International Journal of Health Economics and Management最新文献

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The pharmaceutical distributors' efficiency in Italy: an assessment of the impact of the 2010 reimbursable drug pricing reform. 意大利药品分销商的效率:2010 年有偿药品定价改革的影响评估。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-11-08 DOI: 10.1007/s10754-024-09387-y
Giorgio Matteucci, Daniele De Santis
{"title":"The pharmaceutical distributors' efficiency in Italy: an assessment of the impact of the 2010 reimbursable drug pricing reform.","authors":"Giorgio Matteucci, Daniele De Santis","doi":"10.1007/s10754-024-09387-y","DOIUrl":"https://doi.org/10.1007/s10754-024-09387-y","url":null,"abstract":"<p><p>To assess the impact on pharmaceutical wholesalers' financial viability and efficiency of the reform of the wholesalers' and pharmacies' margins on reimbursable drugs enacted in 2010 that halved the distributors' margins. We perform a stochastic frontier analysis on a large original dataset comprising financial and production data from 2009, a year prior to the reform, to 2019 gathered in order to assess the impact of the reform on firms' profitability and efficiency. The implemented policies have not been successful in fostering the development of a more efficient market that would ultimately benefit social welfare. Overall, our findings indicate that bigger firms lag behind their smaller counterparts in terms of efficiency, even in the long run. Our findings also suggest that an efficient pharmaceutical wholesaler is currently unable to generate normal profit from the distribution of reimbursable drugs. Compared to the other European countries, that seem to have a cost oriented approach, Italy provides one of the lowest margins to pharmaceutical wholesalers without properly considering the costs of the drugs' distribution. A new regulatory approach to wholesaling margins is needed in order to improve efficiency and welfare.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606689","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}
引用次数: 0
Feeling discriminated means poor self-perceived health: a gender analysis using SHARE. 感觉受歧视意味着自我感觉健康不佳:利用 SHARE 进行的性别分析。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-26 DOI: 10.1007/s10754-024-09383-2
Sara Pinillos-Franco, David Cantarero-Prieto, Javier Lera
{"title":"Feeling discriminated means poor self-perceived health: a gender analysis using SHARE.","authors":"Sara Pinillos-Franco, David Cantarero-Prieto, Javier Lera","doi":"10.1007/s10754-024-09383-2","DOIUrl":"https://doi.org/10.1007/s10754-024-09383-2","url":null,"abstract":"<p><p>Most part of the literature has highlighted the detrimental effects of discrimination on health. However, the influence of past and perceived discrimination on older workers' self-assessed health has been understudied. Firstly, we aim at studying whether reported discrimination is associated with self-assessed health among adults of working ages (50-65 years of age). Secondly, we analyze the existence of differences by gender. Data was retrieved from the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to obtain the regular panel of questions, and the third and seventh waves of the SHARELIFE questionnaire, that includes information about discrimination (n = 30,019). We develop logistic regression models to determine the relationship of discrimination on male and female workers' self-assessed health separately. Our results show that 49.0% of our sample was composed of highly discriminated women, while the remaining percentage covered men and women (42.3% males and 8.7% females) that reported lower levels of discrimination. Our estimations reveal a significant association between discrimination and poor health status, especially in the case of men ranging from OR = 1.802 (95% CI 1.502-2.163) to OR = 1.565 (95% CI 1.282-1.910). In the case of women our results range from OR = 1.728 (95% CI 1.463-2.040) to OR = 1.196 (95% CI 0.992-1.442). These findings are essential to highlight the importance of tackling discrimination as a determinant of health that negatively affects both sexes, men and women.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356047","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}
引用次数: 0
Vaccination strategies for different contact patterns: weighing epidemiological against economic outcomes. 针对不同接触模式的疫苗接种策略:权衡流行病学和经济结果。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-24 DOI: 10.1007/s10754-024-09384-1
Rikard Forslid, Mathias Herzing
