Health Economics Policy and Law最新文献

An investment too good to be true?: Reassessing the World Health Organization and World Bank return-on-investment estimates for pandemic preparedness. 一项好得令人难以置信的投资？*重新评估世界卫生组织和世界银行对大流行病防范的投资回报率估计。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-08-06 DOI: 10.1017/S174413312610067X

Garrett Wallace Brown, Jean von Agris, Blagovesta Tacheva, David Bell

{"title":"An investment too good to be true?: Reassessing the World Health Organization and World Bank return-on-investment estimates for pandemic preparedness.","authors":"Garrett Wallace Brown, Jean von Agris, Blagovesta Tacheva, David Bell","doi":"10.1017/S174413312610067X","DOIUrl":"https://doi.org/10.1017/S174413312610067X","url":null,"abstract":"The World Health Organization, World Bank, G20 and related health agencies have requested annual investments of US$31.1 billion in pandemic prevention, preparedness and response. To justify these unprecedented costs, they rely on a return-on-investment case developed by WHO and World Bank. Any investment in one area of public health will have knock-on effects on others, through diversion of funds and human resources. Intended outcomes must outweigh alternate investments and be likely to achieve the results on which such comparisons are predicated. This perspective examines the assumptions underlying the WHO and World Bank return-on-investment estimates and outlines implications for equitable and evidence-based global health financing. The examination reveals several problematic assumptions and crude baselines used for comparison - inflating return-on-investment estimates and undermining its use for policymaking. The case is based on improbable assumptions of 100% mitigation of pandemic economic impacts, including rapid vaccine development completely blocking transmission. WHO/World Bank do not disaggregate direct and indirect costs, while the economic impact of comparator diseases appears significantly undervalued. Thus, the return-on-investment case underpinning the current pandemic agenda appears under-evidenced and unreliable, and the apparent over-valuation of pandemic interventions over existing investment in high-burden infectious diseases raises equity concerns, suggesting a reassessment is needed.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EU excess capacity management through member states-driven patient mobility: economic and legal aspects. 通过成员国驱动的病人流动来管理欧盟过剩产能：经济和法律方面。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-08-04 DOI: 10.1017/S1744133126100632

Markus Frischhut, Rosella Levaggi

{"title":"EU excess capacity management through member states-driven patient mobility: economic and legal aspects.","authors":"Markus Frischhut, Rosella Levaggi","doi":"10.1017/S1744133126100632","DOIUrl":"https://doi.org/10.1017/S1744133126100632","url":null,"abstract":"Capacity management plays an increasingly important role in healthcare delivery, both at national and supranational level, in increasing value for money. In this paper, we propose using cross-border patient mobility across European Union (EU) countries to pool demand and reduce excess capacity. In a setting where the number of patients requiring a specific treatment is fixed but the facility requires a fixed capacity that cannot be adapted to demand, we show that cross-border patient mobility may improve welfare. From a legal perspective, we demonstrate that such mobility is compatible with existing EU law (comprising both EU primary and secondary law, namely the Patient Mobility Directive and the Social Security Coordination Regulation) and the case law of the European Court of Justice. These judgments confirm that planning and cost control objectives may justify not only restricting but also encouraging patient mobility, provided non-discrimination and proportionality are respected. In conclusion, this paper offers interdisciplinary solutions for reconciling patients' preferences with member states' planning goals, showing that cross-border healthcare cooperation can enhance efficiency, equity, and solidarity within the current EU legal framework.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Institutional assembly under constraints: pathways to universal health coverage in Brazil, Rwanda, and China. 约束下的机构集会：巴西、卢旺达和中国实现全民健康覆盖的途径。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-30 DOI: 10.1017/S1744133126100607

