International Journal of Health Economics and Management最新文献_第7页

The union advantage: union membership, access to care, and the Affordable Care Act. 工会的优势:工会会员资格，获得医疗服务，以及《平价医疗法案》。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2023-03-01 DOI: 10.1007/s10754-022-09336-7

Luke Petach, David K Wyant

{"title":"The union advantage: union membership, access to care, and the Affordable Care Act.","authors":"Luke Petach, David K Wyant","doi":"10.1007/s10754-022-09336-7","DOIUrl":"https://doi.org/10.1007/s10754-022-09336-7","url":null,"abstract":"We describe a \"union advantage\" in health insurance coverage and access to care. Using multiple statistical models and data from the Medical Expenditure Panel Survey for 1996-2019, we show that-compared to non-union workers-union workers are more likely to have health insurance coverage (98% vs. 86%), more likely to have a regular care provider (83% vs. 74%), visited office-based providers 31% more often (5.64 vs. 4.27 visits), spend $832 more on healthcare annually, and pay a lower share of their expenditures out-of-pocket (26% vs. 37%). When we control for demographic characteristics across variety of specifications, these differences almost always remain at a statistically significant level. Further, we show that the union advantage is greater for low-income workers. Next, we demonstrate that-although the Affordable Care Act (ACA) appears to have reduced the union advantage in health insurance coverage by increasing coverage rates among non-union workers-a substantial union advantage in access to care remains after the ACA's main provisions become effective. Finally, we explore how the ACA interacted with the trade union goal of maintaining employer-based health insurance. We show that unionized workers are less likely to contribute to \"enrollment shifting,\" which occurs when individuals shift from existing employer-based insurance to a new government funded program. This suggests that union bargaining over fringe benefits may have positive externalities in the form of cost reductions to the public sector.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"23 1","pages":"1-26"},"PeriodicalIF":2.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9329829","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

Minimum wages and health: evidence from European countries. 最低工资与健康:来自欧洲国家的证据。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2023-03-01 DOI: 10.1007/s10754-022-09340-x

Laetitia Lebihan

引用次数: 0

The effect of performance pay incentives on market frictions: evidence from medicare. 绩效薪酬激励对市场摩擦的影响:来自医疗保险的证据。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2023-03-01 DOI: 10.1007/s10754-022-09339-4

Atul Gupta, Guy David, Lucy Kim

引用次数: 0

Pricing behavior in long term care markets: evidence from provider-level data for home help services. 长期护理市场的定价行为:来自家庭帮佣服务提供者层面数据的证据。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2023-03-01 DOI: 10.1007/s10754-022-09334-9

Remco van Eijkel, Mark Kattenberg, Ab van der Torre

引用次数: 0

The influence of strong and weak ties in physician peer networks on new drug adoption. 医师同行网络中强弱关系对新药采用的影响。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2023-03-01 DOI: 10.1007/s10754-022-09335-8

Yong Cai, Mohamed Abouzahra

{"title":"The influence of strong and weak ties in physician peer networks on new drug adoption.","authors":"Yong Cai, Mohamed Abouzahra","doi":"10.1007/s10754-022-09335-8","DOIUrl":"https://doi.org/10.1007/s10754-022-09335-8","url":null,"abstract":"Physicians interact and exchange information through various social networks. Understanding peer effects through different networks can help accelerate new medical technology and innovative treatment adoption. In this research, we measure the influence of strong-tie and weak-tie connections on new drug adoption and study the overlap between advice-discussion and patient-sharing network. We construct two physician networks with strong and weak ties from peer nomination surveys and commercial medical claims data. We design a dynamic system to define peer adoption status and build patient-level hierarchical logistic models to measure the peer influence on new product adoption for treating new-to-therapy patients. Our results show that A strong-tie early adoption peer has six times more influence on new drug adoption than a weak-tie peer. Weak tie peers collectively exert as much or higher influence than strong-tie peers because of the larger network size. In the case of inaccessibility to strong-tie data, researchers can still reliably use the influence of the weak tie data only even though they will lose the effect of the omitted strong ties.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"23 1","pages":"133-147"},"PeriodicalIF":2.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10839548","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: 1

Exploring the effectiveness of demand-side retail pharmaceutical expenditure reforms : Cross-country evidence from weighted-average least squares estimation. 探索需求侧零售药品支出改革的有效性:来自加权平均最小二乘估计的跨国证据。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2023-03-01 DOI: 10.1007/s10754-022-09337-6

