Health Economics Review最新文献

{"title":"Universal health coverage in the context of population ageing: catastrophic health expenditure and unmet need for healthcare.","authors":"Shohei Okamoto, Mizuki Sata, Megumi Rosenberg, Natsuko Nakagoshi, Kazuki Kamimura, Kohei Komamura, Erika Kobayashi, Junko Sano, Yuzuki Hirazawa, Tomonori Okamura, Hiroyasu Iso","doi":"10.1186/s13561-023-00475-2","DOIUrl":"10.1186/s13561-023-00475-2","url":null,"abstract":"<p><strong>Background: </strong>Universal health coverage means that all people can access essential health services without incurring financial hardship. Even in countries with good service coverage and financial protection, the progress towards universal health coverage may decelerate or be limited with respect to the growing older population. This study investigates the incidence/prevalence, determinants, and consequences of catastrophic health expenditure (CHE) and unmet need for healthcare and assesses the potential heterogeneity between younger (≤ 64 years) and older people (65 years≤).</p><p><strong>Methods: </strong>Utilising an annual nationally representative survey of Japanese aged 20 years and over, we estimated the incidence of CHE and unmet need for healthcare using disaggregated estimates by household members' age (i.e. ≤64 years vs. 65 years≤) between 2004 and 2020. Using a fixed-effects model, we assessed the determinants of CHE and unmet need along with the consequences of CHE. We also assessed the heterogeneity by age.</p><p><strong>Results: </strong>Households with older members were more likely to have their healthcare needs met but experienced CHE more so than households without older members. The financial consequences of CHE were heterogeneous by age, suggesting that households with older members responded to CHE by reducing food and social expenditures more so than households without older members reducing expenditure on education. Households without older members experienced an income decline in the year following the occurrence of CHE, while this was not found among households with older members. A U-shaped relationship was observed between age and the probability of experiencing unmet healthcare need.</p><p><strong>Conclusions: </strong>Households with older members are more likely to experience CHE with different financial consequences compared to those with younger members. Unmet need for healthcare is more common among younger and older members than among their middle-aged counterparts. Different types and levels of health and financial support need to be incorporated into national health systems and social protection policies to meet the unique needs of individuals and households.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10826197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576854","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":"Cost-effectiveness of edaravone dexborneol versus human urinary kallidinogenase for acute ischemic stroke in China.","authors":"Pingyu Chen, Mengjie Luo, Yanqiu Chen, Yanlei Zhang, Chao Wang, Hongchao Li","doi":"10.1186/s13561-024-00479-6","DOIUrl":"10.1186/s13561-024-00479-6","url":null,"abstract":"<p><strong>Background: </strong>Clinical trials have demonstrated the efficacy of edaravone dexborneol in the treatment of acute ischemic stroke. This study aims to determine the cost-effectiveness of edaravone dexborneol compared with human urinary kallidinogenase from China's healthcare system perspective.</p><p><strong>Methods: </strong>A combination of the decision tree and Markov model was constructed to evaluate the cost-effectiveness of edaravone dexborneol versus human urinary kallidinogenase in the treatment of acute ischemic stroke over a lifetime horizon. Efficacy data were derived from pivotal clinical trials of edaravone dexborneol and human urinary kallidinogenase (TASTE trial and RESK trial, respectively) and adjusted using matching-adjusted indirect comparison. Cost and health utility inputs were extracted from published literature and open databases. One-way deterministic sensitivity and probabilistic sensitivity analyses were performed to examine the robustness of the results.</p><p><strong>Results: </strong>Compared with human urinary kallidinogenase, edaravone dexborneol generated 0.153 incremental quality-adjusted life years (QALYs) with an incremental cost of ¥856, yielding an incremental cost-effectiveness ratio of ¥5,608 per QALY gained under the willingness-to-pay threshold (one-time gross domestic product per capita). Both one-way deterministic sensitivity analysis and probabilistic sensitivity analysis demonstrated the robustness of the base case results.</p><p><strong>Conclusions: </strong>Edaravone dexborneol is a cost-effective treatment choice for acute ischemic stroke patients compared with human urinary kallidinogenase in China.