Health economics最新文献

Health Insurance Coverage Changes Under the Affordable Care Act Among High Housing Cost Households, 2010-18. 2010-18 年高住房成本家庭在《平价医疗法案》下的医疗保险覆盖变化。

IF 2 3区医学

Health economics Pub Date : 2024-11-13 DOI: 10.1002/hec.4912

Yu Cao, Yuxin Su, Guan Wang, Chengcheng Zhang

引用次数: 0

Impact of hospital-physician vertical integration on physician-administered drug spending and utilization. 医院-医生纵向一体化对医生管理药物支出和使用的影响。

IF 2 3区医学

Health economics Pub Date : 2024-11-12 DOI: 10.1002/hec.4909

Jonathan S Levin, Xiaoxi Zhao, Christopher Whaley

{"title":"Impact of hospital-physician vertical integration on physician-administered drug spending and utilization.","authors":"Jonathan S Levin, Xiaoxi Zhao, Christopher Whaley","doi":"10.1002/hec.4909","DOIUrl":"https://doi.org/10.1002/hec.4909","url":null,"abstract":"We estimate the effects of hospital-physician vertical integration on spending and utilization of physician-administered drugs for hematology-oncology, ophthalmology, and rheumatology. Using a 100% sample of Medicare fee-for-service medical claims from 2013 to 2017, we find that vertical integration shifts treatments away from physician offices and toward hospital outpatient departments. These shifts are accompanied by increases in physician-administered drug administration spending per procedure for all three specialties. Spending on Part B drugs also increases for hematologist-oncologists. At the same time, physician treatment intensity, as measured by the number of beneficiaries who receive drug infusions/injections and the number of drug infusions, decreases across all three specialties. These results suggest that the incentives of the Medicare reimbursement system, particularly site-of-care payment differentials and outpatient drug reimbursement rates, interact with vertical integration to lead to higher overall spending. Policies and merger guidelines should attempt to restrain spending increases attributed to vertical integration.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trade Liberalization and Mortality Rates: Evidence of Pro-Cyclical Mortality From Brazil. 贸易自由化与死亡率：来自巴西的顺周期死亡率证据。

IF 2 3区医学

Health economics Pub Date : 2024-11-12 DOI: 10.1002/hec.4915

Vinicius Curti Cícero, Lucas Cardoso Corrêa Dias, Sammy Zahran

{"title":"Trade Liberalization and Mortality Rates: Evidence of Pro-Cyclical Mortality From Brazil.","authors":"Vinicius Curti Cícero, Lucas Cardoso Corrêa Dias, Sammy Zahran","doi":"10.1002/hec.4915","DOIUrl":"https://doi.org/10.1002/hec.4915","url":null,"abstract":"We trace the evolution of all-cause mortality rates in Brazilian regions with varying exposure to trade-induced economic shocks before, during, and after liberalization reforms in the 1990s. We find consistent evidence of pro-cyclical mortality, with areas more exposed to tariff reductions experiencing larger declines in mortality across varying time horizons. The observed decline in mortality rates is evident across sex, age groups, and for both internal and external causes of mortality. We falsify the observed relationship between mortality and tariff reductions with analyses of causes of death that are plausibly unrelated to economic activity. Concerning proximate mechanisms involved in our finding of pro-cyclical mortality, we show that healthcare infrastructure expanded in local economies more affected by the trade-induced economic shock. This expansion was characterized by the increased capital-intensity of care, facilitated by the import of diagnostic technologies that reduce mortality from internal causes. We also find supporting evidence for the idea that pro-cyclical mortality is partially caused by a decrease in transport and non-transport-related accidents. Overall, our findings highlight an underappreciated dimension of trade policy effects, namely public health.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical Resource Scarcity and Inequality in COVID-19 Fatality Rates: Evidence From Hospitalized Patients in Wuhan, China. 医疗资源稀缺与 COVID-19 死亡率的不平等：中国武汉住院病人的证据。

IF 2 3区医学

Health economics Pub Date : 2024-11-11 DOI: 10.1002/hec.4916

Dandan Zhang, Xiang-Ming Zhang, Xiao Liu

{"title":"Medical Resource Scarcity and Inequality in COVID-19 Fatality Rates: Evidence From Hospitalized Patients in Wuhan, China.","authors":"Dandan Zhang, Xiang-Ming Zhang, Xiao Liu","doi":"10.1002/hec.4916","DOIUrl":"https://doi.org/10.1002/hec.4916","url":null,"abstract":"Wuhan, China, where SARS-CoV-2 was detected first, has been recorded as one of the epicenters with the highest COVID-19 fatality rates worldwide. High COVID-19 fatality rates may stem from severe medical resource scarcity, especially in the early stage of the pandemic outbreak. In the first few weeks of the COVID-19 outbreak, Wuhan experienced the hardship of a severe \"hospital run\" period, when hospitals operated far beyond their maximum capacity and then soon transformed into \"inclusive healthcare,\" that is, every infectious person can access free medical treatment. Based on detailed administrative data of hospital admission and medical treatment for 1537 COVID-19 patients, we investigate how the COVID-19 fatality rates can be affected by the patient's socioeconomic status (SES) and differences in the effect between the two periods. Our estimation results show that low-SES patients had higher fatality rates during the \"hospital run\" period. Differential opportunities for hospitalization do not drive this inequality in fatality rates; rather, they are driven by the medical treatment after hospital admission, namely reduced treatment intensity and limited access to specific medical treatment and medications for COVID-19. When the government implemented the \"inclusive healthcare\" policy, severe medical resource scarcity was alleviated, and the inequality in fatality rates ceased to exist. These findings verify the existence of medical inequality among low-SES people amid severe medical resource shortages and also highlight the importance of rapidly increasing hospital capacity and medical supply in reducing possible unequal treatment and tackling inequalities in medical outcomes, especially during a public health crisis.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0