Michael Berger, Markus Pock, Miriam Reiss, Gerald Röhrling, Thomas Czypionka

{"title":"Exploring the effectiveness of demand-side retail pharmaceutical expenditure reforms : Cross-country evidence from weighted-average least squares estimation.","authors":"Michael Berger, Markus Pock, Miriam Reiss, Gerald Röhrling, Thomas Czypionka","doi":"10.1007/s10754-022-09337-6","DOIUrl":"https://doi.org/10.1007/s10754-022-09337-6","url":null,"abstract":"Increasing expenditures on retail pharmaceuticals bring a critical challenge to the financial stability of healthcare systems worldwide. Policy makers have reacted by introducing a range of measures to control the growth of public pharmaceutical expenditure (PPE). Using panel data on European and non-European OECD member countries from 1990 to 2015, we evaluate the effectiveness of six types of demand-side expenditure control measures including physician-level behaviour measures, system-level price-control measures and substitution measures, alongside a proxy for cost-sharing and add a new dimension to the existing empirical evidence hitherto based on national-level and meta-studies. We use the weighted-average least squares regression framework adapted for estimation with panel-corrected standard errors. Our empirical analysis suggests that direct patient cost-sharing and some-but not all-demand-side measures successfully dampened PPE growth in the past. Cost-sharing schemes stand out as a powerful mechanism to curb PPE growth, but bear a high risk of adverse effects. Other demand-side measures are more limited in effect, though may be more equitable. Due to limitations inherent in the study approach and the data, the results are only explorative.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"23 1","pages":"149-172"},"PeriodicalIF":2.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10854308","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

Discontinuation of performance-based financing in primary health care: impact on family planning and maternal and child health. 停止在初级保健方面按业绩供资:对计划生育和妇幼保健的影响。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2023-03-01 DOI: 10.1007/s10754-022-09333-w

Amira El-Shal, Patricia Cubi-Molla, Mireia Jofre-Bonet

{"title":"Discontinuation of performance-based financing in primary health care: impact on family planning and maternal and child health.","authors":"Amira El-Shal, Patricia Cubi-Molla, Mireia Jofre-Bonet","doi":"10.1007/s10754-022-09333-w","DOIUrl":"https://doi.org/10.1007/s10754-022-09333-w","url":null,"abstract":"Performance-based financing (PBF) is advocated as an effective means to improve the quality of care by changing healthcare providers' behavior. However, there is limited evidence on its effectiveness in low- and middle-income countries and on its implementation in primary care settings. Evidence on the effect of discontinuing PBF is even more limited than that of introducing PBF schemes. We estimate the effects of discontinuing PBF in Egypt on family planning, maternal health, and child health outcomes. We use a difference-in-differences (DiD) model with fixed effects, exploiting a unique dataset of six waves of spatially constructed facility-level health outcomes. We find that discontinuing performance-based incentives to providers had a negative effect on the knowledge of contraceptive methods, iron supplementation during pregnancy, the prevalence of childhood acute respiratory infection, and, more importantly, under-five child mortality, all of which were indirectly targeted by the PBF scheme. No significant effects are reported for directly targeted outcomes. Our findings suggest that PBF can induce permanent changes in providers' behavior, but this may come at the expense of non-contracted outcomes.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"23 1","pages":"109-132"},"PeriodicalIF":2.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10802582","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: 2

Catastrophic health expenditure and its determinants among Nigerian households. 尼日利亚家庭的灾难性卫生支出及其决定因素。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-12-01 Epub Date: 2022-02-14 DOI: 10.1007/s10754-022-09323-y