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10823610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571900","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":"Research trends in contemporary health economics: a scientometric analysis on collective content of specialty journals.","authors":"Clara C Zwack, Milad Haghani, Esther W de Bekker-Grob","doi":"10.1186/s13561-023-00471-6","DOIUrl":"10.1186/s13561-023-00471-6","url":null,"abstract":"<p><strong>Introduction: </strong>Health economics is a thriving sub-discipline of economics. Applied health economics research is considered essential in the health care sector and is used extensively by public policy makers. For scholars, it is important to understand the history and status of health economics-when it emerged, the rate of research output, trending topics, and its temporal evolution-to ensure clarity and direction when formulating research questions.</p><p><strong>Methods: </strong>Nearly 13,000 articles were analysed, which were found in the collective publications of the ten most specialised health economic journals. We explored this literature using patterns of term co-occurrence and document co-citation.</p><p><strong>Results: </strong>The research output in this field is growing exponentially. Five main research divisions were identified: (i) macroeconomic evaluation, (ii) microeconomic evaluation, (iii) measurement and valuation of outcomes, (iv) monitoring mechanisms (evaluation), and (v) guidance and appraisal. Document co-citation analysis revealed eighteen major research streams and identified variation in the magnitude of activities in each of the streams. A recent emergence of research activities in health economics was seen in the Medicaid Expansion stream. Established research streams that continue to show high levels of activity include Child Health, Health-related Quality of Life (HRQoL) and Cost-effectiveness. Conversely, Patient Preference, Health Care Expenditure and Economic Evaluation are now past their peak of activity in specialised health economic journals. Analysis also identified several streams that emerged in the past but are no longer active.</p><p><strong>Conclusions: </strong>Health economics is a growing field, yet there is minimal evidence of creation of new research trends. Over the past 10 years, the average rate of annual increase in internationally collaborated publications is almost double that of domestic collaborations (8.4% vs 4.9%), but most of the top scholarly collaborations remain between six countries only.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10809694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546707","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":"An analysis of the trend towards universal health coverage and access to healthcare in Morocco.","authors":"Tarek Drissi Bouzaidi, Aziz Ragbi","doi":"10.1186/s13561-023-00477-0","DOIUrl":"https://doi.org/10.1186/s13561-023-00477-0","url":null,"abstract":"<p><strong>Objective: </strong>We aim in this study to investigate the association between access to health care services and various components of universal health coverage in Morocco, controlling for socioeconomic, demographic, and cultural factors.</p><p><strong>Data and methods: </strong>The study employed a logistic regression method to model the relationship between access to health care as binary outcome variable and health coverage, using the longitudinal data collected from the Household Panel Survey of the National Observatory of Human Development (ONDH) spanning the period from 2013 to 2019.</p><p><strong>Results: </strong>The study reveals a significant association between access to health care services and having medical coverage taking into consideration socioeconomic and demographic characteristics as the main determinants of access to health care services.</p><p><strong>Conclusion: </strong>The study investigates the impact of demographic and socioeconomic factors on medical care utilization. The econometric model reveals that individuals with medical coverage, particularly through AMO and RAMED, are more likely to seek health care services, emphasizing the positive influence of universal health coverage. Additionally, demographic and socioeconomic characteristics such as gender, education, employment, and living environment significantly affect health care-seeking behavior. Urban residents, women, and those with higher standards of living are more inclined to access health care services.