ERN: Microeconometric Studies of Health Markets (Topic)最新文献_第6页

‘Niramoy’ Micro Health Insurance in Bangladesh: Innovations in Design, Delivery and Distribution Channels 孟加拉国“Niramoy”微型医疗保险:设计、交付和分销渠道的创新

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2013-06-21 DOI: 10.2139/ssrn.2283294

Syed M. Ahsan, S. A. Hamid, Shubhasish Barua, M. R. Haider, C. A. A. Asif

{"title":"‘Niramoy’ Micro Health Insurance in Bangladesh: Innovations in Design, Delivery and Distribution Channels","authors":"Syed M. Ahsan, S. A. Hamid, Shubhasish Barua, M. R. Haider, C. A. A. Asif","doi":"10.2139/ssrn.2283294","DOIUrl":"https://doi.org/10.2139/ssrn.2283294","url":null,"abstract":"Bangladesh needs to start afresh with innovative means of financing the provision of health care since in its absence the poor end up relying largely on self-insurance devices to mitigate health risks, which entails high implicit premiums. Existing insurance type programmes essentially consist of subsidy-oriented interventions, not necessarily in kind, requiring upfront cash at each stage of service delivery, hence failing to overcome the incidence of high out-of-pocket (OOP) payments, nor do the existing programmes succeed in dealing with events leading to catastrophic payments. Given this vacuum, an innovative micro health insurance (MHI) scheme has been designed keeping in view the targets of adequate risk protection, inclusivity of access, affordability and programme sustainability. The research design embracing the methods of cluster randomised trial allows for identification of direct and indirect effects of MHI on actual OOP incurred by the insured vis-a-vis the non-insured households who are otherwise similar in economic, educational and social dimensions. Such an analysis holds the promise of determining whether MHI type of intervention may eventually lead to large-scale implementation so that quality health care reach the poor en masse thereby contributing to the cause of universal health coverage. Key Words: Micro Health Insurance, Cluster Randomised Trials, Out-of-Pocket Payments, Cost of Risks JEL Classification Code: C83, G21, G22 and I18","PeriodicalId":243720,"journal":{"name":"ERN: Microeconometric Studies of Health Markets (Topic)","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133895558","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: 2

Hospital Mergers: A Spatial Competition Approach 医院合并:一种空间竞争方法

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2013-04-04 DOI: 10.2139/ssrn.2253120

Kurt R. Brekke, L. Siciliani, O. Straume

引用次数: 16

Can Long-Term Care Insurance Partnership Programs Increase Coverage and Reduce Medicaid Costs? 长期护理保险合作计划可以增加覆盖面并降低医疗补助费用吗?

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2013-03-01 DOI: 10.2139/SSRN.2359411

Wei Sun, A. Webb

引用次数: 21

Swings in Commercial and Residential Land Prices in the United States 美国商业和住宅土地价格的波动

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2012-07-31 DOI: 10.2139/ssrn.2215021

Joseph B. Nichols, Stephen D. Oliner, Michael R. Mulhall

引用次数: 108

Cost Effectiveness of Risk Stratification Tests vs. Not Doing Them in the Treatment of Acute Myeloid Leukemia in Pediatric Population 儿童急性髓系白血病治疗中风险分层试验与不进行风险分层试验的成本效益

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2012-07-26 DOI: 10.2139/SSRN.2194566