Mengyun Lin, Hanmo Yang, Junjian Yi

{"title":"Institutional assembly under constraints: pathways to universal health coverage in Brazil, Rwanda, and China.","authors":"Mengyun Lin, Hanmo Yang, Junjian Yi","doi":"10.1017/S1744133126100607","DOIUrl":"https://doi.org/10.1017/S1744133126100607","url":null,"abstract":"This paper examines how Brazil, Rwanda, and China have pursued universal health coverage (UHC) beyond classical health system models developed in high-income settings. We introduce the concept of institutional assembly under constraints, offering a complementary framework for understanding UHC pathways in developing countries, where no single trajectory universally applies. Brazil's health system ensures free access at the point of care through tax-based public financing, but limited government spending has produced a dualised system of public and private provision. Rwanda extends coverage to informal and low-income populations through subsidised community-based insurance under strong government stewardship, though the system remains heavily reliant on donor support and household contributions. China employs segmented insurance schemes administered by local governments, integrating payroll-funded coverage for formal-sector workers with publicly subsidised residence-based schemes, achieving rapid scale but embedding regional fragmentation. These cases reflect distinct processes of institutional assembly under constraints, in which health systems are constructed through selective borrowing from classical frameworks combined with institutional innovation rooted in historical legacy, all bounded by fiscal capacity, labour-market structure, and administrative reach.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Policy actors as data integrators: mixing data in tobacco control evaluation and assessment. 作为数据整合者的政策行为者：烟草控制评价和评估中的混合数据。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-27 DOI: 10.1017/S1744133126100619

Claire L Ma, Holly Jarman, Praneetha Vissapragada, Jamie Hartmann-Boyce

{"title":"Policy actors as data integrators: mixing data in tobacco control evaluation and assessment.","authors":"Claire L Ma, Holly Jarman, Praneetha Vissapragada, Jamie Hartmann-Boyce","doi":"10.1017/S1744133126100619","DOIUrl":"https://doi.org/10.1017/S1744133126100619","url":null,"abstract":"Tobacco control policies are complex with the potential for significant health effects. The public health actors and regulators who design, influence, and implement these policies place a high value on the evidence base that underpins them, engaging in scientific and applied debates about how to evaluate the success of existing policies and justify new actions. To investigate the construction of this evidence base, we conducted interviews with 40 individuals involved in formulating, advising, and implementing flavour restrictions for tobacco products. Our interviews inform case studies of six jurisdictions in three US states, Canada, the UK, and the Netherlands. We find that tobacco policy stakeholders, which include regulators and public health personnel, play a vital role as data integrators in the construction of this evidence base: they bring together disparate types and sources of information to create synthetic evaluations of tobacco control policies that incorporate the complexity of the policy environment and differential impacts on population subgroups. Significantly, data integration is not easy to replicate or automate; should these positions be lost due to funding cuts as political priorities shift in the US and globally, the capacity they add to our policymaking and research systems will be difficult to restore.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Redesigning national health service delivery: the case for community-based health service providers in Uganda. 重新设计国家保健服务提供：乌干达社区保健服务提供者的案例。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-21 DOI: 10.1017/S1744133126100644

Megha Rao, Sakshi Mohan, Chrispus Mayora, Elizabeth Ekirapa, Finn McGuire, Brenda Nakimuli, Beatrice Namirembe, Perez Ochanda, Richard Ssempala, Aloysius Ssennyonjo, Paul Revill, Simon Mark Walker, Freddie Ssengooba

{"title":"Redesigning national health service delivery: the case for community-based health service providers in Uganda.","authors":"Megha Rao, Sakshi Mohan, Chrispus Mayora, Elizabeth Ekirapa, Finn McGuire, Brenda Nakimuli, Beatrice Namirembe, Perez Ochanda, Richard Ssempala, Aloysius Ssennyonjo, Paul Revill, Simon Mark Walker, Freddie Ssengooba","doi":"10.1017/S1744133126100644","DOIUrl":"https://doi.org/10.1017/S1744133126100644","url":null,"abstract":"Generating evidence to guide investments in new service delivery platforms remains a major challenge. We applied a linear constrained optimisation model, ex ante, to estimate the potential health impact and trade-offs of integrating community-based providers (CBPs) into Uganda's essential healthcare package. Specifically, we compared a facility-only delivery strategy with an integrated strategy that included Village Health Teams (VHTs) and medicine retailers. Outcomes included potential expansion of the optimal service package, additional net disability-adjusted life years averted, average cost-effectiveness, and maximum cost-effective investment per provider. Integrating CBPs could avert an additional 4.7 million net disability-adjusted life years and expand Uganda's optimal health package by 25 interventions compared to the facility-only strategy. VHTs achieved health gains at $42 per net DALY averted and remained cost-effective at an investment of up to $3,423 per provider; medicine retailers remained cost-effective up to $19,792 per provider. Although current policies restrict CBP utilisation, results indicate substantial potential for health system strengthening. Constrained optimisation provides a systematic approach to quantify the value of new delivery platforms. Our findings provide an evidence-based roadmap for integrating CBPs in Uganda, while the adaptable model itself serves as a replicable tool to inform similar analyses in other settings.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Towards a new compact for health financing in Lao People's Democratic Republic. 制定老挝人民民主共和国卫生筹资新契约。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-16 DOI: 10.1017/S1744133126100620

