Health economics最新文献_第8页

Do physicians' attitudes toward prioritization predict poor-health patients' access to care? 医生对优先顺序的态度是否预示着健康状况不佳的患者能否获得医疗服务？

IF 2 3区医学

Health economics Pub Date : 2024-05-14 DOI: 10.1002/hec.4843

Anne Sophie Oxholm, Dorte Gyrd-Hansen

{"title":"Do physicians' attitudes toward prioritization predict poor-health patients' access to care?","authors":"Anne Sophie Oxholm, Dorte Gyrd-Hansen","doi":"10.1002/hec.4843","DOIUrl":"10.1002/hec.4843","url":null,"abstract":"Physicians often face tight resource constraints, meaning they have to make trade-offs between which patients they care for and the amount of care received. Studies show that patients requiring many resources disproportionately suffer a loss of care when resources are constrained. This study uncovers whether physicians' attitudes toward prioritization of healthcare predicts poor-health patients' access to care. We combine unique survey data on Danish GPs' preferred prioritization principle with register data on their patients' contacts in general practice. We consider different types of contacts as the required effort could impact the need for prioritization. Our results show variation in GPs' prioritization principles, where a majority prefers a principle that may lead to an unequal distribution of services. We further find that GPs' attitudes toward prioritization predict some poor-health patients' access to general practice. GPs who state they prefer the principle of prioritizing patients in the poorest health state when resources tightened provide more contacts to poor-health patients. The additional contacts are typically high-effort contacts such as annual status meetings and home visits, but also low-effort contacts such as emails. Our findings indicate inequity in poor-health patients' access to care across general practices.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"33 8","pages":"1649-1659"},"PeriodicalIF":2.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.4843","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficiency and productivity gains of robotic surgery: The case of the English National Health Service 机器人手术的效率和生产力收益：英国国家医疗服务机构的案例。

IF 2 3区医学

Health economics Pub Date : 2024-05-11 DOI: 10.1002/hec.4838

Laia Maynou, Alistair McGuire, Victoria Serra-Sastre

{"title":"Efficiency and productivity gains of robotic surgery: The case of the English National Health Service","authors":"Laia Maynou, Alistair McGuire, Victoria Serra-Sastre","doi":"10.1002/hec.4838","DOIUrl":"10.1002/hec.4838","url":null,"abstract":"This paper examines the effect of new medical technology (robotic surgery) on efficiency gains and productivity changes for surgical treatment in patients with prostate cancer from the perspective of a public health sector organization. In particular, we consider three interrelated surgical technologies within the English National Health System: robotic, laparoscopic and open radical prostatectomy. Robotic and laparoscopic techniques are minimally invasive procedures with similar clinical benefits. While the clinical benefits in adopting robotic surgery over laparoscopic intervention are unproven, it requires a high initial investment cost and carries high on-going maintenance costs. Using data from Hospital Episode Statistics for the period 2000–2018, we observe growing volumes of prostatectomies over time, mostly driven by an increase in robotic-assisted surgeries, and further analyze whether hospital providers that adopted a robot see improved measures of throughput. We then quantify changes in total factor and labor productivity arising from the use of this technology. We examine the impact of robotic adoption on efficiency gains employing a staggered difference-in-difference estimator and find evidence of a 50% reduction in length of stay (LoS), 49% decrease in post-LoS and 44% and 46% decrease in postoperative visits after 1 year and 2 years, respectively. Productivity analysis shows the growth in radical prostatectomy volume is sustained with a relatively stable number of urology surgeons. The robotic technique increases total production at the hospital level between 21% and 26%, coupled with a 29% improvement in labor productivity. These benefits lend some, but not overwhelming support for the large-scale hospital investments in such costly technology.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"33 8","pages":"1831-1856"},"PeriodicalIF":2.0,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.4838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140908552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk compensation after COVID-19 vaccination: Evidence from vaccine rollout by exact birth date in South Korea 接种 COVID-19 疫苗后的风险补偿：韩国按确切出生日期推广疫苗的证据。

IF 2 3区医学

Health economics Pub Date : 2024-05-10 DOI: 10.1002/hec.4837

Jisoo Hwang, Seung-sik Hwang, Hyuncheol Bryant Kim, Jungmin Lee, Junseok Lee

引用次数: 0

The effect of retirement eligibility on mental health in the United Kingdom: Heterogeneous effects by occupation 英国退休资格对心理健康的影响：不同职业的异质性影响。

IF 2 3区医学

Health economics Pub Date : 2024-05-04 DOI: 10.1002/hec.4835

Joe Spearing

引用次数: 0

Auditing the prescription drug consumer price index in a changing marketplace 在不断变化的市场中审计处方药消费价格指数