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513883","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":"Mechanical ventilation as a major driver of COVID-19 hospitalization costs: a costing study in a German setting.","authors":"Leslie R Zwerwer, Jan Kloka, Simon van der Pol, Maarten J Postma, Kai Zacharowski, Antoinette D I van Asselt, Benjamin Friedrichson","doi":"10.1186/s13561-023-00476-1","DOIUrl":"10.1186/s13561-023-00476-1","url":null,"abstract":"<p><strong>Background: </strong>While COVID-19 hospitalization costs are essential for policymakers to make informed health care resource decisions, little is known about these costs in western Europe. The aim of the current study is to analyze these costs for a German setting, track the development of these costs over time and analyze the daily costs.</p><p><strong>Methods: </strong>Administrative costing data was analyzed for 598 non-Intensive Care Unit (ICU) patients and 510 ICU patients diagnosed with COVID-19 at the Frankfurt University hospital. Descriptive statistics of total per patient hospitalization costs were obtained and assessed over time. Propensity scores were estimated for length of stay (LOS) at the general ward and mechanical ventilation (MV) duration, using covariate balancing propensity score for continuous treatment. Costs for each additional day in the general ward and each additional day in the ICU with and without MV were estimated by regressing the total hospitalization costs on the LOS and the presence or absence of several treatments using generalized linear models, while controlling for patient characteristics, comorbidities, and complications.</p><p><strong>Results: </strong>Median total per patient hospitalization costs were €3,010 (Q1 - Q3: €2,224-€5,273), €5,887 (Q1 - Q3: €3,054-€10,879) and €21,536 (Q1 - Q3: €7,504-€43,480), respectively, for non-ICU patients, non-MV and MV ICU patients. Total per patient hospitalization costs for non-ICU patients showed a slight increase over time, while total per patient hospitalization costs for ICU patients decreased over time. Each additional day in the general ward for non-ICU COVID-19 patients costed €463.66 (SE: 15.89). Costs for each additional day in the general ward and ICU without and with mechanical ventilation for ICU patients were estimated at €414.20 (SE: 22.17), €927.45 (SE: 45.52) and €2,224.84 (SE: 70.24).</p><p><strong>Conclusions: </strong>This is, to our knowledge, the first study examining the costs of COVID-19 hospitalizations in Germany. Estimated costs were overall in agreement with costs found in literature for non-COVID-19 patients, except for higher estimated costs for mechanical ventilation. These estimated costs can potentially improve the precision of COVID-19 cost effectiveness studies in Germany and will thereby allow health care policymakers to provide better informed health care resource decisions in the future.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472666","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":"Upcoding in medicare: where does it matter most?","authors":"Keith A Joiner, Jianjing Lin, Juan Pantano","doi":"10.1186/s13561-023-00465-4","DOIUrl":"10.1186/s13561-023-00465-4","url":null,"abstract":"<p><p>Upcoding in Medicare has been a topic of interest to economists and policy makers for nearly 40 years. While upcoding is generally understood as \"billing for services at higher level of complexity than the service actually pro- vided or documented,\" it has a wide range of definitions within the literature. This is largely because the financial incentives across programs and aspects under the coding control of billing specialists and providers are different, and have evolved substantially over time, as has the published literature. Arguably, the primary importance of analyzing upcoding in different parts of Medicare is to inform policy makers on the magnitude of the process and to suggest approaches to mitigate the level of upcoding. Financial estimates for upcoding in traditional Medicare (Medicare Parts A and B), are highly variable, in part reflecting differences in methodology for each of the services covered. To resolve this variability, we used summaries of audit data from the Comprehensive Error Rate Testing program for the period 2010-2019. This program uses the same methodology across all forms of service in Medicare Parts A and B, allowing direct comparisons of upcoding magnitude. On average, upcoding for hospitalization under Part A represents $656 million annually (or 0.53% of total Part A annual expenditures) during our sample period, while up- coding for physician services under Part B is $2.38 billion annually (or 2.43% of Part B annual expenditures). These numbers compare to the recent consistent estimates from multiple different entities putting upcoding in Medicare Part C at $10-15 billion annually (or approximately 2.8-4.2% of Part C annual expenditures). Upcoding for hospitalization under Medicare Part A is small, relative to overall upcoding expenditures.