Health economics最新文献_第2页

Do Physicians Respond to Additional Capitation Payments in Mixed Remuneration Schemes?

IF 2 3区医学

Health economics Pub Date : 2025-03-06 DOI: 10.1002/hec.4954

Line Planck Kongstad, Nicolai Damslund, Jens Søndergaard, Geir Godager, Kim Rose Olsen

{"title":"Do Physicians Respond to Additional Capitation Payments in Mixed Remuneration Schemes?","authors":"Line Planck Kongstad, Nicolai Damslund, Jens Søndergaard, Geir Godager, Kim Rose Olsen","doi":"10.1002/hec.4954","DOIUrl":"https://doi.org/10.1002/hec.4954","url":null,"abstract":"Mixed remuneration schemes with capitation and fee-for-service (FFS) payments hold financial incentives to add patients to the list and provide services to listed patients. However, as patients with complex needs tend to require longer consultations there is a risk of inequality in access if fees are not adjusted to patient characteristics. In this paper, we assess a natural experiment introducing additional capitation for GPs with a high share of complex patients (moderate scheme) and for GPs in certain geographical areas (intensive scheme). GPs are eligible if the complexity of their listed patients exceeds a threshold, but as the scheme is subject to a national budget constraint, some eligible general practitioners (GPs) are left without additional payment. For the most favored GPs, the reform distributed additional capitation at 8% of the total baseline income. We study the effects on the number of patients per GP and the number of services per patient, applying difference-in-difference (DiD) models. For both schemes (moderate and intensive), we find tendencies of reductions in the number of patients served and the level of service provision per patient. This also holds for complex patients indicating that the reform did not improve equity in access. The effect on income showed a 2.5% increase in the first follow-up year but the effect became insignificant in the second year after the reform. We interpret this result as a sign that GPs trade income increases with leisure as suggested by the target income hypothesis.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566918","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

Healthcare Quality by Specialists Under a Mixed Compensation System: An Empirical Analysis 混合薪酬制度下专科医生的医疗质量：实证分析

IF 2 3区医学

Health economics Pub Date : 2025-03-03 DOI: 10.1002/hec.4943

Damien Echevin, Bernard Fortin, Aristide Houndetoungan

引用次数: 0

Economic Shocks and Infant Health: The Intergenerational Effects of Import Competition in the U.S.

IF 2 3区医学

Health economics Pub Date : 2025-02-24 DOI: 10.1002/hec.4946

Patralekha Ukil

{"title":"Economic Shocks and Infant Health: The Intergenerational Effects of Import Competition in the U.S.","authors":"Patralekha Ukil","doi":"10.1002/hec.4946","DOIUrl":"https://doi.org/10.1002/hec.4946","url":null,"abstract":"This paper investigates the intergenerational health impacts of a persistent negative economic shock faced by individuals residing in the United States. Specifically, the paper examines the impact of economic shocks in local labor markets on infant health by exploiting the increasing import competition from China between 2005 and 2015 on U.S. commuting zones as a plausibly exogenous source of variation in household economic conditions. Using yearly restricted-access data from the Natality Vital Statistics and yearly measures of the U.S local labor markets' exposure to import competition at the per capita level, this paper provides evidence that negative shocks in the form of worsening local labor market conditions are associated with a negative impact on infant health outcomes. Results indicate that increased import penetration from China in U.S commuting zones led to a reduction in the average birthweight and an increase in the incidence of low birthweight. Analyses of transmission mechanisms suggest worsening household economic circumstances as a result of negative labor market outcomes in the form of reduced wages, reduced household income per capita and increased reliance on food stamps, reduced access to healthcare and an increase in mental health declines among women of childbearing age.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491689","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

Impact of Tobacco-21 Laws on Maternal Smoking Behavior.

IF 2 3区医学

Health economics Pub Date : 2025-02-23 DOI: 10.1002/hec.4951

Tim Bersak, Makayla Lavender, Lyudmyla Sonchak-Ardan

{"title":"Impact of Tobacco-21 Laws on Maternal Smoking Behavior.","authors":"Tim Bersak, Makayla Lavender, Lyudmyla Sonchak-Ardan","doi":"10.1002/hec.4951","DOIUrl":"https://doi.org/10.1002/hec.4951","url":null,"abstract":"This study employs a logit difference-in-differences model to estimate the extent to which raising the tobacco purchasing age to 21 (T-21) reduced the prevalence of smoking among mothers aged 18-20 both before and during their pregnancies. Using United States Vital Statistics data from 2012 to 2019, we estimate that counties which adopted T-21, whether individually or as part of a state-level policy, experienced small but statistically significant decreases in maternal smoking prior to and during their pregnancies. Our estimates also suggest that the decline in smoking during pregnancy is driven by fewer women smoking prior to pregnancy rather than increased quit rates during pregnancy. Finally, our estimation strategy also allows us to focus on the expansions in New York City and California, which are the locations with the largest number of impacted births in our sample. We estimate T-21 decreased maternal smoking both prior to and during pregnancy in California by up to 14% from baseline. Other studies which examined T-21 on a broader set of young adults have found larger reductions in smoking rates, suggesting that the subpopulation of young mothers who choose to smoke may be relatively less responsive to policies that raise the minimum purchase age of tobacco products.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482742","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

There Is No Place Like Home: The Impact of Public Home-Based Care on the Mental Health and Well-Being of Older People.