M. García Molina, Liliana Chicaíza, Adriana Linares Ballesteros, Óscar Ramírez Wurttemberger

{"title":"Cost Effectiveness of Risk Stratification Tests vs. Not Doing Them in the Treatment of Acute Myeloid Leukemia in Pediatric Population","authors":"M. García Molina, Liliana Chicaíza, Adriana Linares Ballesteros, Óscar Ramírez Wurttemberger","doi":"10.2139/SSRN.2194566","DOIUrl":"https://doi.org/10.2139/SSRN.2194566","url":null,"abstract":"Objective: To assess the cost-effectiveness of risk stratification tests vs. not doing them in pediatric population with acute myeloid leukemia (AML).Methods: A decision tree model was built with life years gained as outcome, from the perspective of the health system, and including all direct costs. In the transplant arm we included the costs of risk-stratification tests for all the patients, (even those who are not consolidated with transplant, given the test results). Pharmaceutical prices were obtained from the System of Information of Medicaments SISMED (2008), and the value of procedures was calculated from the 2001 ISS tariff manual adding 30%. All monetary amounts were expressed in Colombian pesos of 2010. No discount was applied as costs are incurred in during the first year. The cost-effectiveness threshold per life year gained was three times the 2010 per capita GDP. Univariate and probabilistic sensitivity analysis were performed.Results: When adding the cost of risk-stratification tests for all patients the incremental cost-effectiveness ratio (ICER) of transplantation was $$8.559.944, which is lower than the per capita GDP of 2010, $12.047.418. Hence, risk-stratification tests are cost effective. Results are robust to changes in the values of the model’s parameters. Probabilistic sensitivity analysis with ten thousand simulations showed that unrelated transplant has a 74% probability of being cost effective. Conclusions: In the Colombian health system, performing risk-stratification tests in AML pediatric patients is a cost-effective alternative.","PeriodicalId":243720,"journal":{"name":"ERN: Microeconometric Studies of Health Markets (Topic)","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128046389","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

Cost-Effectiveness of Related Hematopoietic Stem Cell Transplantation Versus Chemotherapy for Consolidation Treatment to Acute Myeloid Leukemia in Pediatric Patients 相关造血干细胞移植与化疗在小儿急性髓系白血病巩固治疗中的成本-效果

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2012-07-12 DOI: 10.2139/ssrn.2194559

M. García Molina, Liliana Chicaíza, H. Quitián, Adriana Linares Ballesteros, Óscar Ramírez Wurttemberger

{"title":"Cost-Effectiveness of Related Hematopoietic Stem Cell Transplantation Versus Chemotherapy for Consolidation Treatment to Acute Myeloid Leukemia in Pediatric Patients","authors":"M. García Molina, Liliana Chicaíza, H. Quitián, Adriana Linares Ballesteros, Óscar Ramírez Wurttemberger","doi":"10.2139/ssrn.2194559","DOIUrl":"https://doi.org/10.2139/ssrn.2194559","url":null,"abstract":"Methods: A decision tree model was built with life years gained as outcome, from the perspective of the health system, and including all direct costs. Pharmaceutical prices were obtained from the System of Information of Medicaments SISMED (2008), and the value of procedures was calculated from the 2001 ISS tariff manual adding 30%. All monetary amounts were expressed in Colombian pesos of 2010. No discount was applied as costs are incurred in during the first year. The cost-effectiveness threshold used was three times the 2010 per capita GDP per life year gained. Univariate and probabilistic sensitivity analysis were performed over the variables having the higher effect on the incremental cost-effectiveness ratio (ICER). Results: The ICER of transplantation was $6.646.980 in high risk and $6.246.762 in intermediate risk patients. The ICERs are lower than the per capita GDP of 2010, $12.047.418. Results are robust to changes in the values of the parameters. Probabilistic sensitivity analysis with ten thousand simulations showed that unrelated transplant has a 78% probability of being cost effective. Conclusions: In the Colombian health system, related stem cell transplantation is a cost-effective strategy for the treatment of AML in high or intermediate risk pediatric patients.","PeriodicalId":243720,"journal":{"name":"ERN: Microeconometric Studies of Health Markets (Topic)","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116666587","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

Health Aid and Health Improvement in Sub Saharan Africa 撒哈拉以南非洲的卫生援助和卫生改善

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2012-04-27 DOI: 10.2139/ssrn.2047219

Douzounet Mallaye, Urbain Thierry Yogo

引用次数: 7

Is the Aim of the Health Care System to Maximise QALYs? An Investigation of ‘What Else Matters’ in the NHS 医疗保健系统的目标是最大限度地提高质量年吗?对国民保健服务中“其他重要事项”的调查

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2011-05-01 DOI: 10.2139/ssrn.2634413

