Lin, Lee-Kai., Simon, Kosali., Hollingsworth, Alex., and Brendan Saloner. 2019. “Association between the Number of Certified Buprenorphine Prescribers and the Quantity of Buprenorphine Prescriptions: Evidence from 2015 to 2017.”' Journal of General Internal Medicine. Accepted.
Hollingsworth, Alex., Soni, Aparna., Carroll, Aaron., Cawley, John., and Kosali Simon. 2019. “Gains in health insurance coverage explain variation in Democratic vote share in the 2008-2016 presidential elections”. PLoS ONE 14(4): e0214206. DOI: 10.1371/journal.pone.0214206
Hollingsworth, Alex. and Ivan Rudik. 2019. “External Impacts of Local Energy Policy: The Case of Renewable Portfolio Standards.” Journal of the Association of Environmental and Resource Economists. Volume 6, Number 1, Pages 187-213. DOI: 10.1086/700419
Zirogiannis, Nikos., Alex Hollingsworth, and David Konisky. 2018. Understanding Excess Emissions from Industrial Facilities: Evidence from Texas.” Environmental Science & Technology. Volume 52, Number 5, Pages 2482-2490 DOI: 10.1021/acs.est.7b04887
Hollingsworth, Alex., Ruhm, Christopher J., and Kosali Simon. 2017. “Macroeconomic Conditions and Opioid Abuse.” Journal of Health Economics. Volume 56, Pages 222-233. DOI: 10.1016/j.jhealeco.2017.07.009. (Earlier version released as NBER Working Paper No. 23192)
Media: Vox, Scientific American, CNBC, The Atlantic, The Washington Post, Axios,
U.S. News, Marginal Revolution, Breitbart, Bloomberg, National Affairs
Gordon, Paul., Gray, Laurel., Hollingsworth, Alex., Shapiro, Eve., and James Dalen. 2017. Opposition to Obamacare: A Closer Look.” Academic Medicine. Volume 92, Issue 9, Pages 1241-1247. DOI: 10.1097/ACM.0000000000001725
Honorable Mention- Best Research Paper- Society of Teachers of Family Medicine, 2018
“Care management reduces infant mortality for Medicaid managed care enrollees.” Revisions Requested. Not publicly available, but available by request.
with Ashley Kranz and Debbie Freund
“The Effect of Health Insurance on Mortality: Power Analysis and What We Can Learn from the Affordable Care Act Coverage Expansions.” Under review. Available as NBER Working Paper No. 25568.
with Bernard Black, Leticia Nunes, and Kosali Simon
“The health consequences of weak regulation: Evidence from excess emissions in Texas.” Under review. Available here.
with Nikos Zirogiannis and David Konisky
“Unintended Consequences of Recreational and Medical Marijuana Laws On Adult and Youth Drug Use.” Under review. Available here.
with Ashley Bradford and Coady Wing
“Excess emissions are common, harmful, and under-regulated.” Under review. Not publicly available, but available by request.
with David Konisky, Ivan Rudik, and Nikos Zirogiannis
“Can policy affect initiation of addictive substance use? Evidence from opioid prescribing.” Under review. Available by request.
with Daniel Sacks, Thuy Nguyen, and Kosali Simon
Abstract: Drug control policy can have unintended consequences by pushing existing users to alternative, possibly more dangerous substances. Policies that target only new users may therefore be especially promising. Using commercial insurance claims data, we provide the first evidence on a set of new policies intended to reduce opioid use among new users in the form of limits on initial prescription length. We also provide the first evidence on the impact of must-access Prescription Drug Monitoring Programs (MA PDMPs), laws that do not target new users, on initial opioid use. Although initial prescription limits reduce the average length of initial prescriptions, they do so primarily by raising the frequency of short prescriptions, resulting in increases in opioids dispensed to new users. In contrast, we find that MA PDMPs reduce opioids dispensed to new users, even though they do not explicitly target new opioid use. Neither policy significantly affects extreme use such as doctor shopping among new patients, because such behavior is very rare.
Abstract: Over 20% of Americans do not have adequate access to primary care services due to a lack of available physicians (HRSA, 2014). In response many have called for an increased role of the Nurse Practitioner. The retail health clinic, a recent innovation, is well suited to serve as a conduit for this expanded role. In this paper, I examine retail health clinics by estimating the determinants of clinic location choice and by evaluating their impact on unnecessary visits to nearby emergency departments (EDs). First, I construct a structural discrete choice model of clinic location that accounts for both demand and competition effects. This model incorporates a rich error structure that allows for spatial correlation and market level unobservable heterogeneity. I find that clinics are more likely to locate in areas that are populous, wealthy, educated, and white, and that they are less likely to locate in traditionally under-served communities. Second, I combine the results of my predictive model with data on ED visits to determine if clinics help direct patients away from receiving treatment at expensive emergency rooms. I find that access to retail clinics causes a substantial decrease in the number of ED visits for bronchitis and upper respiratory infections. The savings associated with retail clinic induced ED diversion is conservatively estimated to be at least $88 million in 2012 alone. In California, counterfactual analysis suggests that relaxing the barriers to clinic entry would result in $10.5 million in annual health care savings.
Abstract: Once thought to be a disease of the past, tuberculosis is making a worldwide resurgence due to the advent of drug resistant strains of the disease. As our pharmacological weapons become less effective, some are calling for a return of sanitaria, institutions from the time before antibiotics that have been credited for causing a pre-antibiotic decline in tuberculosis mortality. However, no quantitative studies have been conducted to validate this claim and there has been no research that has identified the primary mechanism through which sanitaria could have made such an impact. Using data from North Carolina, this paper measures the impact of sanitaria on the decline in tuberculosis mortality. Results from an instrumental variables approach indicate that access to an additional sanitaria bed reduced the death rate from tuberculosis for white residents by nearly .695 per 100,000 and had no impact for black residents. Interpreting these results through the lens of an epidemiological model it is inferred that this benefit was provided through both quarantine and through reducing the likelihood of disease transmission by educating the public in hygienic practice.
Work in Progress:
“The social cost of leaded gasoline: Evidence from regulatory exemptions.”
With Ivan Rudik.
“Recreational Marijuana and Substitution of Psychoactive Substances: An Application of Synthetic Control Using Lasso” Github repo with R package available here.
with Coady Wing