IF 2 3区医学

Health economics Pub Date : 2025-02-20 DOI: 10.1002/hec.4948

Ludovico Carrino, Erica Reinhard, Mauricio Avendano

{"title":"There Is No Place Like Home: The Impact of Public Home-Based Care on the Mental Health and Well-Being of Older People.","authors":"Ludovico Carrino, Erica Reinhard, Mauricio Avendano","doi":"10.1002/hec.4948","DOIUrl":"10.1002/hec.4948","url":null,"abstract":"Despite a significant policy shift from institutional to home-based care for older adults, evidence on the effectiveness of policies incentivizing home care is limited. This study provides novel evidence on the causal effect of public home-based care on the mental health and well-being of older people. To address endogenous selection, we implement a novel instrumental variable approach that exploits eligibility rules for long-term care as defined in national legislations. We link longitudinal data from the Survey of Health, Aging & Retirement in Europe (SHARE, 2004-2017) to national LTC eligibility rules in France, Germany, Spain and Belgium (disaggregated for Wallonia and Flanders regions) and examine how exogenous variation in the use of long-term care caused by varying eligibility rules impacts depressive symptoms (EURO-D scale), quality of life (CASP scale) and loneliness (R-UCLA scale). We find that receiving formal home-based care significantly reduces depressive symptom scores by 2.6 points (large effect size measured by Cohen's d) and the risk of depression by 13 percentage points. The use of home-based formal care also increases quality of life as measured by the CASP scale, particularly by increasing feelings of control over life. We show that one potential mechanism involves the impact of home-based care on loneliness: we estimate that receiving formal home-based care reduces the risk of loneliness by 6.7 percentage points. Our results provide evidence that an increase in home-based care coverage is justified in terms of improved mental health and well-being outcomes for older people.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467871","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

Understanding the Demand-Side of an Illegal Market: A Case Study of the Prohibition of Menthol Cigarettes 了解非法市场的需求方：薄荷香烟禁令案例研究》。

IF 2 3区医学

Health economics Pub Date : 2025-02-19 DOI: 10.1002/hec.4937

Don Kenkel, Alan Mathios, Grace Phillips, Revathy Suryanarayana, Hua Wang, Sen Zeng

引用次数: 0

Marketing Status and Brand-Name Drug Prices: Evidence From Rx-To-OTC Switch.

IF 2 3区医学

Health economics Pub Date : 2025-02-17 DOI: 10.1002/hec.4952

Lin Lin, Bo Wang

引用次数: 0

Strategic Coding in the Assessment of Long-Term Care Needs: Evidence From France.

IF 2 3区医学

Health economics Pub Date : 2025-02-11 DOI: 10.1002/hec.4950

Delphine Roy

引用次数: 0

The Power of Presence: The Impact of Paternity Leave on Child Health in China.

IF 2 3区医学

Health economics Pub Date : 2025-02-08 DOI: 10.1002/hec.4947

Xiaoman Li, Yu Fu, Ailin Mao

引用次数: 0

Spillovers From Medicaid Contraceptive Use to Non-Medicaid Patients: Evidence From New York

IF 2 3区医学

Health economics Pub Date : 2025-02-03 DOI: 10.1002/hec.4945

Kevin Callison, Marisa Carlos, Barton Willage

{"title":"Spillovers From Medicaid Contraceptive Use to Non-Medicaid Patients: Evidence From New York","authors":"Kevin Callison, Marisa Carlos, Barton Willage","doi":"10.1002/hec.4945","DOIUrl":"10.1002/hec.4945","url":null,"abstract":"<div>\u0000 \u0000 This study examines spillovers from a 2014 New York Medicaid policy change that increased reimbursement for immediate postpartum long-acting reversible contraceptive (LARC) insertion. Using administrative data on hospital deliveries from 2011 through 2019, we analyze whether physicians who inserted immediate postpartum LARCs for Medicaid patients following the policy change were more likely to subsequently perform the procedure on non-Medicaid patients. We find significant spillovers, as physicians who first perform an immediate postpartum Medicaid LARC insertion following the 2014 payment reform are 9.3 percentage points more likely to perform immediate postpartum non-Medicaid LARC insertions; an association that increases with the physician's share of Medicaid deliveries. To distinguish between physician-specific and hospital-specific factors driving spillovers, we compare physicians within the same hospital-year. Results indicate approximately half the spillover is due to physician-specific factors and half to hospital-specific factors. Our findings highlight how targeted reimbursement policies can have broader impacts beyond the intended population and demonstrate the influence of both individual physician behavior and institutional factors in shaping clinical practice patterns. Understanding these spillover dynamics is important for policymakers and healthcare providers aiming to promote effective and equitable contraceptive care across patient populations.\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 5","pages":"821-826"},"PeriodicalIF":2.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122557","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