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10759668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075463","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":"Inequalities in unmet health care needs under universal health insurance coverage in China.","authors":"Jingxian Wu, Yongmei Yang, Ting Sun, Sucen He","doi":"10.1186/s13561-023-00473-4","DOIUrl":"10.1186/s13561-023-00473-4","url":null,"abstract":"<p><strong>Background: </strong>Expanding health insurance is a critical step towards universal health coverage due to its positive effect on reducing unmet health care needs and enhancing equitable access to health care. Despite previous studies on the socioeconomic factors associated with unmet health care needs, few studies have analysed the inequalities in such needs and the impact of universal health insurance coverage on addressing them. This study aimed to measure the contribution of social health insurance (SHI) coverage to inequalities in financially and non-financially constrained unmet health care needs among middle-aged and elderly Chinese adults.</p><p><strong>Methods: </strong>The study data were obtained from the China Health and Retirement Longitudinal Study (2011-2015). A total of 11,592 respondents reporting outpatient care needs and 6320 reporting inpatient care needs were included. The concentration index (CI) was employed to measure the extent of income-related inequalities in unmet health care needs. A decomposition method based on a probit model was used to investigate the contribution of SHI to the inequalities.</p><p><strong>Results: </strong>The incidence rates of unmet outpatient needs due to financial and non-financial constraints were 4.68% and 24.78%, respectively; these rates were 18.69% and 15.73% for unmet inpatient needs. The CIs of unmet outpatient needs due to financial and non-financial constraints were - 0.1872 and 0.0195, respectively; these values were - 0.1558 and 0.0352 for unmet inpatient needs. The percentages of the contribution of SHI to the CIs of financially constrained unmet outpatient and inpatient needs were 0.2639% and 1.8898%, respectively. Moreover, the percentages of the contribution of SHI to the CIs of non-financially constrained unmet outpatient and inpatient needs were - 0.4513% and - 6.4192%, respectively.</p><p><strong>Conclusion: </strong>The universal coverage of SHI in China increased pro-poor inequalities in financially constrained unmet health care needs but decreased pro-rich inequalities in non-financially constrained unmet needs. Additionally, the contribution of SHI to inequalities in financially constrained unmet needs for inpatient care was stronger than that for outpatient care. Policy-makers are advised to introduce favourable reimbursement policies for patients with poor socioeconomic conditions and address both financial and non-financial barriers to promote equitable access to health care for the entire population.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10759442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075462","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":"Cost-effectiveness analysis of parenteral iron therapy compared to oral iron supplements in managing iron deficiency anemia among pregnant women.","authors":"Somen Saha, Devang Raval, Komal Shah, Deepak Saxena","doi":"10.1186/s13561-023-00474-3","DOIUrl":"10.1186/s13561-023-00474-3","url":null,"abstract":"<p><strong>Objective: </strong>This study compared the clinical efficacy and cost-effectiveness of parenteral iron, using intravenous iron sucrose (IVIS) therapy against the standard regimen of oral iron (OI) therapy for managing iron-deficiency anemia (IDA) among pregnant women in a natural primary care setting in Gujarat.</p><p><strong>Design: </strong>A prospective cost-effectiveness study was conducted in natural programme setting wherein 188 pregnant women in their 14 to 18 weeks with moderate and severe anemia women enrolled from two districts of Gujarat, and 142 were followed up until the post-partum phase. The intervention group comprised of 82 participants who were administered IVIS, while the comparison group comprised of 106 participants who were put on OI therapy. Hemoglobin (Hb) levels were measured at periodic intervals, first during enrollment and then during each month of pregnancy period and finally on the 42nd day of the post-natal period.</p><p><strong>Outcome measures: </strong>Change in mean Hb level from baseline was the primary outcome, while the incidence of morbidity and mortality was a secondary outcome measure.</p><p><strong>Results: </strong>The intervention group showed a significant incremental mean change in Hb level from 8.2 g/dl to 11.45 g/dl at the fourth follow-up, while the control group's mean Hb level reduced from 9.99 g/dl to 9.55 g/dl. The discounted cost per beneficiary for IVIS was US$ 87, while that for OI was US$ 49. The incremental cost-effectiveness ratio (ICER) was US$ 9.84, which is 0.049% of India's per capita GDP.