Essays in Applied Health Economics

This dissertation examines the role of innovation in contemporary healthcare systems from an applied health economics perspective, focusing on individuals' behavioral responses and the implications for healthcare resource utilization and welfare. Through three empirical contributions, it investigates how digital technologies, organizational models, and public policies shape care-related behaviors, individual choices, and health outcomes. The first chapter analyzes the introduction of telemonitoring as an innovation in care delivery for chronic cardiac patients within an Italian local health authority. Using individual-level administrative data and a quasi-experimental difference-in-differences design, it assesses whether telemonitoring acts as a substitute for or a complement to traditional in-person care. Results show that telemonitoring complements rather than substitutes traditional care: while it does not reduce the overall number of hospitalizations, it is associated with lower hospitalization costs and a significant increase in outpatient specialist visits, suggesting a reallocation toward more continuous and preventive management. The second chapter explores medication adherence as a key mechanism linking telemedicine to healthcare utilization among chronic cardiac and diabetic patients. Employing longitudinal administrative data and econometric models, including a recursive multivariate probit, it shows that telemedicine exposure is associated with improved adherence for some medication classes, and that higher adherence is strongly linked to reduced use of acute care services, particularly hospitalizations and emergency department visits, indicating adherence as a mediating channel. The third chapter shifts focus to product and policy innovation, examining electronic cigarettes as a harm-reduction tool. Exploiting geographic and temporal variation in U.S. e-cigarette taxation and longitudinal survey data, it shows that fiscal policy significantly reduces e-cigarette use at both the extensive and intensive margins, but does not substantially correct misaligned risk perceptions, with behavioral responses depending critically on individuals' baseline beliefs. The three chapters show that healthcare innovation does not generate automatic or uniform effects, but produces heterogeneous outcomes shaped by institutional context, individual characteristics, and informational dynamics. The dissertation underscores the importance of jointly considering technology, behavior, and regulation in designing effective and sustainable health interventions, and of coordinating fiscal and regulatory tools with coherent information strategies.