Health Economics Review最新文献

{"title":"The heterogeneous association between education and the adoption of safe food handling practices in Ethiopia.","authors":"Kai Su, Barbara Kowalcyk, Devin LaPolt, Lina Gazu, Silvia Alonso, Binyam Moges Azmeraye, Desalegne Degefaw, Galana Mamo, Dessie Abebaw Angaw, Amete Mihret Teshale, Robert Scharff","doi":"10.1186/s13561-025-00601-2","DOIUrl":"10.1186/s13561-025-00601-2","url":null,"abstract":"<p><strong>Background: </strong>Foodborne disease is a great concern to low- and middle-income countries. To prevent illness and death, intervention strategies need to be implemented across the food safety system and should include promoting the adoption of safe food handling practices. The positive association between education and health has been well-established, and one possible mechanism is that education may improve health by encouraging individuals to adopt more appropriate protective practices. Decisions regarding adoption of these practices may also be influenced by the food safety risks individuals face, the trade-offs they make to maximize utility, or behavior biases which may be correlated with education. This study aims to estimate the heterogeneous association between education and the adoption of safe food handling practices among people facing different levels of food safety risk.</p><p><strong>Methods: </strong>Models were constructed based on the Grossman health model and risk as well as behavior bias theories. Multivariate logistic regression models were estimated to explore the heterogeneous associations using data from a community survey conducted in Ethiopia. Agricultural household status and livestock presence were used as proxies to represent varying risk levels. Average marginal effects were estimated to provide a more accessible interpretation of the results.</p><p><strong>Results: </strong>Results showed that the association between education and certain safe food handling practices was positive among individuals in households assumed to face higher food safety risks, while the association was less pronounced (or even negative) for those facing lower levels of risk. We observed that secondary education attainment was associated with a 20 percentage points increase (p < 0.01) in the probability of washing hands compared to the reference group (illiterate) in agricultural households. However, for non-agricultural households, secondary education was associated with a 10 percentage points decrease (p < 0.05) in probability. Similar patterns were found for washing surface.</p><p><strong>Conclusions: </strong>Education is associated with increased adoption of safe food handling practices among individuals facing higher food safety risks. This has important implications for developing targeted policies focused on individuals most susceptible to foodborne diseases. Future policies aimed at increasing the adoption of safe food handling practices should also integrate individuals' decision-making processes and behavior biases in the context of varying risk levels.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"12"},"PeriodicalIF":2.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476995","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":"Effects of emergency department length of stay on inpatient utilization and mortality.","authors":"Kai-Jie Ma, Yi-Chen Hsu, Wei-Wen Pan, Ming-Hsien Chou, Wei-Sheng Chung, Jong-Yi Wang","doi":"10.1186/s13561-025-00598-8","DOIUrl":"10.1186/s13561-025-00598-8","url":null,"abstract":"<p><strong>Introduction: </strong>The annual increase in emergency department (ED) visits in Taiwan has led to overcrowding in major hospitals and extended patient stays in the ED. International studies suggest that prolonged ED stays may influence healthcare costs and clinical outcomes for hospitalized patients. However, such investigations are scarce in Taiwan. This study aims to explore the effects of ED stay duration on inpatient medical utilization and mortality risk.</p><p><strong>Methods: </strong>This study analyzed data from 42,139 patients at a central Taiwan medical center, using generalized estimating equations (GEE) to evaluate hospital stay duration and costs. Logistic regression assessed mortality risks after hospitalization.</p><p><strong>Results: </strong>GEE analysis showed longer ED stays led to increased hospital stays: patients with 24-48 h in the ED had an additional 2.27 days (P < 0.001), and those with ≥ 48 h had an additional 3.22 days (P < 0.001). Logistic regression indicated higher mortality risks for patients with 24-48 h (OR = 1.73, P < 0.001) and ≥ 48 h (OR = 2.23, P < 0.001) in the ED compared to those with ≤ 2 h. Conversely, longer ED stays were associated with lower hospitalization costs; patients with ≥ 48 h in the ED incurred $1,211 less in costs compared to those with ≤ 2 h (P < 0.001). Logistic regression revealed that longer ED stays were linked to higher mortality risks, with patients staying 24-48 h in the ED showing an OR of 1.726 (P < 0.001) and those with ≥ 48 h an OR of 2.225 (P < 0.001).</p><p><strong>Conclusion: </strong>Prolonged ED stays are associated with longer hospital stays, higher mortality risks, and lower hospitalization costs due to resource consumption in the ED. These findings highlight the need for strategies to reduce ED stay durations to improve patient outcomes and optimize resource use.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"11"},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450027","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 moral dilemma of healthcare service utilization: a perspective from the consolidation of urban and rural resident health insurance policy in China.","authors":"Hui Yuan, Jubo Han, Ruifeng Luo","doi":"10.1186/s13561-025-00591-1","DOIUrl":"10.1186/s13561-025-00591-1","url":null,"abstract":"<p><p>Patient moral hazard is a significant issue in healthcare system reform and a prominent factor affecting the efficiency of healthcare services in China. Based on the consolidation of urban and rural resident health insurance, this paper employs a staggered DID model to analyze the impact of patient moral hazard on the healthcare service utilization. The findings are as follows. First, the healthcare service utilization significantly increases after the consolidation of urban and rural resident health insurance. This conclusion remains robust when subjected to the placebo test, the mitigation of non-random policy effects, and the exclusion of other insurance type interference. Second, after considering the effects of patient healthcare demand release, supplier-induced demand, and collusion between doctors and patients, we find the evidence of patient moral hazard leading to increased healthcare service utilization. Third, patient moral hazard is mainly manifested in the heightened utilization of patients with general illnesses and middle income, indicating the phenomena of \"over-treatment for minor ailments\". The study is limited by its focus on expanded reimbursement in urban and rural insurance consolidation, excluding details like fund management changes. Future research should incorporate more policy details and longer time horizons.