The European Journal of Health Economics最新文献_第4页

Inefficiencies in a healthcare system with a regulatory split of power: a spatial panel data analysis of avoidable hospitalisations in Austria. 效率低下的医疗保健系统与监管权力分裂：空间面板数据分析可避免住院在奥地利。

The European Journal of Health Economics Pub Date : 2020-02-01 Epub Date: 2019-09-09 DOI: 10.1007/s10198-019-01113-7

Anna-Theresa Renner

{"title":"Inefficiencies in a healthcare system with a regulatory split of power: a spatial panel data analysis of avoidable hospitalisations in Austria.","authors":"Anna-Theresa Renner","doi":"10.1007/s10198-019-01113-7","DOIUrl":"10.1007/s10198-019-01113-7","url":null,"abstract":"Despite generous universal social health insurance with little formal restrictions of outpatient utilisation, Austria exhibits high rates of avoidable hospitalisations, which indicate the inefficient provision of primary healthcare and might be a consequence of the strict regulatory split between the Austrian inpatient and outpatient sector. This paper exploits the considerable regional variations in acute and chronic avoidable hospitalisations in Austria to investigate whether those inefficiencies in primary care are rather related to regional healthcare supply or to population characteristics. To explicitly account for inter-regional dependencies, spatial panel data methods are applied to a comprehensive administrative dataset of all hospitalisations from 2008 to 2013 in the 117 Austrian districts. The initial selection of relevant covariates is based on Bayesian model averaging. The results of the analysis show that supply-side variables, such as the number of general practitioners, are significantly associated with decreased chronic and acute avoidable hospitalisations, whereas characteristics of the regional population, such as the share of population with university education or long-term unemployed, are less relevant. Furthermore, the spatial error term indicates that there are significant spatial dependencies between unobserved characteristics, such as practice style or patients' utilization behaviour. Not accounting for those would result in omitted variable bias.","PeriodicalId":22450,"journal":{"name":"The European Journal of Health Economics","volume":"32 1","pages":"85-104"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74265071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 value of persistence in treatment with subcutaneous TNF-alpha inhibitors for ankylosing spondylitis. 持续使用皮下tnf - α抑制剂治疗强直性脊柱炎的价值。

The European Journal of Health Economics Pub Date : 2020-02-01 Epub Date: 2019-09-14 DOI: 10.1007/s10198-019-01110-w

Axel Svedbom, Johan Dalén, Moa Ivergård, Rebekah H Borse, Christopher M Black, Karin Luttropp, Sumesh Kachroo

{"title":"The value of persistence in treatment with subcutaneous TNF-alpha inhibitors for ankylosing spondylitis.","authors":"Axel Svedbom, Johan Dalén, Moa Ivergård, Rebekah H Borse, Christopher M Black, Karin Luttropp, Sumesh Kachroo","doi":"10.1007/s10198-019-01110-w","DOIUrl":"10.1007/s10198-019-01110-w","url":null,"abstract":"Objective: To estimate the impact of persistence on cost-effectiveness of subcutaneous tumor necrosis factor-α inhibitors (SC-TNFis) from healthcare and societal perspectives in a United Kingdom ankylosing spondylitis (AS) population using a recently published Markov cohort model.Methods: A recently published cost-effectiveness model developed for a National Institute for health and Care Excellence appraisal was extended to fit the current study; in brief, it is a Markov cohort model where treatment responders continue from the trial period with maintenance SC-TNFi treatment, while non-responders transition to conventional care. Costs and effects were modeled for a hypothetical SC-TNFi with average efficacy and price. Model outcomes included quality-adjusted life-years (QALYs), total direct and indirect lifetime costs, and incremental cost-effectiveness ratios (ICERs). The cost-effectiveness of SC-TNFi persistence was estimated by decreasing the annual discontinuation probability in five percentage point increments from 25 to 5% per annum.Results: From a health care perspective, the ICERs for the modeled discontinuation rates compared to the baseline annual discontinuation rate (25%) ranged between GBP 17,277 and GBP 18,161. From a societal perspective, increased discontinuation rates resulted in decreased total costs and higher QALYs; hence, lower discontinuation rates dominated higher discontinuation rates from a societal perspective.Conclusion: In conclusion, this study shows that, all else equal, higher SC-TNFi treatment persistence in AS is cost effective from a health care perspective and dominant from a societal perspective. Hence, all else equal, prescribing the SC-TNFi with the highest persistence may be considered a cost-effective strategy.","PeriodicalId":22450,"journal":{"name":"The European Journal of Health Economics","volume":"32 1","pages":"45-54"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86054448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-compensatory aggregation method to measure social and material deprivation in an urban area: relationship with premature mortality 衡量城市地区社会和物质剥夺的非补偿性汇总方法:与过早死亡的关系

