{"title":"Effects of public long-term care insurance on the medical service use by older people in South Korea.","authors":"Yoon-Min Cho, Soonman Kwon","doi":"10.1017/S174413312200024X","DOIUrl":"https://doi.org/10.1017/S174413312200024X","url":null,"abstract":"<p><p>Public long-term care insurance (LTCI), which provides home and institutional care benefits, was introduced in July 2008 in South Korea. This study aims to evaluate the effects of the introduction of LTCI on older people's medical service use, including outpatient visits, inpatient services and longer stays (181 days or longer) in hospitals by implementing a quasi-experiment design with a generalised difference-in-difference method. The results showed that the introduction of LTCI did not change the use of outpatient medical services, although the medical costs of older people who used medical services at least once decreased by 9.4%. For the inpatient services, hospitalisation rates declined by 2.7% as a result of the LTCI. Length of stay and inpatient expenses decreased by 15.6 and 9.5%, respectively. For older people of LTC grade 2, eligible for long-term care facilities (LTCF), prolonged hospitalisation rates decreased by 1.6% due to the LTCI. In conclusion, the introduction of LTCI in South Korea has contributed to decreasing the use of inpatient services and longer stays in hospitals, which suggests that the utilisation of LTCF has become a substitute for some social admissions in hospitals.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 2","pages":"154-171"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9903931","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}
{"title":"Saving children's lives through interventions: a quasi-experimental analysis of GAVI.","authors":"Admasu Asfaw Maruta, Clifford Afoakwah","doi":"10.1017/S1744133122000226","DOIUrl":"https://doi.org/10.1017/S1744133122000226","url":null,"abstract":"<p><p>This study evaluates the impact of the Global Alliance for Vaccines and Immunization (GAVI) on children's health outcomes in developing countries. Using a difference-in-differences identification strategy, we find that GAVI has reduced neonatal, infant and under-five mortality rates. The impact of GAVI on children's health outcomes is larger in countries with lower per capita income. Our findings underscore the relevance of health interventions in improving children's health outcomes in developing economies.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 2","pages":"121-138"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9903926","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}
Michael K Gusmano, Irina Grafova, Rafael Ayoub, Daniel Weisz, Victor G Rodwin
{"title":"Neighborhood inequalities and the decline of infant mortality in São Paulo.","authors":"Michael K Gusmano, Irina Grafova, Rafael Ayoub, Daniel Weisz, Victor G Rodwin","doi":"10.1017/S1744133122000111","DOIUrl":"https://doi.org/10.1017/S1744133122000111","url":null,"abstract":"<p><p>This paper documents changes in infant mortality (IM) rates in São Paulo, Brazil, between 2003 and 2013 and examines the association among neighborhood characteristics and IM. We investigate the extent to which increased use of health care services and improvements in economic and social conditions are associated with reductions in IM. Using data from the Brazilian Census and the São Paulo Secretaria Municipal da Saúde/SMS, we conducted a longitudinal analysis of panel data in all 96 districts of São Paulo for every year between 2003 and 2013. Our regression model includes district level measures that reflect economic, health care and social determinants of IM. We find that investments in health care have contributed to lower IM rates in the city, but the direct effect of increased spending is most evident for people living in São Paulo's middle- and high-income neighborhoods. Improvements in social conditions were more strongly associated with IM declines than increases in the use of health care among São Paulo's low-income neighborhoods. To reduce health inequalities, policies should target benefits to lower-income neighborhoods. Subsequent research should document the consequences of recent changes in Brazil's economic capacity and commitment to public health spending for population health.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 2","pages":"111-120"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9541512","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}
Anna García-Altés, Martin McKee, Luigi Siciliani, Pedro Pita Barros, Lasse Lehtonen, Heather Rogers, Dionne Kringos, Jelka Zaletel, Jan De Maeseneer
