HCDF: Health Expenditures (Topic)最新文献

{"title":"Free Distribution or Cost-Sharing? Evidence from a Randomized Malaria Prevention Experiment","authors":"Jessica L. Cohen, P. Dupas","doi":"10.2139/ssrn.1080301","DOIUrl":"https://doi.org/10.2139/ssrn.1080301","url":null,"abstract":"It is widely believed that cost-sharing - charging a subsidized, positive price - for a health product is necessary to avoid wasting resources on those who will not use or do not need the product. We explore this argument in the context of a field experiment in Kenya, in which we randomized the price at which pregnant women could buy long lasting anti-malarial insecticide-treated nets (ITNs) at prenatal clinics. We find no evidence that cost-sharing reduces wastage on those that will not use the product: women who received free ITNs are not less likely to use them than those who paid subsidized positive prices. We also find no evidence that cost-sharing induces selection of women who need the net more: those who pay higher prices appear no sicker than the prenatal clients in the control group in terms of measured anemia (an important indicator of malaria). Cost-sharing does, however, considerably dampen demand. We find that uptake drops by 75 percent when the price of ITNs increases from 0 to $0.75, the price at which ITNs are currently sold to pregnant women in Kenya. We combine our estimates in a cost-effectiveness analysis of ITN prices on infant mortality that incorporates both private and social returns to ITN usage. Overall, given the large positive externality associated with widespread usage of insecticide-treated nets, our results suggest that free distribution to pregnant women is both more effective and more cost-effective than cost-sharing.","PeriodicalId":414943,"journal":{"name":"HCDF: Health Expenditures (Topic)","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130184160","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}

{"title":"Education and Health in G7 Countries: Achieving Better Outcomes with Less Spending","authors":"M. Verhoeven, Victoria Gunnarsson, Stéphane Carcillo","doi":"10.5089/9781451868265.001","DOIUrl":"https://doi.org/10.5089/9781451868265.001","url":null,"abstract":"Enhancing the efficiency of education and health spending is a key policy challenge in G7 countries. The paper assesses this efficiency and seeks to establish a link between differences in efficiency across countries and policy and institutional factors. The findings suggest that reforms aimed at increasing efficiency need to take into account the nature and causes of inefficiencies. Inefficiencies in G7 countries mostly reflect lack of cost effectiveness in acquiring real resources, such as teachers and pharmaceuticals. We also find that high wage spending is associated with lower efficiency. In addition, lowering student-teacher ratios is associated with reduced efficiency in the education sector, while immunizations and doctors' consultations coincide with higher efficiency in the health sector. Greater autonomy for schools seems to raise efficiency in secondary education.","PeriodicalId":414943,"journal":{"name":"HCDF: Health Expenditures (Topic)","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130348475","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}

{"title":"Financing Health Promotion: A Case Study on Thailand","authors":"P. Prakongsai, K. Bundhamcharoen, K. Tisayatikom, V. Tangcharoensathien","doi":"10.2139/ssrn.1070747","DOIUrl":"https://doi.org/10.2139/ssrn.1070747","url":null,"abstract":"Objectives: To review the burden of diseases resulted from chronic non-communicable diseases and its trend between 1999 and 2004, financing health care and financing health promotion and disease prevention, with the experiences of innovative financing health promotion and policy makers views on innovative financing health promotion. Methods: The study applied several methodological approaches including literature reviews, interviews of key informants, and primary survey through self administered mail questionnaire to key stakeholders in and outside the Ministry of Public Health. Results: In view of consistent increasing trend of burden of diseases resulted from chronic NCD, the economic and health impact of NCD is far-reaching. The resources available for health promotion is far too low compared to curative services, most of this funding went to personal clinical preventive and health promotion services and little for public interventions. The resources mobilized by the Thai Health Promotion Foundation through 2% levy on tobacco and alcohol consumption, is far too small, though plays a significant catalytic role in mobilizing public awareness toward major killers such as tobacco, alcohol and road traffic injuries, to serve as a strong leverage to halt and reverse the trend of chronic NCD. Two major stakeholders, Ministry of Finance responsible for Civil Servant Medical Benefit Scheme (CSMBS) and the Social Security Office responsible for Social Health Insurance have a tunnel view, and yet to be convinced to invest more in health promotion for their beneficiaries. Recommendations: Three policy messages were proposed, (1) Increase level of financing health promotion and primary, secondary prevention of disease through significant Increase in MOPH annual budget on health promotion and amendment of CSMBS regulation and Social Security Act to incorporate health promotion and disease prevention as their mandates; (2) Increase value for money of conventional clinical prevention and health promotion services through the application of a recent publication on Disease Control Priority for Developing Countries by Jamaison et al (2006), and improve program effectiveness based on evidence; (3) Sustain and accelerate the work of Thai Health Promotion Foundation (THPF) through increase levies from 2% to 5% of tobacco and alcohol consumption and diversify THPF portfolio to cover cost effective interventions. Portfolio and social mobilization by THPF has to be guided by sound evidence.","PeriodicalId":414943,"journal":{"name":"HCDF: Health Expenditures (Topic)","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2007-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121611423","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}

{"title":"Health Care Cost Containment","authors":"E. Nedde","doi":"10.5089/9781451936537.001.A001","DOIUrl":"https://doi.org/10.5089/9781451936537.001.A001","url":null,"abstract":"The Administration`s proposals to reform the U.S. health care system sought to provide for universal health insurance coverage while containing the growth of health care spending. This paper focuses on the latter issue and discusses the ability of regulatory and market-oriented reforms to achieve health care cost containment from several angles: an international comparison of national cost containment measures, a review of past cost containment efforts in the United States, and a discussion of the estimated effects on health care costs of alternative proposals to reform the U.S. health care system.","PeriodicalId":414943,"journal":{"name":"HCDF: Health Expenditures (Topic)","volume":"296 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114056187","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}