Health services research : how economics plays a role in public health for children in Somaliland and inmates in Texas.

Abstract

Throughout this dissertation, I will assess three studies: (1) a cost-effectiveness analysis for pediatric surgery uptake for children in Somaliland with congenital conditions; (2) a survival analysis for time to suicidality for inmates in Travis county, Texas; and (3) an instrumental variables model for mental health courts and their effect on repeat offending and suicidality. Each chapter aims to highlight the economic impact on public health for each of the studied populations. The chapter on cost-effectiveness utilizes a Markov model to display the disability-adjusted life-years averted, net monetary benefits, and incremental cost-effectiveness ratios for nine congenital conditions for children aged 0 to 3 years old in Somaliland. The chapter on survivability for inmates finds the probability of surviving during various length of stays within the Travis county prison for suicidality (suicide attempt and/or suicide ideation). The chapter on mental health courts focuses on their effect on repeat offending and suicidality through evidence from randomized clinicians within the Travis county prison. Each chapter highlights the importance of health services research, the effects of economics and opportunities, and the need to increase health services research for vulnerable populations, such as children in low-income countries and inmates in prison.