International Journal of Health Economics and Management最新文献

{"title":"Cost-efficiency in the patient centered medical home model: New evidence from federally qualified health centers.","authors":"Sudip Chattopadhyay","doi":"10.1007/s10754-021-09295-5","DOIUrl":"https://doi.org/10.1007/s10754-021-09295-5","url":null,"abstract":"<p><p>This research analyzes the cost-efficiency of the Patient Centered Medical Home (PCMH) model vis-à-vis the traditional care delivery model in the Federally Qualified Health Centers (FQHC). We apply the three-stage least squares modeling approach on 2014 UDS data on all FQHCs to estimate per-visit and per-patient cost functions. Log-quadratic and linear-quadratic functional forms of cost are used for the analysis. The estimated models reveal substantial scale economies and cost advantages associated with PCMH status. Aggregate cost-saving impact of PCMH across all FQHCs in 2014 is estimated to be $1.05 billion. Simulations reveal that the PCMH impact on cost savings grows with the size of the patient population. Reaching the full cost-saving potential in PCMH-recognized FQHCs hinges on expanding the health workforce at all levels of care to meet the need of the growing patient population due to aging and Medicaid expansion. For FQHCs that are not PCMH-recognized, capacity/infrastructural expansion appears to be the immediate policy choice.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 3","pages":"295-316"},"PeriodicalIF":2.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10754-021-09295-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25417862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wealth and the utilization of long-term care services: evidence from the United States.","authors":"Jing Dong, Daifeng He, John A Nyman, R Tamara Konetzka","doi":"10.1007/s10754-021-09299-1","DOIUrl":"10.1007/s10754-021-09299-1","url":null,"abstract":"<p><p>Long-term care (LTC) provision and financing has become a major challenge for policymakers in the United States and worldwide. To inform associated policies and more efficiently allocate LTC resources, it is important to understand how demand for different types of LTC services responds to increased wealth. We use data from the United States Health and Retirement Study to examine the use of LTC services following plausibly exogenous positive shocks to wealth. We further account for time-invariant household-level characteristics, including the expectation of a wealth shock at an unknown future time, by employing household fixed effects. We find that large positive wealth shocks lead to a greater probability of purchase of paid home care but not of nursing home care. Our results imply that expanding home and community-based services and insurance coverage of home care for people without sufficient wealth is likely to be efficient and welfare improving and should be considered by policymakers.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 4 Given name: [R. Tamara] Last name: [Konetzka]. Also, kindly confirm the details in the metadata are correct.confirmedPlease confirm the city are correct and amend if necessary in Affiliations 1, 2, 3, 4.confirmed.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 3","pages":"345-366"},"PeriodicalIF":1.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25540494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of prepaid systems of healthcare financing: a worldwide country-level perspective.","authors":"Andrea M Leiter,&nbsp;Engelbert Theurl","doi":"10.1007/s10754-021-09301-w","DOIUrl":"https://doi.org/10.1007/s10754-021-09301-w","url":null,"abstract":"<p><p>In this paper we examine determinants of prepaid modes of health care financing in a worldwide cross-country perspective. We use three different indicators to capture the role of prepaid modes in health care financing: (i) the share of total prepaid financing as percent of total current health expenditures, (ii) the share of voluntary prepaid financing as percent of total prepaid financing, and (iii) the share of compulsory health insurance as percent of total compulsory prepaid financing. In the econometric analysis, we refer to a panel data set comprising 154 countries and covering the time period 2000-2015. We apply a static as well as a dynamic panel data model. We find that the current structure of prepaid financing is significantly determined by its different forms in the past. The significant influence of GDP per capita, governmental revenues, the agricultural value added, development assistance for health, degree of urbanization and regulatory quality varies depending on the financing structure we look at. The share of the elderly and the education level are only of minor importance for explaining the variation in a country's share of prepaid health care financing. The importance of the mentioned variables as determinants for prepaid health care financing also varies depending on the countries' socio-economic development. From our analysis we conclude that more detailed information on indicators which reflect the distribution of individual characteristics (such as income, family size and structure and health risks) within a country's population would be needed to gain deeper insight into the decisive determinants for prepaid health care financing.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 3","pages":"317-344"},"PeriodicalIF":2.4,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10754-021-09301-w","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25552196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of community-based health insurance on utilisation of preventive health services in rural Uganda: a propensity score matching approach.","authors":"Emmanuel Nshakira-Rukundo, Essa Chanie Mussa, Nathan Nshakira, Nicolas Gerber, Joachim von Braun","doi":"10.1007/s10754-021-09294-6","DOIUrl":"10.1007/s10754-021-09294-6","url":null,"abstract":"<p><p>The effect of voluntary health insurance on preventive health has received limited research attention in developing countries, even when they suffer immensely from easily preventable illnesses. This paper surveys households in rural south-western Uganda, which are geographically serviced by a voluntary Community-based health insurance scheme, and applied propensity score matching to assess the effect of enrolment on using mosquito nets and deworming under-five children. We find that enrolment in the scheme increased the probability of using a mosquito net by 26% and deworming by 18%. We postulate that these findings are partly mediated by information diffusion and social networks, financial protection, which gives households the capacity to save and use service more, especially curative services that are delivered alongside preventive services. This paper provides more insight into the broader effects of health insurance in developing countries, beyond financial protection and utilisation of hospital-based services.