Health Economics Review最新文献

{"title":"Socioeconomic-related inequities in child immunization: horizontal and vertical dimensions for policy insights.","authors":"M D Azharuddin Akhtar, Indrani Roy Chowdhury, Pallabi Gogoi, M SriPriya Reddy","doi":"10.1186/s13561-024-00566-8","DOIUrl":"10.1186/s13561-024-00566-8","url":null,"abstract":"<p><strong>Background: </strong>The incomplete immunization has potentially exposed vulnerable children, especially from the socioeconomically disadvantage group, to vaccine preventable diseases. The schemes would maximize social benefit only when the immunization is effectively distributed on an equitable principle.</p><p><strong>Method: </strong>The empirical study is based on unit level data from India's National Sample Survey: \"Social Consumption: Health Survey- NSS 75th Round (2017-18) database. The nationwide survey is designed on the stratified multi-stage sampling method with an objective to make the sample representative. The egalitarian equity principle requires that distribution of vaccine should be based on health needs of children, irrespective of their socioeconomic and regional factors and the principle is broadly based on two aspects - horizontal and vertical equity. The horizontal inequity (HI) is a direct form of injustice, when children with equal needs of routine immunisation are treated differentially due to their socioeconomic status, while vertical inequity (VI) is indirect form of injustice when children with differential health needs and risks exposure do not receive appropriately unequal but equitable immunisation. Using Indirect Standardisation Method and Erreygers' Corrected Concentration Index, we measure the degree of horizontal and vertical inequities, and then linearly decompose them to identify the major factors contributing towards the respective indices.</p><p><strong>Conclusion: </strong>Our findings show that incomplete immunization is significantly concentrated among children belonging to poorer households. After controlling for the confounding effects of need factors, the inequity is still significantly pro-poor (i.e., horizontal inequity). The decomposition reveals that lower education, lower consumption and rural habitation are the major factors driving the corresponding inequity. Further, the differential effect of the needs between all and the target groups (at least based on education), is observed, however, is not statistically significant enough to realize inequity (i.e., no vertical inequity). Overall, the inequity is being induced via non-need factors. We further find that community health services (like anganwadi) have contributed towards reducing the inequity in child immunization significantly. The paper highlights the policy recommendation that the child immunisation program should target factors driving HI and need to align their distribution in terms of risks exposures.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"98"},"PeriodicalIF":2.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost of readmissions in hospitals: the case of the Spanish public hospitals.","authors":"Ana Rodriguez-Alvarez, Eder Alonso-Iglesias","doi":"10.1186/s13561-024-00575-7","DOIUrl":"10.1186/s13561-024-00575-7","url":null,"abstract":"<p><strong>Background: </strong>In this paper, we propose a novel model that allows us to understand the effect of hospital readmissions on technology and costs. To do this, we consider that hospitals may experience heterogeneous discharges: on the one hand, discharges corresponding to patients who have completed their healing process in hospital and, on the other hand, discharges resulting from patients who have been discharged too early and are therefore required to be readmitted to hospital. In the first case, discharges involve more resources; in the second case, the patient returns implying an additional use of resources. In tandem, two new issues arise which need to be addressed: a) Does a trade-off exist between the decision to discharge at the finalisation of fully completed treatment or the decision to discharge taken at an earlier stage; b) Readmissions may prove endogenous and if so, their econometric treatment must be considered in order to obtain unbiased results. Our study contributes to the literature by proposing a novel model which estimates the marginal cost of readmissions, thus allowing us to understand the effect of readmission on technology and hospital costs.</p><p><strong>Methods: </strong>To resolve the foregoing concerns, this paper proposes a theoretical and empirical model based on the dual theory, which combines cost and input-oriented distance functions to obtain the marginal cost of readmissions. Our empirical application uses a panel of Spanish public hospitals observed over the period 2002-2016.