The European Journal of Health Economics Pub Date : 2019-12-06 DOI: 10.1007/s10198-019-01139-x

Carolina Bruzzi, Enrico Ivaldi, S. Landi

引用次数: 15

Correction to: Cost–consequence analysis of fluticasone furoate/vilanterol for asthma management in Spain: an analysis based on the Salford Lung Study in asthma 更正:在西班牙，糠酸氟替卡松/维兰特罗用于哮喘治疗的成本-后果分析:基于哮喘索尔福德肺部研究的分析

The European Journal of Health Economics Pub Date : 2019-12-04 DOI: 10.1007/s10198-019-01137-z

L. Vallejo-Aparicio, J. Molina, I. Ojanguren, A. Viejo Casas, A. Huerta, H. Svedsater

引用次数: 0

Effects of pay-for-performance for primary care physicians on diabetes outcomes in single-payer health systems: a systematic review. 在单一付款人卫生系统中，初级保健医生按绩效付费对糖尿病结局的影响：系统回顾。

The European Journal of Health Economics Pub Date : 2019-12-01 Epub Date: 2019-08-10 DOI: 10.1007/s10198-019-01097-4

Neeru Gupta, Holly M Ayles

{"title":"Effects of pay-for-performance for primary care physicians on diabetes outcomes in single-payer health systems: a systematic review.","authors":"Neeru Gupta, Holly M Ayles","doi":"10.1007/s10198-019-01097-4","DOIUrl":"10.1007/s10198-019-01097-4","url":null,"abstract":"Background: Although pay-for-performance (P4P) for diabetes care is increasingly common, evidence of its effectiveness in improving population health and health system sustainability is deficient. This information gap is attributable in part to the heterogeneity of healthcare financing, covered medical conditions, care settings, and provider remuneration arrangements within and across countries. We systematically reviewed the literature concentrating on whether P4P for physicians in primary and community care leads to better diabetes outcomes in single-payer national health insurance systems.Methods: Studies were identified by searching ten databases (01/2000-04/2018) and scanning the reference lists of review articles and other global health literature. We included primary studies evaluating the effects of introducing P4P for diabetes care among primary care physicians in countries of universal health coverage. Outcomes of interest included patient morbidity, avoidable hospitalization, premature death, and healthcare costs.Results: We identified 2218 reports; after exclusions, 10 articles covering 8 P4P interventions in 7 countries were eligible for analysis. Five studies, capturing records from 717,166 patients with diabetes, were graded as high-quality evaluations of P4P on health outcomes. Based on three quality studies, P4P can result in reduced risk of mortality over the longer term-when linked to performance metrics. However, studies from other jurisdictions, where P4P was not linked to specific patient-oriented objectives, yielded little or mixed evidence of positive health impacts.Conclusion: Evidence of the effectiveness of P4P depends on whether physicians' incentive payments are explicitly tied to performance metrics. However, the most appropriate indicators for performance monitoring remain in question. More research with rigorous evaluation in different settings is needed.","PeriodicalId":22450,"journal":{"name":"The European Journal of Health Economics","volume":"12 1","pages":"1303-1315"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73183029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ex-post moral hazard in the health insurance market: empirical evidence from German data. 健康保险市场的事后道德风险：来自德国数据的经验证据。

The European Journal of Health Economics Pub Date : 2019-12-01 Epub Date: 2019-08-12 DOI: 10.1007/s10198-019-01091-w

