International Journal of Health Economics and Management最新文献

{"title":"Has pharmaceutical innovation reduced the average cost of U.S. health care episodes?","authors":"Frank R Lichtenberg","doi":"10.1007/s10754-023-09363-y","DOIUrl":"10.1007/s10754-023-09363-y","url":null,"abstract":"<p><p>A number of authors have argued that technological innovation has increased U.S. health care spending. We investigate the impact that pharmaceutical innovation had on the average cost of U.S. health care episodes during the period 2000-2014, using data from the Bureau of Economic Analysis' Health Care Satellite Account and other sources. We analyze the relationship across approximately 200 diseases between the growth in the number of drugs that have been approved to treat the disease and the subsequent growth in the mean amount spent per episode of care, controlling for the growth in the number of episodes and other factors. Our estimates indicate that mean episode cost is not significantly related to the number of drugs ever approved 0-4 years before, but it is significantly inversely related to the number of drugs ever approved 5-20 years before. This delay is consistent with the fact (which we document) that utilization of a drug is relatively low during the first few years after it was approved, and that some drugs may have to be consumed for several years to have their maximum impact on treatment cost. Our estimates of the effect of pharmaceutical innovation on the average cost of health care episodes are quite insensitive to the weights used and to whether we control for 3 covariates. Our most conservative estimates imply that the drugs approved during 1986-1999 reduced mean episode cost by 4.7%, and that the drugs approved during 1996-2009 reduced mean episode cost by 2.1%. If drug approvals did not affect the number of episodes, the drugs approved during 1986-1999 would have reduced 2014 medical expenditure by about $93 billion. However, drug approvals may have affected the number, as well as the average cost, of episodes. We also estimate models of hospital utilization. The number of hospital days is significantly inversely related to the number of drugs ever approved 10-19 years before, controlling for the number of disease episodes. Our estimates imply that the drugs approved during 1984-1997 reduced the number of hospital days by 10.5%. The hospital cost reduction was larger than expenditure on the drugs.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"1-31"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522896","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":"Total expenditure elasticity of spending on self-treatment and professional healthcare: a case of Russia.","authors":"Evguenii Zazdravnykh, Andrey Aistov, Ekaterina Aleksandrova","doi":"10.1007/s10754-023-09353-0","DOIUrl":"10.1007/s10754-023-09353-0","url":null,"abstract":"<p><p>The studies on the demand for healthcare in low- and middle-income countries rarely take into consideration the fact that many people spend their income on self-treatment and professional treatment. The estimation of the income elasticity of demand for self-treatment and professional treatment can show a more precise picture of the affordability of professional care. This paper contributes to the discussion around estimates of income elasticity of health spending and discussion whether professional care and self-treatment are close to a luxury good and inferior good respectively in a middle-income country. We apply the switching regression model to explain the choice between self-treatment and professional healthcare via estimates of the income elasticity. Estimates are made with the use of the Russian Longitudinal Monitoring Survey - Higher School of Economics (RLMS-HSE), a nationally representative survey. While individual expenditure on professional treatment is higher than that on self-treatment, our estimates show that expenses on professional treatment can be income inelastic except when spending on medicines prescribed by a physician that are elastic. The results also indicate that cost of self-treatment is income elastic. In all cases, the considered income elasticities are statistically insignificant between professional and self-treatment.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"81-105"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9258874","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":"Price setting in the Brazilian private health insurance sector.","authors":"Mônica Viegas Andrade, Carolina Marinho, Letícia Nunes, Flavia Colares","doi":"10.1007/s10754-023-09361-0","DOIUrl":"10.1007/s10754-023-09361-0","url":null,"abstract":"<p><p>Brazil's private health insurance market is the second largest in the world, behind only the United States, making it a valuable source of real-world evidence. This paper documents how physicians' inpatient reimbursement fees vary in the country and explores the relationship between these fees and the market share of health providers and health insurance companies. We implement a fixed-effects panel regression and take advantage of an unprecedented database that contains national administrative records of inpatient procedures paid by health insurance companies in 2016. We find a positive correlation between reimbursement for ICU procedures and provider market share. Conversely, we observe a negative correlation with insurers' market share. Additionally, we document substantial variation in procedure prices, both across and within Brazilian states, and observe that more competitive markets in Brazil tend to have higher population and GDP levels. Overall, our research enhances our understanding of the price setting dynamics of physician reimbursement fees in the context of a developing country. The insights gained from this study can assist policymakers in formulating appropriate regulations to ensure appropriate access to healthcare services.