Lea-Karla Matić
Research
Work in Progress
End-of-Life Medical Spending: Patterns and Household Spillovers
Alexander Ahammer, Lea-Karla Matić
March 2025
Medical spending is highly concentrated at the end of life and varies widely across patients, raising a first-order welfare question about whether marginal end-of-life spending reflects waste or generates meaningful benefits. Using Austrian administrative data, we document that end-of-life spending has grown markedly over time and remains highly dispersed even conditional on diagnosis, with predicted mortality explaining only a small share of the variation. We then study a largely underexplored margin: spillovers onto surviving spouses. Event study estimates show large and persistent changes in spouses’ employment and healthcare use around spousal death. However, these dynamics are essentially invariant to the decedent’s end-of-life spending intensity, a finding that is robust to different measures of spending intensity and to an instrumental variables design exploiting provider-level practice variation. Together, these results are consistent with an important role for inefficiencies in end-of-life care.
Working Paper →
Working Paper →
Fig. 1 · Medical spending relative to death
The Right to Parental Part-Time Work in Austria
Lea-Karla Matić, Johanna Luise Reuter
March 2026
Part-time work is a central yet understudied policy margin through which governments seek to reconcile paid employment and family responsibilities. This paper estimates the causal effects of Austria’s 2004 introduction of a legal right to parental part-time work for employees in firms with more than 20 workers. Using rich administrative data and a triple-difference-in-differences design, we show that the reform generates large and persistent increases in part-time work but only modest and short-lived effects on labor market attachment. Instead, post-birth adjustment occurs through both higher employer retention and subsequent fertility. These gains come with persistent earnings losses and a higher child penalty, especially in sectors with steep returns to long and continuous working hours. We also find adverse short-term effects on maternal mental health with no evidence of long-term impacts.
Fig. 1 · Event study estimates: Part-Time Employment
Family Spillovers of Miscarriage
Lea-Karla Matić
March 2025
Using Austrian administrative data, I estimate the causal effect of miscarriage on women’s labour market and health outcomes, as well as its spillover effects on close family members. To do so, I construct counterfactuals for affected individuals from those who encounter the same fertility shock at a later point in time. The results suggest that affected women experience short-term labour market detachment, deterioration in mental health, and increased investment in future fertility. These effects are partially mitigated by subsequent pregnancies and births. For spouses, I find suggestive evidence of an increased likelihood of mental health diagnoses, but no significant changes in compensatory behaviours such as smoking or alcohol use. Spillover effects on sisters indicate an increase in preventive health care, not driven by their own fertility intentions.
Fig. 1 · Incidence rate of miscarriage