{"title":"Vaccination strategies for different contact patterns: weighing epidemiological against economic outcomes.","authors":"Rikard Forslid, Mathias Herzing","doi":"10.1007/s10754-024-09384-1","DOIUrl":"https://doi.org/10.1007/s10754-024-09384-1","url":null,"abstract":"<p><p>The aim of this paper is to shed light on the economic and epidemiological trade-offs that emerge when choosing between different vaccination strategies. For that purpose we employ a setting with three age groups that differ with respect to their fatality rates. The model also accounts for heterogeneity in the transmission rates between and within these age groups. We compare the results for two different contact patterns, in terms of the total number of deceased, the total number of infected, the peak infection rate and the economic gains from different vaccination strategies. We find that fatalities are minimized by first vaccinating the elderly, except when vaccination is slow and the general transmission rate is relatively low. In this case deaths are minimized by first vaccinating the group that is mainly responsible for spreading of the virus. With regard to the other outcome variables it is best to vaccinate the group that drives the pandemic first. A trade-off may therefore emerge between reducing fatalities on the one hand and lowering the number of infected as well as maximizing the economic gains from vaccinations on the other hand.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308731","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}
引用次数: 0
The effect of health facility ownership on perceived healthcare quality: evidence from Ghana 医疗设施所有权对医疗质量感知的影响:来自加纳的证据
IF 2.4 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-16 DOI: 10.1007/s10754-024-09385-0
Alex Bawuah, Simon Appleton, Yang Li
{"title":"The effect of health facility ownership on perceived healthcare quality: evidence from Ghana","authors":"Alex Bawuah, Simon Appleton, Yang Li","doi":"10.1007/s10754-024-09385-0","DOIUrl":"https://doi.org/10.1007/s10754-024-09385-0","url":null,"abstract":"<p>Whether private healthcare providers should be encouraged over public providers remains unclear. On the one hand, because private providers are profit-driven, they are more motivated to compete for demand by enhancing quality if demand is elastic. However, because they are more motivated to maximize revenue, they may sacrifice quality to maximize profit. A crucial factor in determining whether private providers should be encouraged is the extent to which their quality exceeds or falls short of that of the public provider. This study, therefore, investigates whether the public and private differ in providing quality healthcare services using the 2014 Ghana Demographic and Health Survey. Our measure of healthcare quality is based on patient satisfaction level with nine healthcare services (cleanliness, waiting time, comfort and safety, consultation time, privacy, listening, explanation, treatment advice and confidentiality) provided by public and private healthcare facilities. We applied an instrumental variable approach to account for endogeneity issues related to the patient’s choice of healthcare provider. We find that private facility users have a higher probability of being very satisfied with “waiting time”, “consultation time”, “listening”, “cleanliness”, “comfort and safety”, “confidentiality”, and “privacy” than public users, thus suggesting that private facilities provide better service than public. We thus recommend encouraging the private sector to enter the healthcare market. We also find that failing to account for endogeneity in provider choice when estimating the effect of healthcare facility ownership on healthcare service quality underestimates the effects.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"12 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247949","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}
引用次数: 0
Analyzing the 20-year declining trend of hospital length-of-stay in European countries with different healthcare systems and reimbursement models. 分析不同医疗体系和报销模式的欧洲国家 20 年来住院时间的下降趋势。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-01 Epub Date: 2024-03-21 DOI: 10.1007/s10754-024-09369-0
Davide Golinelli, Francesco Sanmarchi, Fabrizio Toscano, Andrea Bucci, Nicola Nante
{"title":"Analyzing the 20-year declining trend of hospital length-of-stay in European countries with different healthcare systems and reimbursement models.","authors":"Davide Golinelli, Francesco Sanmarchi, Fabrizio Toscano, Andrea Bucci, Nicola Nante","doi":"10.1007/s10754-024-09369-0","DOIUrl":"10.1007/s10754-024-09369-0","url":null,"abstract":"<p><p>The study aims to investigate the last 20-year (2000-2019) of hospital length of stay (LOS) trends and their association with different healthcare systems (HS) among 25 European countries. A panel dataset was created using secondary data from Eurostat and Global Burden of Disease study databases, with dependent and control variables aggregated at the national level over a period of 20 years. A time trend analysis was conducted using a weighted least squares model for panel data to investigate the association between LOS, HS models [National Health Service (NHS), National Health Insurance, Social