigate whether switching practice types is associated with changes in spending. To account for potentially endogenous switching, we use the share of all practices in the “destination HRR” that are integrated to instrument for patients switching practices. Switching to an integrated practice is associated with significant increases in spending, which are primarily associated with increased inpatient and skilled nursing and hospice spending.

Work in Progress

Medication use patterns during the Covid-19 pandemic

(with Kate Bundorf, Sumedha Gupta, Salama Freed, Nancy Allen Lapointe, and Kosali Simon)

Long term medication adherence in diabetic patients

(with Sumedha Gupta, Kosali Simon, and Alan Zillich)


"Impact of Cooperatives Membership on Economy in Eastern Oromia: The Case of Haramaya Agricultural Farmers' Cooperative Union (HAFCU)" With Megersa Debela and Sisay Diriba. Annals of Public and Cooperative Economics, September 2018, 89.2, 361-376