Ryoko Sato

{"title":"Catastrophic health expenditure and its determinants among Nigerian households.","authors":"Ryoko Sato","doi":"10.1007/s10754-022-09323-y","DOIUrl":"https://doi.org/10.1007/s10754-022-09323-y","url":null,"abstract":"Health expenditure can be substantial, especially in countries without national health insurance schemes, and it can negatively affect people's welfare. This study uses recent data to evaluate the extent to which Nigerian households suffer from catastrophic health expenditure (CHE) and evaluates its determinants. We used the Living Standards Survey 2018-2019 to estimate the headcount of Nigerian households that experience CHE-the proportion of health expenditures exceeding a certain ratio of such expenditures to non-food expenditures. To evaluate the determinants of CHE, we used ordinary least square regression with state fixed effects. The total sample was 22,110 nationally representative households. Many households, especially poorer ones, do not have any health care expenses; only 60.6% of the poorest households had some health-related expenditure. Even with the limited health-seeking behaviors in this demographic, the percentage of households that suffered from CHE was very high: with a 15% cutoff for CHE thresholds, 34.9 to 44.2% of households experienced CHE. Lower education, higher non-food consumption, and rural residence were correlated with higher amounts of health expenditure and higher odds of CHE. Health-seeking behaviors such as clinic visits for sickness treatment and prevention are limited, especially among the poorer households. Even so, the headcount of households experiencing CHE is very high in Nigeria. Advancing the implementation of national health insurance scheme is important to reduce the burden of health expenditure, especially among the poor, as well as to remove financial barriers to their seeking adequate health services.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"22 4","pages":"459-470"},"PeriodicalIF":2.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39779025","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

Impact evaluation of subsidized health insurance programs on utilization of healthcare facilities: evidence from Indonesia. 补贴医疗保险计划对医疗设施利用的影响评估:来自印度尼西亚的证据。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-09-01 Epub Date: 2022-01-14 DOI: 10.1007/s10754-021-09321-6

Riska Dwi Astuti, Rindang Nuri Isnaini Nugrohowati

{"title":"Impact evaluation of subsidized health insurance programs on utilization of healthcare facilities: evidence from Indonesia.","authors":"Riska Dwi Astuti, Rindang Nuri Isnaini Nugrohowati","doi":"10.1007/s10754-021-09321-6","DOIUrl":"https://doi.org/10.1007/s10754-021-09321-6","url":null,"abstract":"Despite subsidized health insurance has long been proclaimed by many countries including Indonesia, the variety of evaluation results showing that the optimization of benefits obtained by recipients is still questionable. The objective of this study is to analyze the impact of subsidized health insurance programs (ASKESKIN and JAMKESMAS) on the utilization of healthcare facilities in Indonesia. Data from two waves longitudinal data, the Indonesian Family Life Survey (IFLS), were analyzed using the propensity score matching method. This study found that in general, ASKESKIN and JAMKESMAS had very small impacts on the utility of healthcare facilities measured by outpatient and inpatient visits by program's beneficiaries. It implies that being subsidized health insurance holders does not necessarily encourage them to visit formal healthcare facilities. In addition, the comparison of average treatment effect on the treated (ATT) between ASKESKIN and JAMKESMAS also did not show any significant improvement even though the program had tried to be improved. The results of this study provide the basis for advising policy makers that there needs to revisit the effectiveness of subsidized health insurance program implementation.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"315-331"},"PeriodicalIF":2.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39822095","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: 1

Medical insurance and physician-induced demand in China: the case of hemorrhoid treatments. 中国医疗保险与医生需求:以痔疮治疗为例。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-09-01 Epub Date: 2021-11-13 DOI: 10.1007/s10754-021-09318-1

Kebin Deng, Zhong Ding, Jieni Li

{"title":"Medical insurance and physician-induced demand in China: the case of hemorrhoid treatments.","authors":"Kebin Deng, Zhong Ding, Jieni Li","doi":"10.1007/s10754-021-09318-1","DOIUrl":"https://doi.org/10.1007/s10754-021-09318-1","url":null,"abstract":"In October 2015, the Guangdong government of China enacted a so-called unified medical insurance payment for patients residing in Guangdong province, which fundamentally simplifies reimbursement procedures of medical insurance for the involved cross-city in-patients. Using a unique confidential dataset from 2013 to 2018 on hemorrhoid treatments at a renowned hospital in Guangzhou, the provincial capital of Guangdong, and exploiting difference-in-differences estimations based on the abovementioned policy, we document that the physicians' incentives are a negative externality of the full medical insurance policy for cross-city in-patients and account for a 49% probability increase in improper treatments; and neither increasing the communication between physicians and patients nor enhancing the education level of patients reduces the physician-induced demand for improper treatments. A series of robustness tests indicate our findings are solid. In summary, we highlight the substantial roles of medical insurance as a driver of physician-induced demand in an emerging economy such as China.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"257-294"},"PeriodicalIF":2.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39887660","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