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"10"},"PeriodicalIF":2.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442316","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":"Medicare Advantage penetration and the financial distress of rural hospitals.","authors":"Guido Cataife, Siying Liu","doi":"10.1186/s13561-025-00599-7","DOIUrl":"10.1186/s13561-025-00599-7","url":null,"abstract":"<p><strong>Background: </strong>Medicare Advantage (MA) penetration rates have shown an increase in rural areas in the past decade, increasing the bargaining power of MA plans relative to rural hospitals. We study the effect that this increase has had in the revenue of rural hospitals through reductions in the number of inpatient days paid by the plans, which has been reported to be part of the financial bargaining between the two parties.</p><p><strong>Methods: </strong>We use 2014-2020 hospital level data from the American Hospital Association's annual survey and county-level MA penetration rates. We estimate the correlation between MA penetration rates and Medicare and non-Medicare inpatient days using multivariate regressions with hospital and year fixed effects. We use results for urban areas where competition among multiple MA sponsors reduces their individual bargaining power as a falsification test.</p><p><strong>Results: </strong>We find that a 10 percentage points increase in the county-level MA penetration rate is associated with a decrease of 0.87% inpatient days paid to rural hospitals, which unveils a new main factor affecting the fragile finances of rural hospitals. Consistent with our hypothesis, urban hospitals do not exhibit similar effects, underscoring the role of MA plans in rural areas.</p><p><strong>Conclusions: </strong>As MA plans increase their penetration in rural areas, their bargaining power increases relative to rural hospitals. MA plans use this increased bargaining power to reduce the number of paid inpatient days, which creates adverse financial conditions for rural hospitals. Policymakers can safeguard rural hospitals by modifying the fee-for-service prices received by rural hospitals or strengthening the network adequacy criteria of MA plans for rural areas.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"9"},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400225","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":"Correction: The effect of basic public health service equalization on settlement intention of migrant workers in China: the mediating effect model based on subjective feelings.","authors":"Pei Liu, Zhiping Long, Xuemeng Ding","doi":"10.1186/s13561-025-00593-z","DOIUrl":"10.1186/s13561-025-00593-z","url":null,"abstract":"","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"8"},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400255","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":"Risky behaviours and injuries amongst Catalan children with ADHD: does pharmacological treatment improve outcomes?","authors":"Toni Mora, Rowena Jacobs, Jordi Cid, David Roche","doi":"10.1186/s13561-025-00595-x","DOIUrl":"10.1186/s13561-025-00595-x","url":null,"abstract":"<p><strong>Background: </strong>Attention-Deficit/Hyperactivity Disorder (ADHD) prevalence rates are around 5-10% of school-aged children. We test whether medication use for ADHD decreases the likelihood of risky behaviour (sexual behaviour, alcohol, tobacco, and drug consumption) and injuries amongst children aged 6-18.</p><p><strong>Methods: </strong>We use a large administrative dataset for the whole population of Catalan children in Spain who were born between 1998 and 2012. We apply a scale that contains alternative definitions of ADHD so that over-diagnosis is also identified and estimate a count data model to explain the number of visits whilst accounting for confounding. Our identification strategy relies on instrumenting medication using an average indicator of the probability of prescribing medication for each most visited healthcare centre provider.</p><p><strong>Results: </strong>Our results suggest that medication use significantly reduced the number of visits of children diagnosed with ADHD for injuries but not risky behaviour. This finding is robust irrespective of the considered span or the grace period after including ADHD-related comorbidities as controls.</p><p><strong>Conclusion: </strong>In line with previous literature, medication use amongst children with ADHD reduces the prevalence of injuries but not risky behaviours.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"7"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371302","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":"What does it drive the relationship between cardiovascular disease mortality and economic development? New evidence from Spain.","authors":"Carla Blázquez-Fernández, David Cantarero-Prieto","doi":"10.1186/s13561-025-00594-y","DOIUrl":"10.1186/s13561-025-00594-y","url":null,"abstract":"<p><strong>Background: </strong>During the last decades, there has been a great interest on the link between macroeconomic conditions and health. More precisely, many studies had studied as health outcome cardiovascular disease mortality, focusing in different countries, determinants, and using numerous econometric techniques. Due to its importance, in this paper, we analyse cardiovascular disease mortality across the 17 Spanish regions over the period 2002-2019.