</p><p><strong>Results: </strong>Results indicate that the treatment required by a patient who is readmitted proves more expensive than keeping the patient under observation for a few extra days in order to achieve a definitive discharge. Moreover, this additional cost follows an increasing temporal trend, especially in times of expansion when the availability of resources is greater.</p><p><strong>Conclusions: </strong>Given that the results indicate that readmissions imply an additional cost for the hospital system, they must be contained. In fact, readmission rates are a significant component of current hospital sector activity improvement strategies. Therefore, knowing the cost which readmission implies is relevant for the design of policies that seek to penalize those hospitals with high readmission rates.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"96"},"PeriodicalIF":2.7,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public funding and young children vaccination coverage: Evidence from Socialist-Oriented Market Economy.","authors":"Tri-Duc Luong, Dao Le-Van","doi":"10.1186/s13561-024-00569-5","DOIUrl":"10.1186/s13561-024-00569-5","url":null,"abstract":"<p><p>This study presents empirical evidence on the impact of public funding on the vaccination rate of children under one-year-old in Vietnam from 2014 to 2019. The research findings indicate that, first, the effect of government funding on the vaccination rate of children is positive after addressing endogeneity, cross-sectional dependence, and heteroscedasticity. Second, this impact is more pronounced in underdeveloped regions, particularly those with low female school enrollment rates and underdeveloped infrastructure. This raises a dilemma for Vietnam in pursuing a comprehensive development strategy, as investment in underdeveloped regions yields significantly lower economic returns. Therefore, this study provides further insight into the effectiveness of public funding in pursuing social objectives while initiating discussions regarding policies to achieve multiple goals as the Socialist-Oriented Market Economy reign.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"95"},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does targeted information impact consumers' preferences for value-based health insurance? Evidence from a survey experiment.","authors":"Tess L C Bardy, Stefan Boes","doi":"10.1186/s13561-024-00573-9","DOIUrl":"10.1186/s13561-024-00573-9","url":null,"abstract":"<p><strong>Objectives: </strong>Value-based insurance design (VBID) aims to direct consumers' preferences by incentivizing the use of high-value care and discouraging the use of low-value care. However, consumers often have limited knowledge of health insurance and the health insurance system, possibly distorting their preferences. In this study, we aim to investigate the impact of specific information treatments on consumers' preferences for VBID.</p><p><strong>Methods: </strong>We implemented an information experiment as part of a representative survey on health insurance literacy and preferences for VBID within Switzerland's choice-based health insurance system. Preferences for VBID were measured through a discrete choice experiment. Cross-sectional data on 6,033 respondents aged 26-75 were analyzed using descriptive statistics and mixed logit regressions.</p><p><strong>Results: </strong>Respondents showed strong preferences for their current health insurance instead of VBID alternatives. A general description of current regulations on cost-sharing, drug disbursement, and monthly premiums significantly increased preferences for VBID (p < 0.01). Pointing respondents specifically to VBID further reduced the opposition against VBID plans. At the same time, there is evidence for anchoring effects in copayments after receiving the information treatments, irrespective of the value of the care.</p><p><strong>Conclusions: </strong>The results of this study highlight that individuals are susceptible to provided information about health insurance when building their preferences for VBID. One potential explanation is limited health insurance literacy, implying that tailored communication strategies may be needed to improve insurance decision-making.</p><p><strong>Jel classification: </strong>I11, I13.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"94"},"PeriodicalIF":2.