K. Shah, C. Praet, N. Devlin, J. Sussex, J. Appleby, D. Parkin

{"title":"Is the Aim of the Health Care System to Maximise QALYs? An Investigation of ‘What Else Matters’ in the NHS","authors":"K. Shah, C. Praet, N. Devlin, J. Sussex, J. Appleby, D. Parkin","doi":"10.2139/ssrn.2634413","DOIUrl":"https://doi.org/10.2139/ssrn.2634413","url":null,"abstract":"The appraisal of health care technologies by the UK's National Institute for Health and Clinical Excellent (NICE) focuses on cost effectiveness, usually measured in terms of incremental cost per quality adjusted life year (QALY) gained. According to the findings presented in this Research Paper, however, cost effectiveness does not appear to be the dominant consideration in NHS decisions about resource allocation. In this paper, the authors examine what factors affect NHS decisions by analysing 51 Impact Assessments (IAs) completed by the UK Department of Health (DH) in 2008-9. Of the 51 IAs available, only eight used QALYs to evaluate benefits, including four of those associated with the largest monetised benefits. Ninety-three other unique benefits were applied in making NHS decisions. Most could be grouped into the following categories - improvement in health outcomes (26 of the 51), improvements in health service cost and efficiency (19), improvements in quality (15), and enhancing the patient and carer experience (11). For 21 IAs, no monetary impact was estimated and the statement was made in the IA that benefits could not be monetised or quantified. Setting aside the issue of what cost and benefit perspective is 'appropriate', the authors point out that this research suggests that the perspectives of NICE and the DH are 'very different' with 'clear implications' for efficiency across the health care system. A revised version of this paper has been published in Journal of Health Services Research & Policy and can be downloaded from - http://hsr.sagepub.com/content/17/3/157.long Please cite as - Shah, K., Praet, C., Devlin, N., Sussex, J., Appleby, J. and Parkin, D., 2012. Is the aim of the English health care system to maximize QALYs? Journal of Health Services Research & Policy, 17(3), pp.157-163.","PeriodicalId":243720,"journal":{"name":"ERN: Microeconometric Studies of Health Markets (Topic)","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121331136","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: 3

Medicine Worse than the Malady: Cure Rates, Population Shifts, and Health Insurance 比疾病更糟糕的药物:治愈率、人口变化和健康保险

ERN: Microeconometric Studies of Health Markets (Topic) Pub Date : 2000-08-01 DOI: 10.2139/ssrn.2126775

Robert F. Graboyes

{"title":"Medicine Worse than the Malady: Cure Rates, Population Shifts, and Health Insurance","authors":"Robert F. Graboyes","doi":"10.2139/ssrn.2126775","DOIUrl":"https://doi.org/10.2139/ssrn.2126775","url":null,"abstract":"We examine the welfare effects of the interaction of three types of technological progress in medicine and health insurance; some paradoxes emerge. The model specifies three types of people: W (well); H (sick with high cure rate if treated); and L (sick with low cure rate if treated). There are four insurance modes: Indemnity (I): fully covered treatments for Hs, cash bribes for Ls to forgo treatment); Deductible (D): partially covered treatments for Hs, no treatments for Ls); Zero (Z): no insurance and no treatments); and Full (F): fully covered treatments for Hs and Ls). The three types of technological progress are represented as population shifts from sicker to healthier classes of people; for brevity, we call the shifts L—>W, H—>W, and L—>H, and describe each as follows:L—>W: Improved ability to prevent illness among Ls- unambiguously improves welfare and seems to yield intuitive mode sequences.H—>W: Improved ability to prevent illness among Hs- unambiguously improves welfare but sometimes yields surprising mode sequences. Examples: F-Z (full insurance when there are many Hs, no insurance when there are fewer Hs); and D-F-D (Hs partially covered, then fully covered, then only partially covered once again. Ls not treated, then treated, then not treated once again.).L—>H: Some would-be Ls become more highly treatable Hs. Here, technological progress not only yields surprising mode shifts (e.g., D-Z-I-Z), but the welfare effects of progress are ambiguous. This is because L—>H may lead to more people being treated and cured (a welfare gain), but at a cost of higher premiums for all subscribers (a welfare loss).The paradoxical results are in part explained by the fact that utility is a concave function of wealth and a linear function of health.The three shifts could also be interpreted as autonomous demographic changes rather than as technological progress.","PeriodicalId":243720,"journal":{"name":"ERN: Microeconometric Studies of Health Markets (Topic)","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126133550","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: 1