</p><p><strong>Methods: </strong>In doing so, we estimated several panel data models considering differences by sub-periods of time while also considering gender differences. That is, we transmit a difference on previous evidence by considering a longer period of time and different explanatory factors, so we provide new highlights for Spain.</p><p><strong>Results: </strong>Our empirical results show that: (i) both socioeconomic and environmental factors have a significant importance; (ii) political factors appear not to be significant; and (iii) there exists a Mediterranean (macro-region) cardiovascular disease mortality pattern.</p><p><strong>Conclusions: </strong>These results may have usefulness for cardiovascular disease mortality prevention in Spain.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"6"},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256953","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 privatization decrease the structural efficiency in the Chinese hospital sector?","authors":"Xinju He, Yi Liu","doi":"10.1186/s13561-024-00568-6","DOIUrl":"10.1186/s13561-024-00568-6","url":null,"abstract":"<p><p>This paper examines the resource mismatch in China's healthcare sector from 2010 to 2019. We use structural efficiency to measure the resource mismatch in the healthcare industry (0.2-0.7). We find that an increase in the proportion of private hospitals decreases the healthcare resource mismatch across provincial regions. This ameliorative effect is evident in non-coastal as well as central provinces. In addition, we also find that an increase in the proportion of private hospitals leads to a greater supply of healthcare resources and the number of healthcare services, which in turn better meets the healthcare needs of local residents and decreases the healthcare resource mismatch between regions in each province.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"5"},"PeriodicalIF":2.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075863","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":"Overuse of medical imaging and effects of payer-provider integration: quasi-experimental evidence from Finland.","authors":"Konsta Lavaste","doi":"10.1186/s13561-025-00592-0","DOIUrl":"10.1186/s13561-025-00592-0","url":null,"abstract":"<p><strong>Background: </strong>Healthcare expenditures have risen in middle- and high-income countries. One of the potential contributors is the overuse of diagnostics. I explore whether medical imaging is overused when privately owned clinics in Finland treat patients with voluntary private health insurance (VPHI).</p><p><strong>Methods: </strong>I employ administrative insurance claims data from a major Finnish insurance company, covering 2016-2019, and exploit two market entries of clinics owned by the company in 2017. The underlying assumption is that the insurance company's own clinics had weaker incentives to overuse imaging than other privately owned clinics because the payer and the provider belonged to the same entity. I identify the overuse using the staggered difference-in-differences (DID) strategy, in which I consider patients from cities with a market entry as the treatment group and compare them to patients in other similar cities.</p><p><strong>Results: </strong>I find that the market entries decreased the use of radiography and ultrasound imaging in the treatment of VPHI policyholders, suggesting that private clinics overused these imaging technologies. The more expensive computed tomography (CT) and magnetic resonance imaging (MRI) were, however, not overused.</p><p><strong>Conclusions: </strong>The results show that private clinics in Finland overused some imaging technologies when treating VPHI policyholders. The extent and magnitude of overuse can, however, vary considerably between imaging technologies and medical ailments.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"4"},"PeriodicalIF":2.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053933","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":"Matters arising: cost-utility and cost-effectiveness analysis of disease-modifying drugs of relapsing-remitting multiple sclerosis: a systematic review.","authors":"Carlo Lazzaro, Roberto Bergamaschi, Mauro Zaffaroni, Rocco Totaro, Damiano Paolicelli","doi":"10.1186/s13561-024-00562-y","DOIUrl":"10.1186/s13561-024-00562-y","url":null,"abstract":"<p><strong>Background: </strong>In their interesting systematic review, Gallehzan et al. quoted our article Cost-utility analysis of teriflunomide in naïve vs. previously treated patients with relapsing-remitting multiple sclerosis (RRMS) in Italy. While we are grateful to Gallehzan et al. for their interest in the aim of our research, we would like to clarify some points.</p><p><strong>Methods: </strong>We compare Gallehzan et al.'s statements about our article with the original publication.</p><p><strong>Results: </strong>Gallehzan et al. omitted or misreported some relevant methodological issues and findings presented in our article. As far as methods are concerned, the main omissions were the 7-year time horizon of our study (that falls in between the 5-10 years range mentioned by Gallehzan et al. for other contributions) and the number of simulated RRMS naïve patients (1000). Regarding findings, Gallehzan et al. mistook the 0.480 incremental Quality-Adjusted Life Year gained by RRMS naïve patients vs. RRMS experienced patients on teriflunomide for the base case Incremental Cost-Utility Ratio (ICUR) calculated according to the societal viewpoint. In fact, for both the healthcare sector and societal perspectives adopted in our Markov model-based cost-utility analysis, the baseline results showed teriflunomide in RRMS naïve patients to be strongly dominant (that is, producing more QALYs and being, at the same time, cost-saving) vs. RRMS experienced patients. Therefore, the calculation of the two ICURs was not necessary.</p><p><strong>Conclusions: </strong>As systematic reviews play a remarkable role in disseminating health economic research, a careful description of the methods and the findings reported in the included studies is of paramount importance.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"15 1","pages":"3"},"PeriodicalIF":2.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013626","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}