</p><p><strong>Conclusion: </strong>IVIS therapy was more clinically effective and cost-effective than OI therapy among pregnant women for management of moderate and severe anemia.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10759557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139075461","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":"A comparative study of bibliometric analysis on old adults' cognitive impairment based on Web of Science and CNKI via CiteSpace.","authors":"Shuyi Yan, Mingli Pang, Jieru Wang, Rui Chen, Hui Liu, Xixing Xu, Bingsong Li, Qinling Li, Fanlei Kong","doi":"10.1186/s13561-023-00470-7","DOIUrl":"10.1186/s13561-023-00470-7","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to analyze the current status, the research hot spots and frontiers of cognitive impairment (CI) on old adults from 2012 to 2022 based on Web of Science (WoS) and China National Knowledge Infrastructure (CNKI) via CiteSpace, and provide new in-sights for researchers.</p><p><strong>Methods: </strong>The articles regarding the old adults' CI in the WoS and CNKI were retrieved from 2012 to 2022. CiteSpaceV.6.1.R4 was used to generate network maps.</p><p><strong>Results: </strong>Four thousand seven hundred thirteen publications and 304 publications from CNKI were retrieved. Overall, from 2012 to 2022, the trend of articles published in WoS and CNKI were increasing. Data from WoS showed that USA, University of California, Petersen RC were the most influential country, institution and author respectively; Folstein MF, Neurology and a diagnosis guideline of mild CI were the most cited author, journal and reference separately; while the keywords of CI could be summarized in 3 aspects: related disease and symptom, risk factors, manifestations. Data from CNKI illustrated that Peking Union Medical College, Dan Liu were the most influential institution and scholar respectively, while the keywords of CI could be summarized in 3 aspects: related disease and symptoms, risk factors, intervention.</p><p><strong>Conclusion: </strong>Articles published on old adults' CI were drawing an increasing amount of attention from 2012 to 2022 both in WoS and CNKI. Keywords of CI in WoS and CNKI both focused on risk factors, related disease and symptom, yet WoS contributed more to the mechanism and CNKI contributed more to the intervention.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470977","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":"Do public healthcare programs make societies more equal? Cross-country evidence on subjective wellbeing.","authors":"Ryan Joseph R Dizon","doi":"10.1186/s13561-023-00467-2","DOIUrl":"10.1186/s13561-023-00467-2","url":null,"abstract":"<p><strong>Background: </strong>Universal health coverage (UHC) aims to provide quality healthcare services and safeguard the population from the financial burden of catastrophic health expenditure. Its primary objectives are to improve longevity and enhance overall quality of life. This study investigates the relationship between UHC and the inequality in subjective wellbeing (SWB) and explores whether public health programs can reduce social inequality. By employing SWB inequality as a measure, we go beyond the conventional income-centric approach to assess social inequality.</p><p><strong>Methods: </strong>The SWB data used in this study are derived from the repeated cross-sectional survey obtained from the European Values Study (EVS) and the World Values Survey (WVS). We adopt an observational study design and employ statistical techniques, such as ordinary least squares, Oaxaca-Blinder decomposition, and the recentered influence function (RIF). The RIF, in particular, allows us to characterise the entire distribution of SWB, rather than focusing on a single point.</p><p><strong>Results: </strong>UHC programs are negatively associated with SWB inequality (-0.070, significant at 5%). The negative association is observed at the 5^th, 50^th, and 75^th percentiles of the SWB distribution, whilst the association becomes positive at the 95^th percentile. UHC programs do not contribute to the SWB inequality gap.</p><p><strong>Conclusions: </strong>UHC programs exhibit an inequality-reduction property when the inequality is not severe or when countries are more equal. However, their effectiveness diminishes in the presence of extreme inequality. Health programs do not contribute to the existing SWB inequality gap between developed and developing countries. Strengthening the two dimensions of the UHC program (i.e., service coverage and financial protection) will ensure better health and wellbeing for all, and potentially foster a more equal and inclusive society.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300304","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}