{"title":"Understanding public procurement within the health sector: a priority in a post-COVID-19 world.","authors":"Anna García-Altés, Martin McKee, Luigi Siciliani, Pedro Pita Barros, Lasse Lehtonen, Heather Rogers, Dionne Kringos, Jelka Zaletel, Jan De Maeseneer","doi":"10.1017/S1744133122000184","DOIUrl":"https://doi.org/10.1017/S1744133122000184","url":null,"abstract":"<p><p>Every year, over 250,000 public authorities in the European Union (EU) spend about 14% of GDP on the purchase of services, works and supplies. Many are in the health sector, a sector in which public authorities are the main buyers in many countries. When these purchases exceed threshold values, EU public procurement rules apply. Public procurement is increasingly being promoted as a tool for improving efficiency and contributing to better health outcomes, and as a policy lever for achieving other government goals, such as innovation, the development of small and medium-sized enterprises, sustainable green growth and social objectives like public health and greater inclusiveness. In this paper, we describe the challenges that arise within health care systems with public procurement and identify potential solutions to them. We examined the tendering of pharmaceuticals, health technology, and e-health. In each case we identify a series of challenges relating to the complexity of the procurement process, imbalances in power on either side of transactions and the role of procurement in promoting broader public policy objectives. Finally, we recommend several actions that could stimulate better procurement, and suggest a few areas where further EU cooperation can be pursued.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 2","pages":"172-185"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9548792","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}
{"title":"The effects of a sugar-sweetened beverage tax: moving beyond dental health outcomes and service utilisation.","authors":"P Marcin Sowa, Stephen Birch","doi":"10.1017/S1744133122000147","DOIUrl":"https://doi.org/10.1017/S1744133122000147","url":null,"abstract":"<p><p>Despite considerable academic and policy interest in the taxation of sugar-sweetened beverages (SSBs), its extra-health implications remain largely unexplored. We investigated the impact of an SSB tax on school absenteeism due to improved dental health, in a framework that accounted for the distribution of the benefit. We designed a quantitative, decision-analytic model that synthesised existing evidence in the areas of dental epidemiology, public health and economics, and simulated causal mechanisms that lead to changes in school attendance in Australian children and adolescents aged 6-17, in a tax vs no tax scenarios. Introducing a 20% sales tax on SSBs would result in a 0.73% (95% confidence interval: 0.38; 1.10), or 4684 (2412; 7071) days per year nationwide, reduction in school absences attributable to dental health reasons. While positive impacts would be seen across the board, the distribution of benefit was favourable towards boys, older teens and those from lower socio-economic status. Our study highlights the need for, and the viability of, quantifying distributions of direct and indirect consequences of public health policy. Despite modest effect size, the equity profile of SSB tax, the long-lasting benefits of educational gains, and potential synergies with other interventions, make it an attractive option for policymakers to consider.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 2","pages":"139-153"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9903913","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}
Mirella Cacace, Jan Böcken, Kristin Edquist, Tanja Klenk, Mario Martinez-Jimenez, Uwe Preusker, Karsten Vrangbaek, Ruth Waitzberg
{"title":"Coping with COVID-19: the role of hospital care structures and capacity expansion in five countries.","authors":"Mirella Cacace, Jan Böcken, Kristin Edquist, Tanja Klenk, Mario Martinez-Jimenez, Uwe Preusker, Karsten Vrangbaek, Ruth Waitzberg","doi":"10.1017/S1744133122000275","DOIUrl":"https://doi.org/10.1017/S1744133122000275","url":null,"abstract":"<p><p>This contribution examines the responses of five health systems in the first wave of the COVID-19 pandemic: Denmark, Germany, Israel, Spain and Sweden. The aim is to understand to what extent this crisis response of these countries was resilient. The study focuses on hospital care structures, considering both existing capacity before the pandemic and the management and expansion of capacity during the crisis. Evaluation criteria include flexibility in the use of existing resources and response planning, as well as the ability to create surge capacity. Data were collected from country experts using a structured questionnaire. Main findings are that not only the total number but also the availability of hospital beds is critical to resilience, as is the ability to mobilise (highly) qualified personnel. Indispensable for rapid capacity adjustment is the availability of data. Countries with more centralised hospital care structures, more sophisticated concepts for providing specialised services and stronger integration of the inpatient and outpatient sectors have clear structural advantages. A solid digital infrastructure is also conducive. Finally, a centralised governance structure is crucial for flexibility and adaptability. In decentralised systems, robust mechanisms to coordinate across levels are important to strengthen health care system resilience in pandemic situations and beyond.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 2","pages":"186-203"},"PeriodicalIF":1.7,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9602731","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}