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 2","pages":"203-227"},"PeriodicalIF":2.4,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8192361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25355674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choice, quality and patients' experience: evidence from a Finnish physiotherapy service.","authors":"Visa Pitkänen,&nbsp;Ismo Linnosmaa","doi":"10.1007/s10754-020-09293-z","DOIUrl":"https://doi.org/10.1007/s10754-020-09293-z","url":null,"abstract":"<p><p>We study the relationship between patient choices and provider quality in a rehabilitation service for disabled patients who receive the service frequently but do not have access to quality information. Previous research has found a positive relationship between patient choices and provider quality in health services that patients typically do not have previous experience or use frequently. We contribute by examining choices of new patients and experienced patients who were either forced to switch or actively switched their provider. In the analysis, we combine register data on patients' choices and switches with provider quality data from a competitive bidding, and estimate conditional logit choice models. The results show that all patients prefer high-quality providers within short distances. We find that the willingness to travel for quality is highest among new patients and active switchers. These results suggest that new patients and active switchers compare different alternatives more thoroughly, whereas forced switchers choose their new provider in limited time leading into poorer choices.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 2","pages":"229-245"},"PeriodicalIF":2.4,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10754-020-09293-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38840001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic variation in Part B reimbursement and physician offsetting behavior: a physician matching approach.","authors":"Christopher S Brunt,&nbsp;Joshua R Hendrickson","doi":"10.1007/s10754-021-09297-3","DOIUrl":"https://doi.org/10.1007/s10754-021-09297-3","url":null,"abstract":"<p><p>Historically, Medicare has operated under the assumption that providers respond to reductions in reimbursement through increased provision of services in an effort to offset declining practice revenue; however, some recent empirical work examining fee reductions has found evidence of either small offsetting effects or reductions in the quantity supplied. Using a distance matching approach that matches practices to nearby practices that are subject to different reimbursement rates, we find overall evidence in support of Medicare's offsetting assumption collectively for all services and for evaluation and management services. We also find evidence consistent with a traditional volume response for imaging and testing services.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 2","pages":"115-188"},"PeriodicalIF":2.4,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10754-021-09297-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25505206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of insurance plan characteristics with physician patient-sharing network structure.","authors":"Kimberley H Geissler,&nbsp;Benjamin Lubin,&nbsp;Keith M Marzilli Ericson","doi":"10.1007/s10754-021-09296-4","DOIUrl":"https://doi.org/10.1007/s10754-021-09296-4","url":null,"abstract":"<p><p>Professional and social connections among physicians impact patient outcomes, but little is known about how characteristics of insurance plans are associated with physician patient-sharing network structure. We use information from commercially insured enrollees in the 2011 Massachusetts All Payer Claims Database to construct and examine the structure of the physician patient-sharing network using standard and novel social network measures. Using regression analysis, we examine the association of physician patient-sharing network measures with an indicator of whether a patient is enrolled in a health maintenance organization (HMO) or preferred provider organization (PPO), controlling for patient and insurer characteristics and observed health status. We find patients enrolled in HMOs see physicians who are more central and densely embedded in the patient-sharing network. We find HMO patients see PCPs who refer to specialists who are less globally central, even as these specialists are more locally central. Our analysis shows there are small but significant differences in physician patient-sharing network as experienced by patients with HMO versus PPO insurance. Understanding connections between physicians is essential and, similar to previous findings, our results suggest policy choices in the insurance and delivery system that change physician connectivity may have important implications for healthcare delivery, utilization and costs.