International Journal of Health Economics and Management最新文献_第8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

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

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

Provider responses to discontinuous tariffs: evidence from Dutch rehabilitation care. 提供者对不连续收费的反应:来自荷兰康复护理的证据。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-09-01 Epub Date: 2022-02-01 DOI: 10.1007/s10754-021-09322-5

Katalin Gaspar, Xander Koolman

{"title":"Provider responses to discontinuous tariffs: evidence from Dutch rehabilitation care.","authors":"Katalin Gaspar, Xander Koolman","doi":"10.1007/s10754-021-09322-5","DOIUrl":"https://doi.org/10.1007/s10754-021-09322-5","url":null,"abstract":"Abrupt jumps in reimbursement tariffs have been shown to lead to unintended effects in physicians' behavior. A sudden change in tariffs at a pre-defined point in the treatment can incentivize health care providers to prolong treatment to reach the higher tariff, and then to discharge patients once the higher tariff is reached. The Dutch reimbursement schedule in hospital rehabilitation care follows a two-threshold stepwise-function based on treatment duration. We investigated the prevalence of strategic discharges around the first threshold and assessed whether their share varies by provider type. Our findings suggest moderate response to incentives by traditional care providers (general and academic hospitals, rehabilitation centers and multicategorical providers), and strong response by profit-oriented independent treatment centers. When examining the variation in response based on the financial position of the organization, we found a higher probability of manipulation among providers in financial distress. Our findings provide multiple insights and possible indicators to identify provider types that may be more prone to strategic behavior.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"333-354"},"PeriodicalIF":2.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39754837","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: 1

The impact of state capacity on the cross-country variations in COVID-19 vaccination rates. 国家能力对COVID-19疫苗接种率跨国差异的影响。

IF 2.4 4区经济学

International Journal of Health Economics and Management Pub Date : 2022-09-01 Epub Date: 2022-01-29 DOI: 10.1007/s10754-021-09319-0

Dragan Tevdovski, Petar Jolakoski, Viktor Stojkoski

{"title":"The impact of state capacity on the cross-country variations in COVID-19 vaccination rates.","authors":"Dragan Tevdovski, Petar Jolakoski, Viktor Stojkoski","doi":"10.1007/s10754-021-09319-0","DOIUrl":"https://doi.org/10.1007/s10754-021-09319-0","url":null,"abstract":"The initial period of vaccination shows strong heterogeneity between countries' vaccinations rollout, both in the terms of the start of the vaccination process and in the dynamics of the number of people that are vaccinated. A predominant thesis for this observation is that a key determinant of the swift and extensive vaccine rollout is state capacity. Here, we utilize two measures that quantify different aspects of the state capacity: (i) the external capacity (measured through the soft power of the country) and (ii) the internal capacity (measured via the country's government effectiveness) and provide an empirical test for their relationship with the coronavirus vaccination outcome in the initial period (up to 31st March 2021). By using data on 128 countries and a two-step Heckman approach, we find that the soft power is a robust determinant of whether a country has started with the vaccination process. In addition, the government effectiveness is a key factor that determines vaccine roll-out. Altogether, our findings are in line with the hypothesis that state capacity determines the observed heterogeneity between countries in the initial period of COVID-19 vaccines rollout. As such, they are a stark reminder for the need for transparent and fair global response regarding fair and equitable availability of vaccines to every country.","PeriodicalId":44403,"journal":{"name":"International Journal of Health Economics and Management","volume":" ","pages":"237-255"},"PeriodicalIF":2.4,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39868599","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: 6

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