Forum for Health Economics and Policy最新文献_第9页

Quantifying the Value of Personalized Medicines: Evidence from COX-2 Inhibitors 量化个体化药物的价值:来自COX-2抑制剂的证据

Forum for Health Economics and Policy Pub Date : 2013-01-01 DOI: 10.1515/fhep-2013-0005

N. Sood, T. Philipson, P. Huckfeldt

引用次数: 5

The Effect of Comprehensive Smoking Bans in European Workplaces 欧洲工作场所全面禁烟的效果

Forum for Health Economics and Policy Pub Date : 2013-01-01 DOI: 10.1515/fhep-2012-0030

Federica Origo, Claudio Lucifora

引用次数: 1

Integrating Patient Incentives with Episode-Based Payment. 将患者激励措施与分段付费相结合。

Forum for Health Economics and Policy Pub Date : 2013-01-01 Epub Date: 2013-04-15 DOI: 10.1515/fhep-2012-0002

Lorens A Helmchen, William E Encinosa, Michael E Chernew, Richard A Hirth

{"title":"Integrating Patient Incentives with Episode-Based Payment.","authors":"Lorens A Helmchen, William E Encinosa, Michael E Chernew, Richard A Hirth","doi":"10.1515/fhep-2012-0002","DOIUrl":"10.1515/fhep-2012-0002","url":null,"abstract":"<p><p>To rein in cost, payers are exploring bundled payment, which aggregates fees for a range of services into a single prospective payment. While under bundled payment providers would have incentives to reduce cost, they might also withhold more expensive care that patients prefer. We explore how bundled payment could be aligned with a benefit design that would encourage patients' consideration of cost without jeopardizing access to the most expensive treatments. Least-costly-alternative approaches allow patient choice but might deter patients from choosing more expensive care by exposing them to potentially large out-of-pocket payments. A novel \"shared-savings supplement\" would reward patients for choosing the least costly alternative with a supplemental cash disbursement and thus allow them to share in any cost savings. This cash incentive for the least-costly-alternative allows a reduction of the out-of-pocket payment for the expensive alternative. Thus, patients would still have the option of the more expensive therapy while facing only a modest out-of-pocket cost. Such benefit modifications could be aligned with bundled payment by splitting the responsibility for the incremental cost of more expensive care between patients and their providers.</p>","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6481942/pdf/nihms-1019059.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37190571","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

Why are Testing Rates so Low in Sub-Saharan Africa? Misconceptions and Strategic Behaviors 为什么撒哈拉以南非洲的检测率如此之低?误解和战略行为

Forum for Health Economics and Policy Pub Date : 2013-01-01 DOI: 10.1515/fhep-2012-0033

O. Sterck

{"title":"Why are Testing Rates so Low in Sub-Saharan Africa? Misconceptions and Strategic Behaviors","authors":"O. Sterck","doi":"10.1515/fhep-2012-0033","DOIUrl":"https://doi.org/10.1515/fhep-2012-0033","url":null,"abstract":"Abstract Voluntary testing and counseling (VTC) is a popular method for fighting the HIV/AIDS epidemic. The purpose of VTC is to reduce the incidence of the virus in a two-fold manner. First, testing provides access to health care and antiretroviral therapies that diminish the transmission rate of the virus. Second, counseling encourages safer behavior for not only individuals who test HIV-negative and wish to avoid HIV/AIDS infection but also altruistic individuals who test HIV-positive and wish to protect their partners from becoming infected by HIV. Surprisingly, DHS surveys that were conducted in sub-Saharan Africa provide empirical evidence that testing services are underutilized. Moreover, it is rare for both partners in a couple to be tested for HIV. This paper proposes a theoretical model that indicates how misperceptions about the HIV/AIDS virus may explain these puzzles. More specifically, this study demonstrates that individuals who are at risk of HIV infection may act strategically to avoid the cost of testing if they overestimate the risk of HIV transmission or believe that health care is not required if HIV is asymptomatic. The correction of false beliefs and the promotion of self-testing are expected to increase HIV testing rates.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89723204","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: 6

Formal and Informal Care: An Empirical Bayesian Analysis Using the Two-part Model 正式与非正式关怀:基于两部分模型的实证贝叶斯分析

Forum for Health Economics and Policy Pub Date : 2012-11-19 DOI: 10.1515/1558-9544.1253

Juan Du

{"title":"Formal and Informal Care: An Empirical Bayesian Analysis Using the Two-part Model","authors":"Juan Du","doi":"10.1515/1558-9544.1253","DOIUrl":"https://doi.org/10.1515/1558-9544.1253","url":null,"abstract":"Abstract Informal care provided to the elderly by their children is proposed as a less expensive alternative to institutional long-term care. This paper explores how the elderly's consumption of medical care changes in response to changes in the informal care they receive from their children. Many earlier studies have ignored both the endogeneity of informal care and the complicated nature of health care utilization data. This paper develops a two-part model with informal care treated as an endogenous regressor and imposes exclusion restrictions on the selection process. The model is fitted using the Bayesian Markov Chain Monte Carlo (MCMC) methods, in particular the Gibbs sampler and the Metropolis-Hasting algorithm. The average treatment effects and the distributions of the treatment effects are obtained via posterior simulation. The results indicate that informal care provides a substitute for nursing home care and hospital inpatient care, but it does not affect paid home health care on average. The treatment effects are heterogeneous. The largest substitution effects occur for nursing home and hospital inpatient care at the intensive margin. The policy analysis suggests that informal care policies targeting the group that incurs the largest substitution effect may help to reduce government spending on Medicaid and Medicare.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76400462","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: 6