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of households' willingness to pay for health insurance in Burkina Faso.","authors":"Guiro Jeudi Topan, Noël Thiombiano, Issa Sarambe","doi":"10.1186/s13561-024-00576-6","DOIUrl":"10.1186/s13561-024-00576-6","url":null,"abstract":"<p><strong>Background: </strong>The operationalization of universal health insurance in Burkina Faso represents a significant challenge for health coverage. The willingness of households to pay is a crucial aspect of the process. This highlights the necessity of examining the factors that may explain their willingness to pay. The objective of this study is to analyze the determinants of households' willingness to pay for health insurance in Burkina Faso.</p><p><strong>Methods: </strong>The data used in this study were collected between March and September 2017 in the territory of Burkina Faso, covering six administrative regions. A total of 211 households were surveyed, 71 in urban areas and 140 in rural areas. The Tobit model was employed to analyze the determinants of willingness to pay, with the contingent valuation method used to obtain willingness to pay.</p><p><strong>Results: </strong>The results of the descriptive analysis indicate that households are willing to pay approximately 7,600 F CFA on average for health insurance. The estimation results demonstrate that income has a positive effect on households' willingness to pay. Additionally, the occupation of the head of household and the insurance reimbursement rate are identified as determinants of willingness to pay.</p><p><strong>Conclusion: </strong>The findings of this study indicate that income, the rate of repayment and the occupation of the head of household are the primary determinants of willingness to pay. In terms of implications, it is essential to ensure that the rate of protection is high, which could encourage households to pay the premium. Furthermore, the results of the evaluation suggest that interventions to increase household income may be beneficial.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"93"},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulation of mark-up on medicine prices in Zimbabwe: a pilot survey from 92 community pharmacies in the metropolitan area of Harare.","authors":"Hilma N Nakambale, Penelope Tambama, Varsha Bangalee","doi":"10.1186/s13561-024-00574-8","DOIUrl":"10.1186/s13561-024-00574-8","url":null,"abstract":"<p><strong>Background: </strong>Medicine pricing in the community pharmacy sector in Zimbabwe significantly influences accessibility to health care. In this pilot survey, we investigated how community pharmacies in Zimbabwe apply various mark-up strategies to essential and non-essential medicines, and gathered community pharmacists' perspectives on mark-up regulation.</p><p><strong>Methods: </strong>Using an adapted methodology endorsed by the World Health Organization and Health Action International for studying medicine prices and availability, we conducted a quantitative cross-sectional pilot survey for 46 medicines (31 essential and 15 non-essential) identified using the Zimbabwe Essential Medicines List and classified according to the Vital, Essential, and Non-essential (VEN) tool. We conducted the pilot survey in 92 community pharmacies in the metropolitan area of Harare, Zimbabwe.</p><p><strong>Results: </strong>We gathered a total of 92 responses from 167 distributed questionnaires. The most prevalent mark-up strategy was the cost-plus fixed percentage.The median mark-up for all medicines in the community pharmacies was 60% (interquartile range 50- 82%). We found a statistically significant difference in the median mark-up by essentiality of medicines (p < 0.001), essential medicines had a median mark-up price of 62% while non-essential medicines had a mark-up of 56%. Antipsychotics had the highest mark-up at 82%, while anti-neoplastic medicine had the lowest at 36%. Overall, 55% of the community pharmacists did not support mark-up regulation.</p><p><strong>Conclusion: </strong>Mark-up strategies varied across community pharmacies in the metropolitan area of Harare. Without mark-up regulation, essential medicines remain significantly expensive in Zimbabwe. We recommend mark-up regulation in Zimbabwe's community pharmacy sector and emphasize the effective use of multiple pricing strategies to reduce medicine prices.       .</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"92"},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malaria in the Republic of Guinea 2022-2023: costs associated with the care pathway from the patient's perspective.","authors":"Elhadj Marouf Diallo, Fatoumata Bintou Traore, Alice Langlet, Letitia A Onyango, Marie Blanquet, Bienvenu Salim Camara, Sidikiba Sidibe, Alioune Camara, Laurent Gerbaud","doi":"10.1186/s13561-024-00570-y","DOIUrl":"10.1186/s13561-024-00570-y","url":null,"abstract":"<p><strong>Background: </strong>Access to safe, financial affordable health care is a key factor in reducing health disparities. The malaria is a major public health issue, with significant economic implications in Guinea where the free malaria care services were introduced in 2010. This paper analyzes the costs associated with the care pathway for malaria patients in the Republic of Guinea.