Promotie A.C. Dias Mendes Correia Moura

This dissertation contributes to a greater understanding of the determinants of healthcare expenditures and of the effects of policies that aim at containing them.

The first essay studies the causes of regional variation in healthcare expenditures in the Netherlands. We find that only 30% of the observed variation in healthcare expenditures across Dutch provinces originates from supply-side factors, such as different clinical practice styles or different prices for healthcare services. The remaining 70% originate from demand-side factors, such as different demographics, health status and needs, or different preferences for healthcare consumption. These results imply that policy measures targeting supply-side driven variation will have a limited impact.

The second essay evaluates the impact of liberalizing the sale of over-the-counter (OTC) pharmaceuticals –drugs that do not require a prescription from a physician –on the OTC prices charged by incumbent community pharmacies. We focus on the Lisbon market and show that OTC liberalization reforms can lower prices via increased competition, though this crucially depends on the ability of entrants to exert competitive pressure on incumbent pharmacies.

The third essay investigates whether the availability of publicly subsidized nursing homes and teams providing home-care reduces delayed hospital discharges for patients who lack of alternative care arrangements following a hospital stay (bed-blocking). I find that both nursing homes and home-care teams reduce hospital bed-blocking without harming patients’ health. Policy-makers should use nursing homes can home-care teams in combination, as they target patients with different needs. Reducing bed-blocking has further positive effects on the healthcare system as it allows hospitals to increase the number of programmed admissions, potentially reducing waiting times for elective care.

Ana Moura (Porto, Portugal, 1989) obtained a Bachelor an Master degree in Economics from Nova School of Business and Economics in Lisbon. She worked as an economist for the Portugese government before coming to Tilburg in 2015. Upon completion of the Research Master in Economics at Tilburg University in 2017, Ana joined the Department of Economtrics and Operations Research as a Ph.D. candidate under supervision of prof. dr. Jan Boone and dr. Martin Salm.

• Locatie: Cobbenhagen building, Aula
• Promotor: prof.  dr. J. Boone
• Copromotor: dr. M. Salm