Health Insurance (SHI), and Etatist Social Health Insurance], healthcare reimbursement schemes [Prospective Global Budget (PGB), Diagnosis Related Groups (DRG), and Procedure Service Payment (PSP)], and control variables. The study showed a reduction of average LOS from 9.20 days in 2000 to 7.24 in 2019. SHI was associated with a lower LOS compared to NHS (b = - 0.6327, p < 0.05). Both DRG (b = 1.2399, p < 0.05) and PSP (b = 1.1677, p < 0.05) reimbursement models were positively associated with LOS compared to PGB. Our results confirmed the downward trend of LOS in the last 20 years, its multifactorial nature, and the influence of the SHI model of HS. This could be due to the financial incentives present in fee-for-service payment models and the role of competition in creating a market for healthcare services. These results offer insight into the factors influencing healthcare utilization and can inform the design of more effective, efficient, and sustainable HS.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"375-392"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185873","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}
引用次数: 0
Matching patients with therapists in culturally diverse rehabilitation services during civil unrest. 在内乱期间,为病人和治疗师匹配不同文化背景的康复服务。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-01 Epub Date: 2023-06-28 DOI: 10.1007/s10754-023-09359-8
Stuart B Kamenetsky, Vanessa Chen, Eyal Heled
{"title":"Matching patients with therapists in culturally diverse rehabilitation services during civil unrest.","authors":"Stuart B Kamenetsky, Vanessa Chen, Eyal Heled","doi":"10.1007/s10754-023-09359-8","DOIUrl":"10.1007/s10754-023-09359-8","url":null,"abstract":"<p><p>A primary consideration in rehabilitation is the compatibility between clinicians and patients, where cultural diversity is a defining feature for both. The intricacies of cultural considerations in patient-clinician matching are heightened in areas of conflict and civil unrest. This paper presents three perspectives of the significance of cultural considerations in such assignments: patient-centred approach - prioritizing patients' preferences; professional-centred approach - clinicians' safety, social-emotional, and training needs; and utilitarian approach - what is best for the majority. A case study from an Israeli rehabilitation clinic is presented to exhibit the multifaceted considerations in patient-clinician matching within areas of conflict and civil unrest. The reconciliation of these three approaches in the context of cultural diversity is discussed, suggesting the benefit of a case-by-case strategy involving combinations of the three. Further research could examine how this might feasibly and beneficially optimize outcomes for all in culturally diverse societies in times of unrest.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"407-418"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9746588","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}
引用次数: 0
Contribution of high-technology procedures to public healthcare expenditures: the case of ischemic heart disease in Portugal, 2002-2015. 高科技手术对公共医疗支出的贡献:2002-2015 年葡萄牙缺血性心脏病案例。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-01 Epub Date: 2024-03-29 DOI: 10.1007/s10754-024-09372-5
Wenkang Ma, Ana Timóteo, Vanessa Ribeiro, Céu Mateus, Julian Perelman
{"title":"Contribution of high-technology procedures to public healthcare expenditures: the case of ischemic heart disease in Portugal, 2002-2015.","authors":"Wenkang Ma, Ana Timóteo, Vanessa Ribeiro, Céu Mateus, Julian Perelman","doi":"10.1007/s10754-024-09372-5","DOIUrl":"10.1007/s10754-024-09372-5","url":null,"abstract":"<p><p>The magnitude of the impact of technological innovations on healthcare expenditure is unclear. This paper estimated the impact of high-technology procedures on public healthcare expenditure for patients with ischemic heart disease (IHD) in Portugal. The Blinder-Oaxaca decomposition method was applied to Portuguese NHS administrative data for IHD discharges during two periods, 2008-2015 vs. 2002-2007 (N = 434,870). We modelled per episode healthcare expenditures on the introduction of new technologies, adjusting for GDP, patient age, and comorbidities. The per episode healthcare expenditure was significantly higher in 2008-2015 compared to 2002-2007 for IHD discharges. The increase in the use of high-technology procedures contributed to 28.6% of this growth among all IHD patients, and to 18.4%, 6.8%, 11.1%, and 29.2% for acute myocardial infarction, unstable angina, stable angina, and other IHDs, respectively. Changes in the use of stents and embolic protection and/or coronary brachytherapy devices were the largest contributors to expenditure growth. High-technology procedures were confirmed as a key driver of public healthcare expenditure growth in Portugal, contributing to more than a quarter of this growth.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"419-437"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327230","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}
