Research

Life After Loss: The Causal Effect of Parental Death on Daughters' Fertility, with Rene Wiesinger

Journal of Population Economics, 2025, 38:6 https://doi.org/10.1007/s00148-025-01057-8 

Abstract: 

Using Austrian administrative data, this study examines the causal effect of parental death on daughters’ fertility through a difference-in-differences approach. The findings indicate that parental death leads to quantitatively insignificant changes in the number of children and the probability of childlessness. Complementary analyses show no substantial effects on labor market participation, residential mobility, or long-term mental health. The evidence suggests that fertility decisions remain largely unaffected by the logistical and emotional challenges of parental loss, highlighting the resilience of reproductive choices to external life shocks. 

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A Hard Pill to Swallow? Parental Health Shocks and Children's Mental Health, with Gerald J. Pruckner

Health Economics, 2023, 32(12), 2768–2800. https://doi.org/10.1002/hec.4752  

Abstract: 

Based on comprehensive administrative health record data from Austria, this study examines how children's mental health responds to a severe parental health shock. To account for the endogeneity of a serious parental illness, our sample is restricted to children who experience the health shock of a parent at some point in time and we exploit the timing of shocks in a dynamic DID setting. We find a positive causal effect of parental health shocks on children's mental health care utilization. Affected children have higher medical attendance for the treatment of mental illnesses, consume more psychotropic drugs, and are more likely to be hospitalized with mental and behavioral disorders. A significant increase in the utilization of antidepressants, anxiolytics, and sedatives can be observed for older children, girls and children with a white-collar family background. Our findings have important policy implications for children's access to psychotherapies and mental health care after experiencing a traumatic household event. 

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Hospital Crowding and Patient Outcomes, with Wolfgang Frimmel and Gerald J. Pruckner

Abstract: 

Using high-quality administrative data from Upper Austria, we analyze the effect of hospital crowding on patients' short- and medium-term healthcare utilization and labor market outcomes. Focusing on acute inpatient diagnoses, we exploit idiosyncratic variation in daily diagnosis-related hospital occupancy rates to estimate the causal effect of hospital crowding. We find that higher crowding levels reduce hospital care intensity, as reflected in fewer medical services provided, lower hospital expenditures, and earlier discharges. Despite these changes, quality of care indicators, including readmissions and mortality, remain unaffected. However, no significant effects are observed either on inpatient and outpatient healthcare utilization in the short- and medium-term or on patients' labor market outcomes following initial hospitalization. These results suggest that crowding-induced differences in hospital care do not lead to changes in patients' health or economic situations over the medium term.

Working Paper Download (Version January 2025): [JKU Working Paper] 

Socio-Economic Inequality in Mortality and Healthcare Utilization: Evidence from Cancer Patients, with Wolfgang Frimmel

Abstract: 

Health equality is an important objective in public healthcare systems, and still, we see substantial socio-economic differences. Using high-quality administrative data from Upper Austria, we analyze the socio-economic gradient in mortality and healthcare utilization following a cancer diagnosis. High-SES patients are less likely to die after a cancer hospitalization even when accounting for a comprehensive set of controls, including detailed pre-shock healthcare use. After hospital discharge, patients navigate the healthcare system differently depending on their socio-economic status. We explore potential explanations for the observed SES gradient. Our findings suggest that low-SES cancer patients go to the hospital at a later stage of the disease. Peer groups also matter in explaining SES differences, while healthcare providers do not appear to contribute significantly to the gap. Targeted policies that take into account disease heterogeneity, health awareness, and prevention behavior have the potential to reduce health inequalities.

Working Paper Download (Version November 2024): [JKU Working Paper]