The Distributional Effects of Health Reform Limits on Flexible Spending Accounts 医疗改革对灵活支出账户限制的分配效应

Forum for Health Economics and Policy Pub Date : 2012-11-19 DOI: 10.1515/1558-9544.1310

J. Cardon, J. Moore, M. Showalter

{"title":"The Distributional Effects of Health Reform Limits on Flexible Spending Accounts","authors":"J. Cardon, J. Moore, M. Showalter","doi":"10.1515/1558-9544.1310","DOIUrl":"https://doi.org/10.1515/1558-9544.1310","url":null,"abstract":"Abstract Flexible spending accounts (FSAs) are a widely used arrangement that allow employees to pay for qualified out-of-pocket health expenses with pre-tax dollars. The tax preference given to FSAs has been controversial and recent health care law (Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act) limits the tax exclusion to an inflation-adjusted value of $2,500 (2013 $s). The limit is estimated to increase federal payroll and income tax receipts by $13 billion between 2013 and 2019. But the welfare implications of this change are unclear.This paper uses a unique panel dataset to explore the demographic profile of households likely to be affected by the tax increase. We use a sample of 19,322 households observed over the period 1998–2008. The data include FSA expenditures, insurance claim information for covered medical and dental expenditures, and household demographic information. We explore patterns of FSA usage by income and health status.We find that households likely to be affected by the tax increase disproportionately tend to be households experiencing one or more chronic health conditions. The existence of chronic illness is associated with relatively high and persistent medical expenses and also with relatively older and wealthier households. We estimate an average tax increase of $101 in 2013 for 13.9 million households with an FSA.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74771661","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

The Value of Patent Expiration 专利到期的价值

Forum for Health Economics and Policy Pub Date : 2012-11-19 DOI: 10.1515/1558-9544.1311

M. R. McKellar, Matthew B. Frank, H. Huskamp, M. Chernew

引用次数: 2

A Reexamination of the Costs of Medical R&D Regulation 医药研发监管成本再审

Forum for Health Economics and Policy Pub Date : 2012-10-16 DOI: 10.1515/FHEP-2012-0020

T. Philipson, E. Sun, D. Goldman, A. Jena

{"title":"A Reexamination of the Costs of Medical R&D Regulation","authors":"T. Philipson, E. Sun, D. Goldman, A. Jena","doi":"10.1515/FHEP-2012-0020","DOIUrl":"https://doi.org/10.1515/FHEP-2012-0020","url":null,"abstract":"Abstract Recent evidence suggests that the economic value of increased health has been enormous, with most of these gains being driven by medical R&D. The R&D process for pharmaceuticals is particularly expensive and time consuming, with well-known studies from the Tufts Center for the Study of Drug Development suggesting that developing a single successful drug costs around $1 billion and takes roughly 12 years. We argue that these estimates are incomplete because they do not incorporate the social costs imposed by the regulatory process, namely the costs to producers in terms of forgone profits and the costs to consumers in terms of delayed access to drugs. In this article, we develop a framework to estimate the social costs imposed by the regulatory process. Under this framework, delays in drug development are socially costly because of reduced consumer surplus (due to delayed access to beneficial therapies), reduced producer variable profits, and increased R&D expenditures. We apply this framework to the case of therapies aimed at treating AIDS, non-Hodgkin’s lymphoma, and breast cancer. In each case, we find that the effects of drug delays on consumer surplus and variable producer profits are far larger than the effects on R&D costs. These findings suggest that patients, not firms, would be the primary beneficiaries from any improvements in streamlining the drug development process.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88067293","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

Can Centralization of Cancer Surgery Improve Social Welfare? 癌症手术集中化能改善社会福利吗?

Forum for Health Economics and Policy Pub Date : 2012-10-16 DOI: 10.1515/FHEP-2012-0016

V. Ho, Marah Short, Meei-Hsiang Ku-Goto

{"title":"Can Centralization of Cancer Surgery Improve Social Welfare?","authors":"V. Ho, Marah Short, Meei-Hsiang Ku-Goto","doi":"10.1515/FHEP-2012-0016","DOIUrl":"https://doi.org/10.1515/FHEP-2012-0016","url":null,"abstract":"Abstract The empirical association between high hospital procedure volume and lower mortality rates has led to recommendations for the centralization of complex surgical procedures. Yet redirecting patients to a select number of high-volume hospitals creates potential negative consequences for market competition. We use patient-level data to estimate the association between hospital procedure volume and patient mortality and costs. We also estimate the association between hospital market concentration and mortality, cost, and prices. We use our estimates to simulate the change in social welfare resulting from redirecting patients at low-volume hospitals to high-volume facilities. We find that a higher procedure volume leads to significant reductions in mortality for patients undergoing surgery for pancreatic cancer, but not colon cancer. Procedure volume also influences costs for both surgeries, but in a nonlinear fashion. Increased market concentration is associated with higher costs and prices for colon cancer, but not pancreatic cancer patients. Simulations indicated that centralizing pancreatic cancer surgery is unambiguously welfare enhancing. In contrast, there is less evidence to suggest that centralizing colon cancer surgery would be welfare improving.","PeriodicalId":38039,"journal":{"name":"Forum for Health Economics and Policy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80282086","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: 12

The Impact of Household Investments on Early Child Neurodevelopment and on Racial and Socioeconomic Developmental Gaps - Evidence from South America. 家庭投资对儿童早期神经发育以及种族和社会经济发展差距的影响——来自南美洲的证据。

Forum for Health Economics and Policy Pub Date : 2012-10-04 DOI: 10.2202/1558-9544.1237

George L Wehby, Ann Marie McCarthy, Eduardo E Castilla, Jeffrey C Murray

引用次数: 15