引用次数: 0
Too many cooks could spoil the broth: choice overload and the provision of ambulatory health care. 太多的厨师会把肉汤煮坏:选择过多和提供流动医疗服务。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI: 10.1007/s10754-024-09379-y
Helmut Herwartz, Christoph Strumann
{"title":"Too many cooks could spoil the broth: choice overload and the provision of ambulatory health care.","authors":"Helmut Herwartz, Christoph Strumann","doi":"10.1007/s10754-024-09379-y","DOIUrl":"10.1007/s10754-024-09379-y","url":null,"abstract":"<p><p>Patient empowerment calls for an intensified participation of (informed) patients with more treatment opportunities to choose from. A growing body of literature argues that confronting consumers with too many opportunities can lead to a choice overload (CO) resulting in uncertainty that the selected alternative dominates all other options in the choice set. We examine whether there is a CO effect in the demand for ambulatory health care in Germany by analyzing the association of medical specialists supply on so-called patients' health uncertainty. Further, we investigate if the CO effect is smaller in areas with a higher density of general practitioners (GPs). We find that patients who live in an area with a large supply of specialists are subject to a CO effect that is expressed by an increased health uncertainty. The coordinating role of GPs seems to be effective to reduce the CO effect, while preserving free consumer choice.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"357-373"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157323","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}
引用次数: 0
The effect of health facility births on newborn mortality in Malawi. 马拉维医疗机构分娩对新生儿死亡率的影响。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-01 Epub Date: 2023-04-03 DOI: 10.1007/s10754-023-09348-x
Dawoon Jung, Booyuel Kim
{"title":"The effect of health facility births on newborn mortality in Malawi.","authors":"Dawoon Jung, Booyuel Kim","doi":"10.1007/s10754-023-09348-x","DOIUrl":"10.1007/s10754-023-09348-x","url":null,"abstract":"<p><p>We examine the effect of health facility delivery on newborn mortality in Malawi using data from a survey of mothers in the Chimutu district, Malawi. The study exploits labour contraction time as an instrumental variable to overcome endogeneity of health facility delivery. The results show that health facility delivery does not reduce 7-day and 28-day mortality rates. In a low-income country like Malawi where the healthcare quality is severely compromised, we conclude that encouraging health facility delivery may not guarantee positive health outcomes for newborn births.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"393-406"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235670","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}
引用次数: 0
Strategic behaviour and decision making in competitive hospital markets: an experimental investigation. 竞争性医院市场中的战略行为和决策:一项实验研究。
IF 1.5 4区 经济学
International Journal of Health Economics and Management Pub Date : 2024-09-01 Epub Date: 2024-03-15 DOI: 10.1007/s10754-024-09366-3
Johann Han, Nadja Kairies-Schwarz, Markus Vomhof
{"title":"Strategic behaviour and decision making in competitive hospital markets: an experimental investigation.","authors":"Johann Han, Nadja Kairies-Schwarz, Markus Vomhof","doi":"10.1007/s10754-024-09366-3","DOIUrl":"10.1007/s10754-024-09366-3","url":null,"abstract":"<p><p>We investigate quality provision and the occurrence of strategic behaviour in competitive hospital markets where providers are assumed to be semi-altruistic towards patients. For this, we employ a laboratory experiment with a hospital market framing. Subjects decide on the quality levels for one of three competing hospitals respectively. We vary the organizational aspect of whether quality decisions within hospitals are made by individuals or teams. Realized monetary patient benefits go to real patients outside the lab. In both settings, we find that degrees of cooperation quickly converge towards negative values, implying absence of collusion and patient centred or competitive quality choices. Moreover, hospitals treat quality as a strategic complement and adjust their quality choice in the same direction as their competitors. The response magnitude for team markets is weaker; this is driven by non-cooperative or altruistic teams, which tend to set levels of quality that are strategically independent.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"333-355"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137300","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}
引用次数: 0
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