Essays in Health Care and Public Economics
type: CreativeWork
description: This dissertation has been motivated by my two broad areas of interest - the nonprofit sector and health care, - and in particular by the growing number of community health centers in the United States in the last decade. The dissertation consists of three chapters: In the first chapter, I estimate the causal impact of community health centers on the utilization of emergency rooms in California, in 2006-2010. In the second chapter, I study the San Francisco healthcare reform of 2007-2008. And in the third chapter, I analyze California's Nonprofit Integrity Act of 2004 and its impact on governance and revenue growth of nonprofit organizations. The First Chapter is titled "The Effect of Community Health Centers on Utilization of Emergency Care: Evidence from California." The United States has a long list of programs that aim to reduce disparities in access to health care, including public health insurance, subsidies, and health insurance mandates on employers, insurers, and private citizens. This paper focuses on an alternative but complementary way of bringing medical care to medically underserved populations: community health centers (CHCs). CHCs provide primary health care services to two main groups - the uninsured and Medicaid enrollees - who face barriers to accessing primary health services and often turn to their local emergency departments (EDs) for non-urgent medical care. To examine the effect of CHCs on ED visits that do not result in an immediate hospital admission, I first use an event study that relies on an ED patient's proximity to a CHC and exploits the variation in the number of clinics in each zip code over time. To deal with endogenous clinic entry, I use a second differences-in-differences strategy that uses proximity to a highway to model the patient's level of access to a CHC. I find that recent expansions in the CHC sector have been effective in reducing the number of non-hospitalization ED visits by uninsured non-elderly adults and have had n…
abstract: This dissertation has been motivated by my two broad areas of interest - the nonprofit sector and health care, - and in particular by the growing number of community health centers in the United States in the last decade. The dissertation consists of three chapters: In the first chapter, I estimate the causal impact of community health centers on the utilization of emergency rooms in California, in 2006-2010. In the second chapter, I study the San Francisco healthcare reform of 2007-2008. And in the third chapter, I analyze California's Nonprofit Integrity Act of 2004 and its impact on governance and revenue growth of nonprofit organizations. The First Chapter is titled "The Effect of Community Health Centers on Utilization of Emergency Care: Evidence from California." The United States has a long list of programs that aim to reduce disparities in access to health care, including public health insurance, subsidies, and health insurance mandates on employers, insurers, and private citizens. This paper focuses on an alternative but complementary way of bringing medical care to medically underserved populations: community health centers (CHCs). CHCs provide primary health care services to two main groups - the uninsured and Medicaid enrollees - who face barriers to accessing primary health services and often turn to their local emergency departments (EDs) for non-urgent medical care. To examine the effect of CHCs on ED visits that do not result in an immediate hospital admission, I first use an event study that relies on an ED patient's proximity to a CHC and exploits the variation in the number of clinics in each zip code over time. To deal with endogenous clinic entry, I use a second differences-in-differences strategy that uses proximity to a highway to model the patient's level of access to a CHC. I find that recent expansions in the CHC sector have been effective in reducing the number of non-hospitalization ED visits by uninsured non-elderly adults and have had n…
author: Zhanabekova, Zhanna Victorovna
language: English
keywords: Economics
date published: 2013
date modified: 2026-07-24T01:44:34Z
provider: Columbia University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Columbia University

PropertyValue
property ID: DOI
value: 10.7916/D8H994Q8