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

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

Competition and physician-induced demand in a healthcare market with regulated price: evidence from Ghana. 价格管制的医疗保健市场中的竞争和医生诱导的需求:来自加纳的证据。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-09-01 DOI: 10.1007/s10754-021-09320-7

Adolf Kwadzo Dzampe, Shingo Takahashi

引用次数: 8

Predicting diagnostic coding in hospitals: individual level effects of price incentives. 预测医院诊断编码:价格激励的个体水平效应。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-06-01 Epub Date: 2021-10-06 DOI: 10.1007/s10754-021-09314-5

Kjartan Sarheim Anthun

{"title":"Predicting diagnostic coding in hospitals: individual level effects of price incentives.","authors":"Kjartan Sarheim Anthun","doi":"10.1007/s10754-021-09314-5","DOIUrl":"https://doi.org/10.1007/s10754-021-09314-5","url":null,"abstract":"The purpose of this paper is to test if implicit price incentives influence the diagnostic coding of hospital discharges. We estimate if the probability of being coded as a complicated patient was related to a specific price incentive. This paper tests empirically if upcoding can be linked to shifts in patient composition through proxy measures such as age composition, length of stay, readmission rates, mortality- and morbidity of patients. Data about inpatient episodes in Norway in all specialized hospitals in the years 1999-2012 were collected, N = 11 065 330. We examined incentives present in part of the hospital funding system. First, we analyse trends in the proxy measures of diagnostic upcoding: can hospital behavioural changes be seen over time with regards to age composition, readmission rates, length of stay, comorbidity and mortality? Secondly, we examine specific patient groups to see if variations in the price incentive are related to probability of being coded as complicated. In the first years (1999-2003) there was an observed increase in the share of episodes coded as complicated, while the level has become more stable in the years 2004-2012. The analysis showed some indications of upcoding. However, we found no evidence of widespread upcoding fuelled by implicit price incentive, as other issues such as patient characteristics seem to be more important than the price differences. This study adds to previous research by testing individual level predictions. The added value of such analysis is to have better case mix control. We observe the presence of price effects even at individual level.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"22 2","pages":"129-146"},"PeriodicalIF":2.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9090893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39489043","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

Temporary and persistent overweight and long-term labor market outcomes. 暂时和持续的超重和长期的劳动力市场后果。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-06-01 Epub Date: 2021-11-09 DOI: 10.1007/s10754-021-09315-4

Liisa T Laine, Ari Hyytinen

引用次数: 1

State minimum wages and health insurance coverage in the United States: 2008-2018. 美国各州最低工资和医疗保险覆盖率:2008-2018年。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-06-01 Epub Date: 2021-09-08 DOI: 10.1007/s10754-021-09313-6

Masanori Kuroki

引用次数: 1

The weekend effect in stroke mortality: evidence from Austrian acute care hospitals. 周末对中风死亡率的影响:来自奥地利急症医院的证据。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-06-01 Epub Date: 2021-11-03 DOI: 10.1007/s10754-021-09317-2

Florian Bachner, Martin Zuba

{"title":"The weekend effect in stroke mortality: evidence from Austrian acute care hospitals.","authors":"Florian Bachner, Martin Zuba","doi":"10.1007/s10754-021-09317-2","DOIUrl":"https://doi.org/10.1007/s10754-021-09317-2","url":null,"abstract":"Many studies provide evidence for the so-called weekend effect by demonstrating that patients admitted to hospital during weekends show less favourable outcomes such as increased mortality, compared with similar patients admitted during weekdays. The underlying causes for this phenomenon are still discussed controversially. We analysed factors influencing weekend effects in inpatient care for acute stroke in Austria. The study analysed secondary datasets from all 130 public acute care hospitals in Austria between 2010 and 2014 (Austrian DRG Data). The study cohort included 86,399 patient cases admitted with acute ischaemic stroke. By applying multivariate regression analysis, we tested whether patient, treatment or hospital characteristics drove in-hospital mortality on weekends and national holidays. We found that the risk to die after an admission at weekend was significantly higher compared to weekdays, while the number of admissions following stroke was significantly lower. Adjustment for patient, treatment and hospital characteristics substantially reduced the weekend effect in mortality but did not eliminate it. We conclude that the observed weekend effect could be explained either by lower quality of health care or higher severity of stroke admissions at the weekend. In depth analyses supported the hypothesis of higher stroke severity in weekend patients as seen in other studies. While DRG data is useful to analyse stroke treatment and outcomes, adjustment for case mix and severity is essential.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":"22 2","pages":"205-236"},"PeriodicalIF":2.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39586955","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

The sensitivity of hospital coding to prices: evidence from Indonesia. 医院编码对价格的敏感性：印度尼西亚的证据。

IF 1.5 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-06-01 Epub Date: 2021-09-07 DOI: 10.1007/s10754-021-09312-7

Martin Chalkley, Budi Hidayat, Royasia Viki Ramadani, María José Aragón

引用次数: 0

Eliciting relative preferences for the attributes of health insurance schemes among rural consumers in India 引起印度农村消费者对医疗保险计划属性的相对偏好

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-04-08 DOI: 10.1007/s10754-022-09327-8

Mohd. Zuhair, R. Roy

引用次数: 0