</p><p><strong>Methods: </strong>An analysis of the costs associated with malaria disease was conducted using data from a cross-sectional survey on the determinants of malaria care pathway between December 2022 and March 2023. The data were collected in health facilities and at community health workers. According to the patient's perspective, Time-Driven Activity-Based Costing (TDABC) and micro-costing approaches were used to assess the costs associated with care-seeking, cases management, and income loss.</p><p><strong>Results: </strong>A total of 3300 patients were recruited in 60 health facilities. The majority were in urban areas (64.8%). One third of the patients were children under five years old. Over half of the patients or caregivers were without formal education, and most households were headed by husbands (78.5%). The median monthly income of the head of households was $116.0. Furthermore, after diagnosis, 25.5% of cases were uncomplicated malaria, 19.2% were complicated, and 52.2% were malaria associated with other diseases. Globally 41% of cases were on their first care pathway. The costs of care-seeking varied according to type of malaria, from $3.5 and $13.5 respectively for uncomplicated and complicated cases. The median direct costs of case management at health facilities were $7.3 (IQR: $4.1,13.3) for uncomplicated and $30.5 (IQR: 15.7, 51.4) for complicated cases. The total costs associated with the global care pathway differed across types of malaria and age groups, with median costs estimated at $17.4 (IQR: 6.7, 34.8) for uncomplicated cases and $43.5 (IQR: $ 19.7, 74.0) for complicated malaria. A delay in appropriate care-seeking accounted for 19% of the costs incurred by malaria patients in Guinea (p < 0.001).</p><p><strong>Conclusion: </strong>Despite the introduction of free malaria prevention services, malaria patients or their caregivers continue to incur costs and loss of income. An approach to selective, free and affordable flat-rate costs could ensure the financial viability of health facilities and reduce out-of-pocket expenses. The next research will focus on the impact of free selective and flat-rate pricing on out-of-pocket expenses, and the analysis of the perception of the malaria care services by care providers and users.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"91"},"PeriodicalIF":2.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations when applying equity weights within economic evaluation when making drug reimbursement decisions.","authors":"Doug Coyle","doi":"10.1186/s13561-024-00556-w","DOIUrl":"10.1186/s13561-024-00556-w","url":null,"abstract":"<p><p>When decision-makers use economic evaluation to facilitate making decisions about reimbursing whether to reimburse pharmaceuticals within a publicly funded health care system, they may consider whether to prioritise specific patient populations or diseases: e.g., cancer or rare disease. This can be achieved through applying equity weights to outcomes such as QALYs. Decision makers, however, must choose whether equity weights are applied to solely the treatment of a specific disease or to treatments of the patient with the specific disease. Without such clarification, confusion may arise which can hinder the work of those who must make reimbursement recommendations and decisions. This study examines the repercussions of implementation of equity weights. For illustration, two hypothetical case studies relating to a rare disease are considered. The first case study demonstrates that applying equity weights only to the treatment of the rare disease of interest can lead to a patient with that rare disease accruing less benefits at a higher cost to the payer. The second case study demonstrates that if equity weights are applied to the patients who have a specific rare disease, then funding of a treatment for a common disease may be restricted only to those patients for whom treatment is more costly and less effective. As discussions continue with respect to applying equity weights within economic evaluation, it is important that the repercussions outlined are recognised.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"90"},"PeriodicalIF":2.