Stefanie Thönnes

{"title":"Ex-post moral hazard in the health insurance market: empirical evidence from German data.","authors":"Stefanie Thönnes","doi":"10.1007/s10198-019-01091-w","DOIUrl":"10.1007/s10198-019-01091-w","url":null,"abstract":"In this paper, I analyze whether premium refunds can reduce ex-post moral hazard behavior in the health insurance market. I do so by estimating the effect of these refunds on different measures of medical demand. I use panel data from German sickness funds that cover the years 2006-2010 and I estimate effects for the year 2010. Applying regression adjusted matching, I find that choosing a tariff that contains a premium refund is associated with a significant reduction in the probability of visiting a general practitioner. Furthermore, the probability of visiting a doctor due to a trivial ailment such as a common cold is reduced. Effects are mainly driven by younger (and, therefore, healthier) individuals, and they are stronger for men than for women. Medical expenditures for doctor visits are also reduced. I conclude that there is evidence that premium refunds are associated with a reduction in ex-post moral hazard. Robustness checks support these findings. Yet, using observable characteristics for matching and regression, it is never possible to completely eliminate a potentially remaining selection bias and results may not be interpreted in a causal manner.","PeriodicalId":22450,"journal":{"name":"The European Journal of Health Economics","volume":"28 1","pages":"1317-1333"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75850547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stratified medicine in schizophrenia: how accurate would a test of drug response need to be to achieve cost-effective improvements in quality of life? 精神分裂症的分层药物治疗：药物反应测试需要多精确才能达到具有成本效益的生活质量改善？

The European Journal of Health Economics Pub Date : 2019-12-01 Epub Date: 2019-08-28 DOI: 10.1007/s10198-019-01108-4

Huajie Jin, Paul McCrone, James H MacCabe

{"title":"Stratified medicine in schizophrenia: how accurate would a test of drug response need to be to achieve cost-effective improvements in quality of life?","authors":"Huajie Jin, Paul McCrone, James H MacCabe","doi":"10.1007/s10198-019-01108-4","DOIUrl":"10.1007/s10198-019-01108-4","url":null,"abstract":"Objective: Stratified medicine refers to the use of tests that predict treatment response to drive treatment decisions for individual patient. The pharmacoeconomic implications of this approach in schizophrenia are unknown. We aimed to assess the cost-effectiveness of a hypothetical stratified medicine algorithm (SMA) compared with treatment as usual (TAU), for patients with schizophrenia who failed a first-line antipsychotic.Methods: A decision analytic model with embedded Markov process was constructed, which simulated the health and cost outcomes for patients followed SMA or TAU over a lifetime horizon, from healthcare and social care perspective. In the base-case analysis, sensitivity and specificity of the stratifier were both set as 60%. Extensive sensitivity analyses were conducted to test the impact of uncertainty around the value of important parameters. The primary outcome was the incremental cost per quality-adjusted life year (QALY) gained.Results: When both sensitivity and specificity of the stratified test were set at 60%, SMA appeared to be the optimal strategy as it produces more QALYs and incurs lower costs than TAU. This is robust to all scenarios tested. At a willingness-to-pay threshold of £20,000 per QALY, the probability for SMA to be the optimal strategy is 82.4%.Conclusions: Our results suggest that use of any stratifier with a sensitivity and specificity over 60% is very likely to be cost-effective comparing to TAU, for psychotic patients who failed a first-line antipsychotic. This finding, however, should be interpreted with caution due to lack of evidence for clozapine as a second-line antipsychotic.","PeriodicalId":22450,"journal":{"name":"The European Journal of Health Economics","volume":"22 1","pages":"1425-1435"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6856032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81783731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 societal monetary value of a QALY associated with EQ-5D-3L health gains 与EQ-5D-3L健康收益相关的QALY的社会货币价值

The European Journal of Health Economics Pub Date : 2019-11-28 DOI: 10.1007/s10198-019-01140-4

L. Vallejo-Torres, B. García-Lorenzo, O. Rivero-Arias, J. Pinto-Prades

引用次数: 8

Economic evaluation of meningococcal vaccines: considerations for the future 脑膜炎球菌疫苗的经济评价:对未来的考虑

The European Journal of Health Economics Pub Date : 2019-11-21 DOI: 10.1007/s10198-019-01129-z

H. Christensen, H. Al-Janabi, P. Levy, M. Postma, D. Bloom, Paolo Landa, O. Damm, D. Salisbury, J. Díez-Domingo, A. Towse, P. Lorgelly, K. Shah, K. Hernandez-villafuerte, Vinny Smith, L. Glennie, C. Wright, L. York, R. Farkouh

引用次数: 23

Unfolding the relationship between mortality, economic fluctuations, and health in Italy 揭示意大利死亡率、经济波动和健康之间的关系

The European Journal of Health Economics Pub Date : 2019-11-20 DOI: 10.1007/s10198-019-01135-1

Maddalena Cavicchioli, B. Pistoresi

引用次数: 6