Praveena Gunaratnam, Sengchanh Kounnavong, Elizabeth A Ashley, Manilung Nalongsack, Tom Drake, Bounserth Keopasith, Mayfong Mayxay

{"title":"Towards a new compact for health financing in Lao People's Democratic Republic.","authors":"Praveena Gunaratnam, Sengchanh Kounnavong, Elizabeth A Ashley, Manilung Nalongsack, Tom Drake, Bounserth Keopasith, Mayfong Mayxay","doi":"10.1017/S1744133126100620","DOIUrl":"https://doi.org/10.1017/S1744133126100620","url":null,"abstract":"Inadequate or ineffective health financing poses a significant challenge to the Government of Lao People's Democratic Republic's goal of achieving universal health coverage by 2030. Here we explore possible application in the Lao context of the Center for Global Development's New Compact approach, including locally-led evidence-informed prioritisation, domestic financing and consolidated supplementary aid. Using WHO's political economy analysis guide we identify opportunities and barriers and propose a road map towards implementation of the New Compact. This includes firstly, increasing local capacity and systems to generate and use evidence in policy and resource allocation decisions, starting with specific use cases related to the Essential Services Health Package and vaccines portfolio. Secondly, shifting available domestic resources to highest priority services, including at the primary health care level, based on deeper understanding of existing funding and where efficiency, cost-effectiveness and equity can be optimised. Thirdly, improving government and donor coordination aligned to national priorities and gradually increasing funds pooling as feasible.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-14"},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Private health insurance in universal health systems: a comparative analysis of Discovery Group's operations in the United Kingdom and South Africa. 全民医疗系统中的私人医疗保险：探索集团在英国和南非业务的比较分析。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-08 DOI: 10.1017/S1744133126100590

Pauline Pearcy, Kay-Leigh Sussman, Rocco Friebel

{"title":"Private health insurance in universal health systems: a comparative analysis of Discovery Group's operations in the United Kingdom and South Africa.","authors":"Pauline Pearcy, Kay-Leigh Sussman, Rocco Friebel","doi":"10.1017/S1744133126100590","DOIUrl":"https://doi.org/10.1017/S1744133126100590","url":null,"abstract":"The growing involvement of private health insurers within universal health systems has intensified debate over their effects on access, equity, and long-term system sustainability. This paper examines the role of private insurers in the United Kingdom (UK) and South Africa through a case study of the Discovery Group, operating across both settings. We explore how private sector engagement shapes health financing, workforce dynamics, service delivery, digital infrastructure, and governance. Our analysis reveals that the impact of private health insurance on universal health systems is fundamentally context-dependent, mediated by institutional frameworks, regulatory environments, and the stage of universal coverage development. We find that private insurers can contribute meaningfully to digital health innovation and behavioural health interventions. However, expansion also introduces significant risks concerning workforce distribution, financing sustainability, and equity of access. These dynamics manifest differently across contexts. In the UK's mature universal system, private insurance plays a supplementary role offering expedited access to care for members. In South Africa's transitional dual system, private insurers more fundamentally shape whether quality care is accessible at all. As health systems evolve, the central challenge lies in developing governance frameworks that enable beneficial private sector contributions while safeguarding equitable access and national health system priorities.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From infodemics to collective resistance: populist mobilisation and health consequences. 从信息流行病到集体抵抗：民粹主义动员和健康后果。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-08 DOI: 10.1017/S1744133126100589