IF 2 3区医学

Health economics Pub Date : 2024-04-29 DOI: 10.1002/hec.4836

Andrew L. Hicks, Ernst R. Berndt, Richard G. Frank

{"title":"Auditing the prescription drug consumer price index in a changing marketplace","authors":"Andrew L. Hicks, Ernst R. Berndt, Richard G. Frank","doi":"10.1002/hec.4836","DOIUrl":"10.1002/hec.4836","url":null,"abstract":"Changes in the dynamics of prescription drug markets have raised issues regarding whether the United States Bureau of Labor Statistics' (BLS’) Prescription Drug Consumer Price Index (CPI-Rx) has adequately kept up with the evolving marketplace. The CPI-Rx limits its sampling frame to retail outpatient outlets and excludes prescription pharmaceuticals dispensed in non-retail settings such as hospitals, physician/clinic outpatient facilities, and nursing homes. Thus, the CPI-Rx overlooks the increasingly important specialty pharmaceuticals dispensed in non-retail settings, whose transactions are instead captured in the overall hospital and professional services component of the medical care CPI. Specialty drugs now account for about 55% of all U.S. drug spending, double the share of a decade earlier. To the extent specialty drug price growth differs from that of traditional pharmaceuticals, the CPI-Rx could provide an inaccurate measure of overall drug price inflation. We calculate a chained Laspeyres CPI using data from the Merative™ MarketScan® Databases for the years 2010–2019 and IQVIA-designated specialty drugs and offer evidence showing that by not sampling specialty drugs in non-retail settings, the CPI-Rx has understated overall U.S. prescription drug inflation by just under 75 basis points annually. We discuss implications for health care policy and suggest the BLS examine the feasibility of publishing an overall pharmaceutical price index incorporating both traditional and specialty pharmaceuticals dispensed in retail and non-retail settings.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"33 8","pages":"1793-1810"},"PeriodicalIF":2.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833778","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

Integrating decision modeling and machine learning to inform treatment stratification 整合决策建模和机器学习，为治疗分层提供信息。

IF 2 3区医学

Health economics Pub Date : 2024-04-25 DOI: 10.1002/hec.4834

David Glynn, John Giardina, Julia Hatamyar, Ankur Pandya, Marta Soares, Noemi Kreif

{"title":"Integrating decision modeling and machine learning to inform treatment stratification","authors":"David Glynn, John Giardina, Julia Hatamyar, Ankur Pandya, Marta Soares, Noemi Kreif","doi":"10.1002/hec.4834","DOIUrl":"10.1002/hec.4834","url":null,"abstract":"There is increasing interest in moving away from “one size fits all (OSFA)” approaches toward stratifying treatment decisions. Understanding how expected effectiveness and cost-effectiveness varies with patient covariates is a key aspect of stratified decision making. Recently proposed machine learning (ML) methods can learn heterogeneity in outcomes without pre-specifying subgroups or functional forms, enabling the construction of decision rules (‘policies’) that map individual covariates into a treatment decision. However, these methods do not yet integrate ML estimates into a decision modeling framework in order to reflect long-term policy-relevant outcomes and synthesize information from multiple sources. In this paper, we propose a method to integrate ML and decision modeling, when individual patient data is available to estimate treatment-specific survival time. We also propose a novel implementation of policy tree algorithms to define subgroups using decision model output. We demonstrate these methods using the SPRINT (Systolic Blood Pressure Intervention Trial), comparing outcomes for “standard” and “intensive” blood pressure targets. We find that including ML into a decision model can impact the estimate of incremental net health benefit (INHB) for OSFA policies. We also find evidence that stratifying treatment using subgroups defined by a tree-based algorithm can increase the estimates of the INHB.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"33 8","pages":"1772-1792"},"PeriodicalIF":2.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.4834","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140657247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The brother's penalty: Boy preference and girls' health in rural China 兄弟的惩罚：中国农村地区的男孩偏好与女孩健康。

IF 2 3区医学

Health economics Pub Date : 2024-04-05 DOI: 10.1002/hec.4833

Yuli Ye, Qinying He, Qiang Li, Lian An

引用次数: 0

The effects of dental hygienist autonomy on dental care utilization 牙科保健员的自主性对牙科保健利用率的影响。

IF 2 3区医学

Health economics Pub Date : 2024-03-27 DOI: 10.1002/hec.4832

Jie Chen, Chad D. Meyerhoefer, Edward J. Timmons

引用次数: 0

Pornography usage during adolescence: Does it lead to risky sexual behavior? 青春期使用色情制品：它会导致危险的性行为吗？

IF 2 3区医学

Health economics Pub Date : 2024-03-21 DOI: 10.1002/hec.4825

Hamida Mubasshera

引用次数: 0

Nudging healthy food choices through e-messages in a supermarket 在超市通过电子信息提示人们选择健康食品。

IF 2 3区医学

Health economics Pub Date : 2024-03-21 DOI: 10.1002/hec.4831

Ana Balsa, Cecilia Noboa, Patricia Triunfo

{"title":"Nudging healthy food choices through e-messages in a supermarket","authors":"Ana Balsa, Cecilia Noboa, Patricia Triunfo","doi":"10.1002/hec.4831","DOIUrl":"10.1002/hec.4831","url":null,"abstract":"This paper analyses the impact of a healthy food nudge intervention on purchases of 1590 customers of a supermarket chain's loyalty program in Uruguay through a randomized controlled trial. Nudges were presented in the form of messages sent through WhatsApp to customers three times a week for 8 weeks (between July and September 2020). Messages highlighted the benefits of cooking at home and eating mindfully and healthy (vegetables, fruits, healthy snacks, legumes, and fish), and included easy to implement tips. Results show that, on average, customers assigned to the treatment group increased their purchases of healthy food by 8% and substituted sugar-sweetened for sugar-free beverages. We find an unintended increase in purchases of unhealthy food of 7%, with no correlative increase in calories, suggesting that customers substituted higher calorie products for lower calorie ones. We find that households with lower educational attainment, lower income, and with children under the age of 12 are more likely to increase purchases of fruits and vegetables, while other households are more likely to improve the diet quality without increasing expenditure. Effects do not persist after the intervention is over, suggesting that salience, rather than information is the main channel triggering the effects.","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"33 8","pages":"1705-1725"},"PeriodicalIF":2.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174258","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