Essays in Applied Health Economics: Evidence on Health and Health Care in Italy and UK

This thesis is the result of my experience as a PhD student taking part in the Joint Doctoral Programme at the University of York and the University of Bologna. In my thesis I deal with topics that are of particular interest in Italy and in Great Britain. Chapter 2 focuses on the empirical test of the existence of the relationship between technological profiles and market structure claimed by Sutton’s theory (1991, 1998) in the specific economic framework of hospital care services provided by the Italian National Health Service (NHS). In order to test the empirical predictions by Sutton, we identify the relevant markets for hospital care services in Italy in terms of both product and geographic dimensions. In particular, the Elzinga and Hogarty (1978) approach has been applied to data on patients’ flows across Italian Provinces in order to derive the geographic dimension of each market. Our results provide evidence in favour of the empirical predictions of Sutton. Chapter 3 deals with the patient mobility in the Italian NHS. To analyse the determinants of patient mobility across Local Health Authorities, we estimate gravity equations in multiplicative form using a Poisson pseudo maximum likelihood method, as proposed by Santos-Silva and Tenreyro (2006). In particular, we focus on the scale effect played by the size of the pool of enrolees. In most of the cases our results are consistent with the predictions of the gravity model. Chapter 4 considers the effects of contractual and working conditions on selfassessed health and psychological well-being (derived from the General Health Questionnaire) using the British Household Panel Survey (BHPS). We consider two branches of the literature. One suggests that “atypical” contractual conditions have a significant impact on health while the other suggests that health is damaged by adverse working conditions. The main objective of our paper is to combine the two branches of the literature to assess the distinct effects of contractual and working conditions on health. The results suggest that both sets of conditions have some influence on health and psychological well-being of employees.

An optimal estimator for the correlation of CMB anisotropies with Large Scale Structures and its application to WMAP-7year and NVSS

In the thesis we present the implementation of the quadratic maximum likelihood (QML) method, ideal to estimate the angular power spectrum of the cross-correlation between cosmic microwave background (CMB) and large scale structure (LSS) maps as well as their individual auto-spectra. Such a tool is an optimal method (unbiased and with minimum variance) in pixel space and goes beyond all the previous harmonic analysis present in the literature. We describe the implementation of the QML method in the {\it BolISW} code and demonstrate its accuracy on simulated maps throughout a Monte Carlo. We apply this optimal estimator to WMAP 7-year and NRAO VLA Sky Survey (NVSS) data and explore the robustness of the angular power spectrum estimates obtained by the QML method. Taking into account the shot noise and one of the systematics (declination correction) in NVSS, we can safely use most of the information contained in this survey. On the contrary we neglect the noise in temperature since WMAP is already cosmic variance dominated on the large scales. Because of a discrepancy in the galaxy auto spectrum between the estimates and the theoretical model, we use two different galaxy distributions: the first one with a constant bias $b$ and the second one with a redshift dependent bias $b(z)$. Finally, we make use of the angular power spectrum estimates obtained by the QML method to derive constraints on the dark energy critical density in a flat $\Lambda$CDM model by different likelihood prescriptions. When using just the cross-correlation between WMAP7 and NVSS maps with 1.8° resolution, we show that $\Omega_\Lambda$ is about the 70\% of the total energy density, disfavouring an Einstein-de Sitter Universe at more than 2 $\sigma$ CL (confidence level).

Un modello multicriteriale di supporto alla pianificazione territoriale finalizzato alla classificazione del territorio rurale e alla caratterizzazione dell’Impronta Agro ambientale delle aree agricole periurbane.

La ricerca proposta si pone l’obiettivo di definire e sperimentare un metodo per un’articolata e sistematica lettura del territorio rurale, che, oltre ad ampliare la conoscenza del territorio, sia di supporto ai processi di pianificazione paesaggistici ed urbanistici e all’attuazione delle politiche agricole e di sviluppo rurale. Un’approfondita disamina dello stato dell’arte riguardante l’evoluzione del processo di urbanizzazione e le conseguenze dello stesso in Italia e in Europa, oltre che del quadro delle politiche territoriali locali nell’ambito del tema specifico dello spazio rurale e periurbano, hanno reso possibile, insieme a una dettagliata analisi delle principali metodologie di analisi territoriale presenti in letteratura, la determinazione del concept alla base della ricerca condotta. E’ stata sviluppata e testata una metodologia multicriteriale e multilivello per la lettura del territorio rurale sviluppata in ambiente GIS, che si avvale di algoritmi di clustering (quale l’algoritmo IsoCluster) e classificazione a massima verosimiglianza, focalizzando l’attenzione sugli spazi agricoli periurbani. Tale metodo si incentra sulla descrizione del territorio attraverso la lettura di diverse componenti dello stesso, quali quelle agro-ambientali e socio-economiche, ed opera una sintesi avvalendosi di una chiave interpretativa messa a punto allo scopo, l’Impronta Agroambientale (Agro-environmental Footprint - AEF), che si propone di quantificare il potenziale impatto degli spazi rurali sul sistema urbano. In particolare obiettivo di tale strumento è l’identificazione nel territorio extra-urbano di ambiti omogenei per caratteristiche attraverso una lettura del territorio a differenti scale (da quella territoriale a quella aziendale) al fine di giungere ad una sua classificazione e quindi alla definizione delle aree classificabili come “agricole periurbane”. La tesi propone la presentazione dell’architettura complessiva della metodologia e la descrizione dei livelli di analisi che la compongono oltre che la successiva sperimentazione e validazione della stessa attraverso un caso studio rappresentativo posto nella Pianura Padana (Italia).

The XENON1T experiment: Monte Carlo background estimation and sensitivity curves study

Despite the scientific achievement of the last decades in the astrophysical and cosmological fields, the majority of the Universe energy content is still unknown. A potential solution to the “missing mass problem” is the existence of dark matter in the form of WIMPs. Due to the very small cross section for WIMP-nuleon interactions, the number of expected events is very limited (about 1 ev/tonne/year), thus requiring detectors with large target mass and low background level. The aim of the XENON1T experiment, the first tonne-scale LXe based detector, is to be sensitive to WIMP-nucleon cross section as low as 10^-47 cm^2. To investigate the possibility of such a detector to reach its goal, Monte Carlo simulations are mandatory to estimate the background. To this aim, the GEANT4 toolkit has been used to implement the detector geometry and to simulate the decays from the various background sources: electromagnetic and nuclear. From the analysis of the simulations, the level of background has been found totally acceptable for the experiment purposes: about 1 background event in a 2 tonne-years exposure. Indeed, using the Maximum Gap method, the XENON1T sensitivity has been evaluated and the minimum for the WIMP-nucleon cross sections has been found at 1.87 x 10^-47 cm^2, at 90% CL, for a WIMP mass of 45 GeV/c^2. The results have been independently cross checked by using the Likelihood Ratio method that confirmed such results with an agreement within less than a factor two. Such a result is completely acceptable considering the intrinsic differences between the two statistical methods. Thus, in the PhD thesis it has been proven that the XENON1T detector will be able to reach the designed sensitivity, thus lowering the limits on the WIMP-nucleon cross section by about 2 orders of magnitude with respect to the current experiments.