{"title":"Performance of Contracts upon the Fundamental Change of Circumstances in Vietnam’s Civil Code 2015","authors":"Duong Quynh Hoa","doi":"10.22158/elp.v6n1p46","DOIUrl":"https://doi.org/10.22158/elp.v6n1p46","url":null,"abstract":"While performance of contracts upon the fundamental change of circumstances is not a new matter in the laws of developed countries, it is newly regulated in the 2015 Civil Code of Vietnam. Only now, Vietnam has had guiding documents from competent state agencies on this matter, so the application in practice is still inconsistent, especially in determining what is the fundamental change of circumstances. Therefore, on the basis of clarifying the concept, legal status and practical application problems, the article will also make some recommendations for the contracting parties as well as the Court in handling the matter of performance of contracts upon the fundamental change of circumstances.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"173 ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72431313","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}
{"title":"Constraints and Challenges to the Legal Relationship: From the Legal Entity to the Animal and the Robot","authors":"Jose Luis Bonifacio Ramos","doi":"10.22158/elp.v6n1p1","DOIUrl":"https://doi.org/10.22158/elp.v6n1p1","url":null,"abstract":"The purpose of this article is to reflect on the constraints placed on the legal relationship, due to the autonomy of the legal person, as well as the possible attribution of rights to animals and robots. Such modifications, by implying the correlative quality of legal subjects, raise new challenges to the legal relationship, bearing in mind, above all, the recent emergence to the re-personalization of civil law.","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"519 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77198459","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}
Idaira Rodriguez Santana, Anne Mason, Nils Gutacker, Panagiotis Kasteridis, Rita Santos, Nigel Rice
{"title":"Need, demand, supply in health care: working definitions, and their implications for defining access.","authors":"Idaira Rodriguez Santana, Anne Mason, Nils Gutacker, Panagiotis Kasteridis, Rita Santos, Nigel Rice","doi":"10.1017/S1744133121000293","DOIUrl":"https://doi.org/10.1017/S1744133121000293","url":null,"abstract":"<p><p>Effective policymaking in health care systems begins with a clear typology of the terminology - need, demand, supply and access to care - and their interrelationships. However, the terms are contested and their meaning is rarely stated explicitly. This paper offers working definitions of need, demand and supply. We draw on the international literature and use a Venn diagram to explain the terms. We then define access to care, reviewing alternative and competing definitions from the literature. We conclude by discussing potential applications of our conceptual framework to help to understand the interrelationships and trade-offs between need, demand, supply and access in health care.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 1","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10616806","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}
{"title":"Learning lessons about lesson-learning: Covid complexity.","authors":"Calum Paton","doi":"10.1017/S1744133122000135","DOIUrl":"https://doi.org/10.1017/S1744133122000135","url":null,"abstract":"<p><p>In the article, 'Learning Lessons from the Covid-19 Pandemic', Powell (2022) rightly implies that there is a profusion of confusion in the 'industry' which has grown up around lesson-learning from the pandemic. His contribution sets out a helpful framework for classifying or making attempts at lesson-learning. He combines the tripartite classification of inadequate approaches to policy-learning and policy transfer developed 30 years ago by Dolowitz and Marsh ('uninformed-incomplete-inappropriate'), which he inverts to produce a classification of approaches which are informed, complete and appropriate, with the framework of 'outcome-mechanism-context' from realistic evaluation. (I use the term realistic rather than realist, as the latter implies an epistemological stance as opposed to what was intended, which is that evaluation takes account of complexity in a realistic manner.) This produces a classification, and possibly an 'ideal type', of informed outcomes, complete mechanisms and appropriate context. Powell rightly implies that no overall conclusion is available from the literature reviewed. He does however imply that different approaches may work in different settings. This is true in one sense but misleading in another. This commentary argues that such 'relativism' is not only dangerous in practice but mistaken in theory.</p>","PeriodicalId":46836,"journal":{"name":"Health Economics Policy and Law","volume":"18 1","pages":"104-110"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10609550","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}