Working Paper: NBER ID: w28334
Authors: Petra Persson; Xinyao Qiu; Maya Rossin-Slater
Abstract: The health care system commonly relies on information about family medical history in the allocation of screenings and in diagnostic processes. At the same time, an emerging literature documents that treatment for “marginally diagnosed” patients often has minimal impacts. This paper shows that reliance on information about relatives' health can perpetuate marginal diagnoses across family members, thereby raising caseloads and health care costs, but without improving patient well-being. We study Attention Deficit Hyperactivity Disorder (ADHD), the most common childhood mental health condition, and document that the younger siblings and cousins of marginally diagnosed children are also more likely to be diagnosed with and treated for ADHD. Moreover, we find that the younger relatives of marginally diagnosed children have no better adult human capital and economic outcomes than the younger relatives of those who are less likely to be diagnosed. Our analysis points to a simple adjustment to physician protocol that can mitigate these marginal diagnosis spillovers.
Keywords: ADHD; diagnosis; spillover effects; family medical history; health care costs
JEL Codes: I14; I18; J13
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Older sibling marginal diagnosis (Y80) | Younger sibling diagnosis (J13) |
| Older sibling marginal diagnosis (Y80) | Younger sibling treatment (C92) |
| Older sibling marginal diagnosis (Y80) | Younger cousin diagnosis (Y80) |
| Older sibling marginal diagnosis (Y80) | Younger cousin treatment (C92) |
| Younger sibling diagnosis (J13) | Relative age effects on ADHD diagnoses (C22) |