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trastuzumab plus chemotherapy versus chemotherapy alone in HER2-positive gastric cancer treatment in Iran: a cost-effectiveness analysis.","authors":"Sara Kaveh, Nashmil Ghadimi, Amirhossein Zarei Alvar, Kamran Roudini, Rajabali Daroudi","doi":"10.1186/s13561-024-00571-x","DOIUrl":"10.1186/s13561-024-00571-x","url":null,"abstract":"<p><strong>Background: </strong>Combining Trastuzumab with chemotherapy for HER2-positive gastric cancer shows treatment promise but may raise costs. We aimed to evaluate the cost-effectiveness of combining Trastuzumab with chemotherapy for HER2-positive gastric cancer treatment in Iran.</p><p><strong>Methods: </strong>We employed a partitioned survival model (PSM) to evaluate the cost-effectiveness of trastuzumab plus chemotherapy versus chemotherapy alone. The PSM framework included three distinct health states: progression-free, post-progression, and death. Clinical data, including overall survival and progression-free survival rates, were derived from the ToGA trial, a randomized controlled study. A bottom-up approach was used to calculate costs by considering drug costs, adverse event management costs and other disease management costs separately for the progression-free and post-progression states. The analysis was conducted from the Iranian healthcare system's perspective, considering direct medical costs. We performed a cost-effectiveness analysis to determine the optimal strategy by comparing the incremental cost-effectiveness ratio (ICER) to Iran's cost-effectiveness threshold, set at one to three times the GDP per capita. Additionally, we conducted sensitivity analyses to assess the robustness of our findings.</p><p><strong>Results: </strong>Both FOLFOX-based regimens were strongly dominated. In comparison, the CAPOX regimen cost $2,811.11 for 0.75 QALYs. Adding Trastuzumab to CAPOX increased the cost to $6,128 and improved effectiveness to 0.92 QALYs, resulting in an ICER of $19,089.94 per QALY, which is between 2 and 3 times the GDP per capita in 2022.</p><p><strong>Conclusion: </strong>The addition of trastuzumab to chemotherapy regimens improved clinical outcomes in HER2-positive gastric cancer patients. From an economic perspective, the CAPOX regimen is the most cost-effective option when considering a cost-effectiveness threshold of up to two times Iran's GDP per capita. However, when the threshold increases to three times the GDP per capita, the CAPOX + Trastuzumab regimen becomes the preferred choice. These findings provide valuable insights for healthcare policymakers in Iran.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"89"},"PeriodicalIF":2.7,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can public hospital reform reduce medical resource mismatches? Evidence from China.","authors":"Yulin Chai, Ying Liu, Shanna Li, Linlin Zhang, Dan Chen, Wenqiang Yin, Lin Guo","doi":"10.1186/s13561-024-00567-7","DOIUrl":"https://doi.org/10.1186/s13561-024-00567-7","url":null,"abstract":"<p><strong>Background: </strong>The mismatch of medical resources is a significant issue in global healthcare, undermining both service accessibility and system efficiency. In China, despite the implementation of the \"Healthy China\" strategy, persistent mismatches remain due to factors such as industrialization, urbanization, and population aging. This study empirically evaluates the impact of Public Hospital Reform (PHR) on mitigating these mismatches.</p><p><strong>Methods: </strong>A Difference-in-Differences (DD) approach is applied to panel data from 300 cities spanning 2010 to 2021, using the phased implementation of PHR as a quasi-natural experiment. This allows for a comparative analysis of changes in resource allocation between cities that adopted the reform and those that did not. Quantile regression assesses the effects of PHR across varying levels of resource mismatch, while mechanism tests investigate how PHR influences mismatches through cost reduction and supply expansion.</p><p><strong>Results: </strong>PHR is found to reduce medical resource mismatches by 13.9%, primarily driven by cost reductions and increased resource supply. The effects are more pronounced at both lower and higher levels of mismatch, with a limited impact at mid-levels. Furthermore, the reform's effectiveness diminishes as it is extended to more cities, suggesting a potential saturation effect.</p><p><strong>Conclusions: </strong>This study demonstrates that PHR significantly alleviates medical resource mismatches in China. The findings underscore the need to focus on cost control and resource supply in future healthcare reforms, providing key insights for policymakers in developing countries facing similar healthcare resource challenges.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"88"},"PeriodicalIF":2.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}