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"57-80"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10205388","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":"Out-of-pocket expenditure, need, utilisation, and private health insurance in the Australian healthcare system.","authors":"Timothy Ludlow, Jonas Fooken, Christiern Rose, Kam Ki Tang","doi":"10.1007/s10754-023-09362-z","DOIUrl":"10.1007/s10754-023-09362-z","url":null,"abstract":"<p><p>Despite widespread public service provision, public funding, and private health insurance (PHI), 20% of all healthcare expenditure across the OECD is covered by out-of-pocket expenditure (OOPE). This creates an equity concern for the increasing number of individuals with chronic conditions and greater need, particularly if higher need coincides with lower income. Theoretically, individuals may mitigate OOPE risk by purchasing PHI, replacing variable OOPE with fixed expenditure on premiums. Furthermore, if PHI premiums are not risk-rated, PHI may redistribute some of the financial burden from less healthy PHI holders that have greater need to healthier PHI holders that have less need. We investigate if the burden of OOPE for individuals with greater need increases less strongly for individuals with PHI in the Australian healthcare system. The Australian healthcare system provides public health insurance with full, partial, or limited coverage, depending on the healthcare service used, and no risk rating of PHI premiums. Using data from the Household, Income and Labour Dynamics in Australia survey we find that individuals with PHI spend a greater share of their disposable income on OOPE and that the difference in OOPE share between PHI and non-PHI holders increases with greater need and utilisation, contrary to the prediction that PHI may mitigate OOPE. We also show that OOPE is a greater concern for poorer individuals for whom the difference in OOPE by PHI is the greatest.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"33-56"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215428","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":"Are women breaking the glass ceiling? A gendered analysis of the duration of sick leave in Spain.","authors":"Ángel L Martín-Román, Alfonso Moral, Sara Pinillos-Franco","doi":"10.1007/s10754-023-09351-2","DOIUrl":"10.1007/s10754-023-09351-2","url":null,"abstract":"<p><p>We study the gender gap in the duration of sick leave in Spain by splitting this duration into two types of days - those which are related to biological characteristics and those derived from behavioral reasons. Using the Statistics of Accidents at Work for 2011-2019, we found that women presented longer standard durations (i.e., purely attached to physiological reasons) compared to men. However, when estimating individuals' efficiency as the ratio between actual and standard durations, we found that women were more inefficient at lower levels of income, whereas in case of men, this occurred at higher levels of income. These results were reinforced when considering that men and women do not recover from the same injury at the same rate. Women were more efficient than men across all the compensation distribution, especially at higher income levels.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"107-134"},"PeriodicalIF":2.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10124936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389374","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":"Private equity and its effect on patients: a window into the future.","authors":"Sajith Matthews, Renato Roxas","doi":"10.1007/s10754-022-09331-y","DOIUrl":"10.1007/s10754-022-09331-y","url":null,"abstract":"","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"23 4","pages":"673-684"},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41104603","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":"National or local infodemic? The demand for news in Italy during COVID-19.","authors":"Stefano Castriota, Marco Delmastro, Mirco Tonin","doi":"10.1007/s10754-023-09350-3","DOIUrl":"10.1007/s10754-023-09350-3","url":null,"abstract":"<p><p>Information can have an important impact on health behavior and, according to the World Health Organization, an 'infodemic' has accompanied the current pandemic. Observing TV news viewership in Italy during the COVID-19 pandemic using actual consumption data, we investigate whether demand for national and local news depends on national or local epidemiological developments, as measured by the number of new positives or the number of current positives on any given day. Exploiting the fact that the impact of the pandemic displays a great deal of variation among the different regions, we find that at the regional level, demand for both national and local news responds to national epidemiological developments rather than to local ones. This has implications regarding the incentives for local politicians to take preventive action.