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Gertler, Paul 1955-

Works: 123 works in 394 publications in 2 languages and 3,140 library holdings
Genres: Case studies 
Roles: Author, Honoree
Classifications: RA410.55.D48, 338.433621091724
Publication Timeline
Publications about Paul Gertler
Publications by Paul Gertler
Most widely held works by Paul Gertler
The willingness to pay for medical care : evidence from two developing countries by Paul Gertler( Book )
10 editions published in 1990 in English and held by 252 libraries worldwide
This book is about money - money to pay for delivering health services in developing countries. Our account is based on detailed information from two countries, C;te d'Ivoire and Peru. The feasibility and desirability of raising revenue from patients depend on the price sensitivity of the demand for medical care. There are three issues. First, how price elastic is the demand for medical care in general? Second, is the demand for medical care more or less price sensitive for some groups than for others? Finally, the desirability of expanding the utilization of medical care depends on the extent to which its use improves health. In this research we take as given the notion that medical care is efficacious. In some cases, however, quality is so low that this assumption could be suspect. The main part of this study is devoted to answering the first two questions by analyzing the choice of health care provider made by households in rural communities in two developing countries. The answers to these questions are simple: yes, the demand for medical care is price sensitive, but not so much so that user fees cannot be a viable option for resource mobilization. And yes, the poor as well as children will be hurt more by the introduction of user fees than will the population in general
The willingness to pay for education in developing countries : evidence from rural Peru by Paul Gertler( Book )
8 editions published in 1989 in English and held by 108 libraries worldwide
Family productivity, labor supply, and welfare in a low-income country by John L Newman( Book )
10 editions published between 1992 and 1995 in English and held by 100 libraries worldwide
This paper develops an analytical approach to estimating family labor supply and consumption decisions appropriate for developing countries. The model identifies structural relationships allowing analysis of the welfare implications of intrahousehold allocation decisions, especially across the generations. The approach allows for an arbitrary number of family members, each of whom may or may not engage in multiple activities. The authors identify the marginal returns to work in self-employment without directly observing the marginal returns or estimating the enterprise's production function. The key feature of the approach is to work with underlying structural marginal return and marginal rate of substitution functions together with first order Kuhn-Tucker conditions. The authors use this model to analyze family consumption and labor supply decisions of rural landholding households in Peru
Economic analysis of health sector projects : a review of issues, methods, and approaches by Ramesh Adhikari( Book )
11 editions published in 1999 in English and held by 95 libraries worldwide
Impact evaluation in practice by Paul Gertler( Book )
17 editions published between 2010 and 2016 in English and Spanish and held by 87 libraries worldwide
The second edition of the Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policymakers and development practitioners. First published in 2011, it has been used widely across the development and academic communities. The book incorporates real-world examples to present practical guidelines for designing and implementing impact evaluations. Readers will gain an understanding of impact evaluation and the best ways to use impact evaluations to design evidence-based policies and programs. The updated version covers the newest techniques for evaluating programs and includes state-of-the-art implementation advice, as well as an expanded set of examples and case studies that draw on recent development challenges. It also includes new material on research ethics and partnerships to conduct impact evaluation. The handbook is divided into four sections: Part One discusses what to evaluate and why; Part Two presents the main impact evaluation methods; Part Three addresses how to manage impact evaluations; Part Four reviews impact evaluation sampling and data collection. Case studies illustrate different applications of impact evaluations. The book links to complementary instructional material available online, including an applied case as well as questions and answers. The updated second edition will be a valuable resource for the international development community, universities, and policymakers looking to build better evidence around what works in development.--
Household production of health : a microeconomic perspective on health transitions by Julie DaVanzo( Book )
4 editions published in 1990 in English and held by 86 libraries worldwide
Over the past 20 years, advances in medical technology have not led to desired health improvements in the Third World. Governments may import and distribute medical technologies widely, but the effectiveness of these technologies will depend on how people respond to them. If such programs are to be effective, planners and practitioners must know what governs families' decisions to seek care and engage in health-improving behaviors. In other words, they need to understand and accommodate behavioral and sociocultural influences on health. This Note argues that behavioral research can inform health policy on three dimensions: (1) how behavioral choices affect health status, (2) what determines these choices, and (3) how policymakers can influence these choices. It shows that economic theory--especially the theory of the household production of health--provides a useful framework for analyzing these three dimensions. In particular, the framework provides a theoretical organizing structure for policy analysis and has important implications for data collection, for the empirical specification of models of behavioral choices, and for the statistical analysis
Insuring consumption against illness by Paul Gertler( Book )
13 editions published in 1997 in English and held by 82 libraries worldwide