Yuxi Wang

{"title":"From infodemics to collective resistance: populist mobilisation and health consequences.","authors":"Yuxi Wang","doi":"10.1017/S1744133126100589","DOIUrl":"https://doi.org/10.1017/S1744133126100589","url":null,"abstract":"The COVID-19 pandemic unfolded alongside an unprecedented 'infodemic' that reshaped public engagement with science, health, and authority. This study examines how online infodemics translated into collective resistance and influenced population health through political mobilisation. Using structural equation models across six European countries, I conceptualise resistance as a latent construct - captured by residential mobility and protests opposing vaccines, lockdowns, and public health measures linked to populist radical right (PRR) movements - acting as a behavioural bridge between digital information environments and epidemic outcomes. The findings reveal a robust infodemic-resistance-epidemic pathway: greater exposure to infodemic content consistently predicts stronger opposition to non-pharmaceutical interventions (NPIs) and vaccination. This effect is strongest in Germany and Italy, where PRR networks amplified narratives of 'elite overreach' and 'freedom under threat', transforming online discontent into organised mobilisation. In other countries, resistance appears weaker and more pandemic-specific. By integrating informational, political, and epidemiological processes, the analysis shows how epidemics can evolve into politicised collective behaviour that undermines compliance and sustains transmission. The results highlight populist mobilisation as a key amplifier of epidemic risk and suggest that effective responses must rebuild trust, depoliticise health communication, and address structural sources of grievance.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recent trends in private health insurance prices and cost-sharing for hospital-based professional services. 私人医疗保险价格和医院专业服务费用分摊的最新趋势。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-07 DOI: 10.1017/S1744133126100565

Erin Duffy, Christopher Garmon, Bich Ly

{"title":"Recent trends in private health insurance prices and cost-sharing for hospital-based professional services.","authors":"Erin Duffy, Christopher Garmon, Bich Ly","doi":"10.1017/S1744133126100565","DOIUrl":"https://doi.org/10.1017/S1744133126100565","url":null,"abstract":"Numerous consumer protection regulations (e.g., No Surprises Act, Transparency in Coverage) have been implemented recently in the United States that could impact private health insurance prices and patient cost-sharing for many health care services. We use a large multi-payer database of health insurance claims for employer-sponsored health plans in the U.S. to describe the trajectory of prices and patient cost-sharing for the services of clinicians that are likely most affected by these regulatory changes: emergency physicians, radiologists, pathologists, and neonatologists. We find that in-network prices and patient cost-sharing generally increased for all four specialties between 2012 and 2022. However, all four specialties experienced periods of decline in out-of-network prices and cost-sharing, with different starting points, and substantial reductions in prices and cost-sharing from 2021 to 2022, particularly for self-funded health plans. Although we cannot isolate the causal impact of any law or regulation, our results suggest that out-of-network prices and cost-sharing decreased when the NSA and TIC were implemented in 2022, especially for the previously less regulated self-funded health plans. Our results imply that patients who previously struggled with the financial burdens of surprise out-of-network medical bills may have benefited significantly from the recent regulatory changes.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-28"},"PeriodicalIF":2.2,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A closer look at provider market consolidation and the role of private capital. 仔细研究供应商市场整合和私人资本的作用。

IF 2.2 3区医学

Health Economics Policy and Law Pub Date : 2026-07-06 DOI: 10.1017/S1744133126100553

Lauren C Makhoul, Owen Ayers, Shareef Ghanem

{"title":"A closer look at provider market consolidation and the role of private capital.","authors":"Lauren C Makhoul, Owen Ayers, Shareef Ghanem","doi":"10.1017/S1744133126100553","DOIUrl":"https://doi.org/10.1017/S1744133126100553","url":null,"abstract":"This paper examines the relationship between provider market consolidation, setting-of-care (SOC) dynamics, and healthcare costs in the United States. The authors argue that consolidation is not solely a driver of rising unit prices, but also a response to structural pressures, including rising practice costs, stagnant physician reimbursement, and increasing administrative complexity. Drawing on recent empirical analyses, the authors demonstrate that prices vary substantially by SOC, with hospital outpatient departments representing the highest-cost settings. They further show that physician affiliation models are associated with distinct patterns of SOC utilisation. These findings suggest that the relationship between consolidation and cost is not uniform and depends on underlying organisational incentives. The authors contend that current policy discourse around private capital lacks sufficient nuance and risks obscuring more fundamental drivers of cost growth, particularly reimbursement design. They call for a more balanced dialogue and additional research to better understand how consolidation, payment policy, and SOC decision-making interact, concluding that policymakers should prioritise incentives that support clinically appropriate care in lower-cost settings.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0