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 2","pages":"189-201"},"PeriodicalIF":2.4,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10754-021-09296-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25415023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic inequality in tobacco use in Kenya: a concentration analysis.","authors":"Hermann Pythagore Pierre Donfouet,&nbsp;Shukri F Mohamed,&nbsp;Eric Malin","doi":"10.1007/s10754-020-09292-0","DOIUrl":"https://doi.org/10.1007/s10754-020-09292-0","url":null,"abstract":"<p><p>This paper aims at assessing and exploring socioeconomic inequalities in tobacco use in Kenya. Using the theory of fundamental causes, and concentration index, we investigate the determinants of tobacco use, and whether it disproportionately affects the poor. All data used in this study emanated from the 2014 Global Adult Tobacco Survey implemented in Kenya on a nationally representative sample of men and women aged 15 years and older. Our results suggest a link between tobacco use and socioeconomic inequality. Overall, poorer households are more affected by tobacco use than richer households. This socioeconomic inequality is more evident among men and households living in urban areas. The decomposition of the concentration index indicates that the overall socioeconomic inequality for current tobacco smokers is explained by 69.11% of household wealth. To reduce the prevalence rate of smoking in Kenya, policymakers could design and implement tobacco control programs through the equity lens. Community health workers could be used to promote non-smoking behaviors among the poor.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"21 2","pages":"247-269"},"PeriodicalIF":2.4,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10754-020-09292-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38777856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dimensions and Indicators of Quality of Health Care Used for Healthcare Systems’ Performance Assessment","authors":"V. Nikolova","doi":"10.14748/HEM.V20I1.7672","DOIUrl":"https://doi.org/10.14748/HEM.V20I1.7672","url":null,"abstract":"Delivering high-quality health care is a central goal of all healthcare systems. Quality of health care is one of the basic components used for health system performance assessment (HSPA). Quality of health care is measured by six dimensions – effectiveness, safety, patient-centeredness, access, appropriateness, and continuity of care. This study aims to identify and systematize the most frequently used dimensions and indicators for measuring the quality of health care used for health system performance assessment. To achieve this aim the review is implemented on the base of HSPA reports from various countries and organizations as well as scientific publications related to quality of health care. Founded on the review of conceptual HSPA frameworks are identified 304 different indicators for measuring quality of health care. Most of them are focused on measuring process and outcome of health care. Effectiveness, safety and patient centeredness are the elements consist of the most used dimensions for measuring quality of health care. Certain differences in understanding of the essence of quality of health care dimensions and indicators were identified in the reports. They could be explained by the diversity of concepts of quality of health care, of health insurance models and of health care system goals in different countries. Measuring quality of health care is a key significance in health care system performance assessment. It provides important information about areas and components of the health care system which need of improvement as a basis for consequential policy and political decisions.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"24 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2021-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75836603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managerial competence of health care managers in hospital obstetric structures","authors":"S. Radeva","doi":"10.14748/HEM.V20I2.7675","DOIUrl":"https://doi.org/10.14748/HEM.V20I2.7675","url":null,"abstract":"Health care management in hospital obstetric and gynecological structures is carried out by managers who have organizational and communication qualities specific to the health sector, trained to perform managerial and administrative functions. Managers with their knowledge and skills of planning, organizing, directing and controlling financial, human and material resources largely determine the quality of medical care in a medical institution. Solving problems related to defining the duties, activities, rights and responsibilities of primary and senior midwives is an important condition for improving and developing the quality of medical care. It is important for practice to manage time, activity, motivation, and development by changing not only the work model, but also the approaches, activities, and thinking style of health managers at different hierarchical levels. This means a new development of flexible management competence. Management is inextricably linked to efficiency. It requires constant monitoring of the ratio of „benefits“ of results“ of each activity in different structures and hospitals, as a macronutrient. An effective manager is not just a good employee who is preferred by his subordinates. This is a person who is able to increase the usefulness of medical services with relatively limited resources. the new approach, new style and new way of thinking require managers at different levels of management in hospitals not only to understand hospital management, but also to have the qualities for successful leadership. The purpose of this work is to study the possibility of applying a methodological model of obstetric health care management and its importance for improving their quality and effectiveness. The object of the study is the management of obstetric and gynecological health care in 16 hospitals. The study is based on the use of a direct individual survey and covers 68 primary and senior midwives. Signs related to the organization of work in the ward, the role and place of the midwife in the treatment process were studied. the analysis of the survey data was aimed at characterizing obstetric care in a hospital setting and the applicability of a single health management model with the corresponding information product to the hospital information system.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"195 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2021-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75033268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}