One of the most sizable and least predictable shocks to economic opportunities in developing countries is major illness, both in terms of medical care expenditures and lost income from reduced labor supply and productivity. As a result, families may not be able to smooth their consumption over periods of illness. In this paper, we investigate the extent to which families are able to insure consumption against major illness using a unique panel data set from Indonesia that combines excellent measures of health status with consumption information. We focus on the effect of large exogenous changes in physical functioning. We find that there are significant economic costs associated with these illnesses, albeit more from income loss than from medical expenditures. We also find a robust and striking rejection of full consumption insurance. Indeed, the deviation from full consumption smoothing is significant, particularly for illnesses that severely limit physical function; families are able to smooth less than 30 percent of the income loss from these illnesses. These estimates suggest large welfare gains from the introduction of formal disability insurance, and that the large public subsidies for medical care typical of most developing countries may improve welfare by providing consumption insurance
The substitutability of public and private health care treatment of children in Pakistan by Harold Alderman( Book )
6 editions published in 1989 in English and held by 71 libraries worldwide
Strategies for pricing publicly provided health services by Paul Gertler( file )
12 editions published between 1997 and 1999 in English and Undetermined and held by 68 libraries worldwide
May 1997 User fees are important in cofinancing health care but should not be the primary means of finance, and should not be applied uniformly - or the wealthy will benefit and the poor will suffer. Gertler and Hammer examine how governments finance and allocate public spending, with an eye to developing strategies for pricing publicly provided health services. They also examine the implications of current policy and the possibility for rationalizing competing government priorities. Because governments face budget constraints and cannot fully subsidize all programs and activities, Gertler and Hammer argue the following: Public spending on health can (1) improve health outcomes, (2) promote nonhealth aspects of well-being (for example, reducing individuals' risk of economic losses from random health crises), and (3) finance redistribution to the poor. Optimal subsidy and fee policy will depend on how much relative weight government places on those competing objectives. Subsidies need to be reallocated toward the poor and toward public health, but only a fraction of the resources needed to expand the health sector can be financed by increasing public subsidies. Prices for curative services (user fees) have two distinct roles. They can raise revenue, freeing public resources to be reallocated to public health activities and for limited cofinancing to improve the quality of curative care. More important, they can improve efficiency in the use of public facilities and the health care system as a whole. But those gains must be weighed against evidence that increased fees can compromise public health's three main goals. The literature has focused largely on how raising revenue affects the poor, but the more important effect is likely to be the guidance of resources. User fees are important in cofinancing health care but shouldn't be the primary means of finance. Revenue generated from user fees is sometimes used to improve the quality of, and access to, curative medical care. There is some evidence that people are willing to pay some of the cost of improving health care (especially for drugs), but the wealthy are willing to pay a lot more than the poor. If governments charge the average willingness to pay, the wealthy will use the services more, the poor, less. Prepayment social insurance plans hold promise, but there is evidence that they may introduce inefficient inflation of medical care costs that lower- and middle-income countries cannot afford. This paper - a product of the Public Economics Division, Policy Research Department - is part of a larger effort in the department to analyze the impact of public expenditures. Jeffrey Hammer may be contacted at
Measuring the willingness to pay for social services in developing countries by Paul Gertler( Book )
7 editions published between 1988 and 1989 in English and held by 65 libraries worldwide
Empowering Parents To Improve Education Evidence From Rural Mexico by Paul Gertler( file )
12 editions published between 2006 and 2012 in English and Undetermined and held by 63 libraries worldwide
Mexico's compensatory education program provides extra resources to primary schools that enroll disadvantaged students in highly disadvantaged rural communities. One of the most important components of the program is the school-based management intervention known as AGEs. The impact of the AGEs is assessed on intermediate school quality indicators (failure, repetition and dropout), controlling for the presence of the conditional cash transfer program. Results prove that school-based management is an effective measure for improving outcomes, based on an over time difference-in-difference evaluation. Complementary qualitative evidence corroborates the veracity of such findings
Information and the demand for supplemental medicare insurance by Paul Gertler( Book )
12 editions published between 1993 and 1994 in English and held by 60 libraries worldwide
While the critical role of imperfect information has become axiomatic in explaining health care market failure, the theory is backed by little empirical evidence. In this paper we use a unique panel data set with explicit measures of information and an educational intervention to investigate the role of uncertain information about health insurance benefits on the demand for supplemental Medicare insurance that allows imperfect information to affect both the mean and the variance of the expected benefits distribution. The empirical specification is a structural panel multinomial probit with an unrestricted variance-covariance, including heteroskedasticity and random effects to control for unobserved heterogeneity. The model is computationally complex and is estimated by simulated maximum likelihood. The empirical results indicate that imperfect information affects the demand for supplement Medicare insurance by increasing the variance of the expected benefits distribution rather than by systematically shifting the mean of the distribution. Since the majority of people already purchase insurance, an increase in variance due to imperfect information reduces demand. We estimate that if everyone has perfect information, then the proportion of individuals not purchasing insurance would fall 23% from .096 to .074. We also found that controlling for unobserved heterogeneity was important. The goodness of fit increased by about 25% and the precision of the estimated effect of information on the variance of the expected benefits distribution increased dramatically
Health care financing and the demand for medical care ( Book )
2 editions published in 1988 in English and held by 49 libraries worldwide
Housing, health and happiness by Rocío Titiunik( file )
5 editions published in 2007 in English and held by 38 libraries worldwide