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"507-536"},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10109222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9323206","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":"Hospital cost efficiency: an examination of US acute care inpatient hospitals.","authors":"Sebastian Linde","doi":"10.1007/s10754-023-09356-x","DOIUrl":"https://doi.org/10.1007/s10754-023-09356-x","url":null,"abstract":"<p><p>The use of stochastic frontier models for inference on hospital efficiency is complicated by the inability to fully control for quality differences across hospitals. Additionally, the potential existence of cross-sectional dependence due to the presence of unobserved common factors leads to endogeneity problems that can bias both cost function and efficiency estimates. Using a panel consisting of 1518 hospitals for the years 1996-2013 (T = 18), I adopt techniques for dealing with long, cross-sectionally dependent panel data in order to estimate cost parameters and hospital specific efficiency. In particular, I employ the estimation technique proposed by Bai (Econometrica 77(4):1229-1279, 2009), which assumes that the unobservable heterogenous effects have a factor structure. I find evidence of considerable scale economies and that hospital cost inefficiencies have been increasing during the period of 1996-2013, and that the growth in expenditures is, in part, driven by spending that increases patient satisfaction, but that does not significantly contribute to improved patient health outcomes.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"23 3","pages":"325-344"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10089798","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":"Priority setting in the German healthcare system: results from a discrete choice experiment.","authors":"V Meusel,&nbsp;E Mentzakis,&nbsp;P Baji,&nbsp;G Fiorentini,&nbsp;F Paolucci","doi":"10.1007/s10754-023-09347-y","DOIUrl":"https://doi.org/10.1007/s10754-023-09347-y","url":null,"abstract":"<p><p>Worldwide, social healthcare systems must face the challenges of a growing scarcity of resources and of its inevitable distributional effects. Explicit criteria are needed to define the boundaries of public reimbursement decisions. As Germany stands at the beginning of such a discussion, more formalised priority setting procedures seem in order. Recent research identified multi-criteria decision analysis (MCDA) as a promising approach to inform and to guide decision-making in healthcare systems. In that regard, this paper aims to analyse the relative weight assigned to various criteria in setting priority interventions in Germany. A discrete choice experiment (DCE) was employed in 2015 to elicit equity and efficiency preferences of 263 decision makers, through six attributes. The experiment allowed us to rate different policy interventions based on their features in a composite league table (CLT). As number of potential beneficiaries, severity of disease, individual health benefits and cost-effectiveness are the most relevant criteria for German decision makers within the sample population, the results display an overall higher preference towards efficiency criteria. Specific high priority interventions are mental disorders and cardiovascular diseases.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"23 3","pages":"411-431"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10116083","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 COVID-19 on hospital screening, diagnosis and treatment activities among prostate and colorectal cancer patients in Canada.","authors":"Shin-Haw Lee,&nbsp;Andrew Toye Ojo,&nbsp;Matthew Halat,&nbsp;Nataly Bleibdrey,&nbsp;Steven Zhang,&nbsp;Rob Chalmers,&nbsp;Dan Zimskind","doi":"10.1007/s10754-023-09342-3","DOIUrl":"https://doi.org/10.1007/s10754-023-09342-3","url":null,"abstract":"<p><strong>Background: </strong>Suspension of cancer screening and treatment programs were instituted to preserve medical resources and protect vulnerable populations. This research aims to investigate the implications of COVID-19 on cancer management and clinical outcomes for patients with prostate and colorectal cancer in Canada.</p><p><strong>Methods: </strong>We examined hospital cancer screening, diagnosis, treatment, length of stay, and mortality data among prostate and colorectal cancer patients between April 2017 and March 2021. Baseline trends were established with data between April 2017 and March 2020 for comparison with data collected between April 2020 and March 2021. Scenario analyses were performed to assess the incremental capacity requirements needed to restore hospital cancer care capacities to the pre-pandemic levels.</p><p><strong>Results: </strong>For prostate cancer, A 12% decrease in diagnoses and 5.3% decrease in treatment activities were observed during COVID-19 between April 2020 and March 2021. Similarly, a 43% reduction in colonoscopies, 11% decrease in diagnoses and 10% decrease in treatment activities were observed for colorectal cancers. An estimated 1,438 prostate and 2,494 colorectal cancer cases were undiagnosed, resulting in a total of 620 and 1,487 unperformed treatment activities for prostate and colorectal cancers, respectively, across nine provinces in Canada. To clear the backlogs of unperformed treatment procedures will require an estimated 3%-6% monthly capacity increase over the next 6 months.</p><p><strong>Interpretation: </strong>A concerted effort from all stakeholders is required to immediately ameliorate the backlogs of cancer detection and treatment activities. Mitigation measures should be implemented to minimize future interruptions to cancer care in Canada.</p>","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"23 3","pages":"345-360"},"PeriodicalIF":2.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10089254","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}