María E. Dávalos

Economic evaluation methods for telemedicine include cost analysis, cost-effectiveness analysis, and benefit–cost analysis (BCA). Each has its strengths and weaknesses and often they don't give a complete picture. BCA is the most comprehensive of these three tools. A review of the literature was conducted to determine what has been done and what has not been done. The result of this review provides research guidelines for conducting BCA and introduces specific recommendations for future research. Telemedicine programs provide specialty health services to remote populations using telecommunications technology. This innovative approach to medical care delivery has been expanding for several years and currently covers various specialty areas such as cardiology, dermatology, and pediatrics. Economic evaluations of telemedicine, however, remain rare, and few of those conducted have accounted for the wide range of economic costs and benefits. Rigorous benefit–cost analyses of telemedicine programs could provide credible and comparative evidence of their economic viability and thus lead to the adoption and/or expansion of the most successful programs. To facilitate more advanced economic evaluations, this article presents research guidelines for conducting benefit–cost analyses of telemedicine programs, emphasizing opportunity cost estimation, commonly used program outcomes, and monetary conversion factors to translate outcomes to dollar values. The article concludes with specific recommendations for future research.

Individuals can react to financial stress in a variety of ways, such as reducing discretionary spending or engaging in risky behaviors. This article investigates the effect of changing macroeconomic conditions (measured by the unemployment rate in the state of residence) on one type of risky behavior: excessive alcohol consumption. Using unique and recent panel data from waves 1 and 2 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) and estimating fixed-effects models, we find that changes in the unemployment rate are positively related to changes in binge drinking, alcohol-involved driving, and alcohol abuse and/or dependence. Some differences are present among demographic groups, primarily in the magnitude of the estimated effects. These results contradict previous studies and suggest that problematic drinking may be an indirect and unfortunate consequence of an economic downturn.

The growing economic fissures in the societies of Europe and Central Asia between generations, between insiders and outsiders in the labor market, between rural and urban communities, and between the super-rich and everyone else, are threatening the sustainability of the social contract. The institutions that helped achieving a remarkable degree of equity and prosperity over the course of several decades now face considerable difficulties in coping with the challenges presented by these emerging forms of inequality. Public surveys reveal rising concerns over inequality of opportunity, while electoral results show a marked shift to populist parties that offer radical solutions to voters dissatisfied with the status quo.There is no single solution to relieve these tensions, and attempts to address them will vary considerably across the region. However, this publication proposes three broad policy principles: (1) promote labor market flexibility while maintaining protection for all types of labor contracts; (2) seek universality in the provision of social assistance, social insurance, and basic quality services; and (3) expand the tax base by complementing progressive labor-income taxation with taxation of capital. These principles could guide the rethinking of the social contract and fulfil European citizens' aspirations for growth and equity

Household income inequality has declined in Latin America in the past decades, contributing significantly to poverty reduction in the region. Although available evidence shows that changes in the labor income are among the main factors behind these inequality trends, few studies have analyzed more closely the labor market dynamics that have led to a decline in total income inequality in some countries, but also to an increase in others. Using household survey data for a sample of 15 countries in Latin America from 1995 to 2010, this paper uses an extension of the Juhn-Murphy-Pierce methodology to decompose changes in labor income inequality (hourly wages) into a quantity effect (capturing changes in the distribution of workers' skills), price effect (reflecting returns to skills), and unobservables effect (other components, within skill groups, affecting labor income). The results show that falling returns to skills for both education and experience is, on average, driving the decline in labor income inequality in Latin America. The quantity effect, in turn, has contributed little to inequality reduction, mostly attributable to a larger dispersion in years of experience, possibly linked to the region's demographic transition and to significant increases in female labor force participation. Additional findings show that wage inequality, still high in the region, is coupled with inequality in terms of hours worked. The paper complements the existing literature by presenting separate results for males and females, as well as formal and informal sector workers as an attempt to control for secular shifts in these characteristics.