Abstract: Despite the importance of housing for people's well-being, there has been little work done to assess the causal impact of housing and housing improvement programs on health and welfare. In this paper the authors help fill this gap by investigating the impact of a large-scale effort by the Mexican government to replace dirt floors with cement floors on child health and adult happiness. They find that replacing dirt floors with cement floors significantly reduces parasitic infestations in young children, reduces diarrhea, reduces anemia, and improves cognitive development. Finally, they also find that this program leave adults substantially better off, as measured by satisfaction with their housing and quality of life and by their significantly lower rates of depression and perceived stress
Quality adjusted cost functions by Paul Gertler( Book )
8 editions published in 1990 in English and held by 33 libraries worldwide
We propose a simple method for estimating cost functions in the presence of endogenous and unobserved quality. The theory of production, the equilibrium conditions implied by optimizing behavior, and exogenous influences on product demand are used to identify the model. An important advantage of the method is that the data requirements, above those necessary for standard cost function estimation, are minimal and the data are usually readily available. Specifically, exogenous information that influences the demand for the firm's product is required. We apply this method to estimate quality-adjusted cost functions in the nursing home industry. Estimation of a translog cost function that ignores quality yields seriously misleading estimates of marginal cost and economies of scale. In particular, while estimation of a quality-exogenous cost function reports economies of scale, estimation of a quality adjusted cost function reveals diseconomies of scale for high quality homes, constant returns to scale for average quality homes, and economies of scale for low quality homes
Medicaid and the cost of improving access to nursing home care by Paul Gertler( Book )
9 editions published in 1989 in English and held by 32 libraries worldwide
In this paper I show that the Medicaid program can improve the access of financially indigent patients to nursing home care by raising the rate of return paid on Medicaid patients' care, but only at the cost of lower quality of care. To quantify the policy tradeoff, I derive expressions for the elasticity of access with respect to total Medicaid expenditures and the elasticity of access with respect to quality. These elasticities expressions are complicated by the fact that Medicaid payment formulas are cost based and, therefore, depend on the quality choices of nursing homes. Using New York State data, I find that a 10% increase in Medicaid expenditures induces a 4.1% increase in Medicaid patient care but also reduces nursing home expenditures on patient services by about 3.4%
Moral hazard in partnerships by Martin Gaynor( Book )
8 editions published between 1990 and 1996 in English and Undetermined and held by 31 libraries worldwide
Abstract: existence of a unique data set on a prominent form of professional partnership
Investing cash transfers to raise long term living standards by Paul Gertler( Book )
8 editions published in 2006 in English and held by 28 libraries worldwide
"The authors test whether poor households use cash transfers to invest in income generating activities that they otherwise would not have been able to do. Using data from a controlled randomized experiment, they find that transfers from the Oportunidades program to households in rural Mexico resulted in increased investment in micro-enterprise and agricultural activities. For each peso transferred, beneficiary households used 88 cents to purchase consumption goods and services, and invested the rest. The investments improved the household's ability to generate income with an estimated rate of return of 17.55 percent, suggesting that these households were both liquidity and credit constrained. By investing transfers to raise income, beneficiary households were able to increase their consumption by 34 percent after five and a half years in the program. The results suggest that cash transfers to the poor may raise long-term living standards, which are maintained after program benefits end."--World Bank web site
Are user fees regressive? : the welfare implications of health care financing proposals in Peru by Paul Gertler( Book )
8 editions published between 1986 and 1987 in English and held by 26 libraries worldwide
In this paper, we derive a discrete choice model of the demand for medical care from a theoretical model that implies a natural interrelation between price and income. We show that, in the context of a discrete choice model, if health is a normal good, then the price elasticity of the demand for health care must decline as income rises. This implies that the models in previous discrete choice studies which restrict the price effect to be independent of income are misspecified. The model is estimated using data from a 1984 Peruvian survey, and a parsimonious flexible functional form. Unlike previous studies, we find that price plays a significant role in the demand for health care, and that demand becomes more elastic as income falls, implying that user fees would reduce the access to care for the poor proportionally more than for the rich. Our simulations show that user fees can generate substantial revenues, but are accompanied by substantial reductions in aggregate consumer welfare, with the burden of the loss on the poor. These results demonstrate that undiscriminating user fees would be regressive both in terms of access and welfare
Labor market returns to early childhood stimulation : a 20-year followup to an experimental intervention in Jamaica by Paul Gertler( Book )
6 editions published in 2013 in English and held by 6 libraries worldwide
We find large effects on the earnings of participants from a randomized intervention that gave psychosocial stimulation to stunted Jamaican toddlers living in poverty. The intervention consisted of one-hour weekly visits from community Jamaican health workers over a 2-year period that taught parenting skills and encouraged mothers to interact and play with their children in ways that would develop their children's cognitive and personality skills. We re-interviewed the study participants 20 years after the intervention. Stimulation increased the average earnings of participants by 42 percent. Treatment group earnings caught up to the earnings of a matched non-stunted comparison group. These findings show that psychosocial stimulation early in childhood in disadvantaged settings can have substantial effects on labor market outcomes and reduce later life inequality
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Alternative Names
Gertler, P. 1955-
Gertler, Paul 1955-
Gertler, Paul J.
Gertler, Paul J. 1955-
Paul Gertler American economist
English (170)
Spanish (3)
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