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UHC in Morocco: a bottom-up estimation of public hospitals' financing size based on a costing database. 摩洛哥的全民医保:基于成本核算数据库的公立医院筹资规模自下而上的估算。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-04-01 DOI: 10.1186/s13561-024-00501-x
El Houcine Akhnif, Abdelouahab Belmadani, Awad Mataria, Maryam Bigdeli
{"title":"UHC in Morocco: a bottom-up estimation of public hospitals' financing size based on a costing database.","authors":"El Houcine Akhnif, Abdelouahab Belmadani, Awad Mataria, Maryam Bigdeli","doi":"10.1186/s13561-024-00501-x","DOIUrl":"10.1186/s13561-024-00501-x","url":null,"abstract":"<p><strong>Background: </strong>Morocco is engaged in a health system reform aimed at generalizing health insurance across the whole population by 2025. This study aims to build a national database of costs at all levels of public hospitals in Morocco and craft this database as a resource for further use in a strategic purchasing system. It also aims at estimating the funding gap and the budget that should be secured for public hospitals in Morocco to fully play their roles in the current ambitious reform.</p><p><strong>Method: </strong>A costing study was implemented in 39 hospitals in 12 regions of Morocco (10 provincial hospitals, 11 regional hospitals, and 18 teaching hospitals). Using the hospital costing approach, we adapted and validated nationally our methodology to generate a database of unit costs based on data from 2019. All perspectives on cost were considered. Data collection was performed by cadres from MoH and facilitated by the WHO country office in Morocco. The production of the cost database allowed the development of a bottom-up estimation of the financing size for public health hospitals.</p><p><strong>Results: </strong>The study showed the feasibility of large-scale costing in the context of Morocco. The ownership of MoH and adherence to the process ensured the high quality of the collected data. There are many differences in unit costs for the same services moving from one hospital to another, which indicates existing inefficiencies. The database will contribute to shaping the strategic purchasing mechanism within the generalized health insurance schemes. The studied hospitals could be used as references to systematically update the billing system for health insurance.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"25"},"PeriodicalIF":2.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337191","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}
引用次数: 0
Preferences in adolescents and young people's sexual and reproductive health services in Nigeria: a discrete choice experiment. 尼日利亚青少年对性健康和生殖健康服务的偏好:离散选择实验。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-03-22 DOI: 10.1186/s13561-024-00497-4
Olujide Arije, Jason Madan, Tintswalo Hlungwani
{"title":"Preferences in adolescents and young people's sexual and reproductive health services in Nigeria: a discrete choice experiment.","authors":"Olujide Arije, Jason Madan, Tintswalo Hlungwani","doi":"10.1186/s13561-024-00497-4","DOIUrl":"10.1186/s13561-024-00497-4","url":null,"abstract":"<p><strong>Background: </strong>Barriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contraceptive use, and patient knowledge and satisfaction.</p><p><strong>Objective: </strong>The objective of this study was to elicit, and derive relative valuations for, attributes of SRH services that adolescents and young people value, and their willingness to pay for these services, in public health facilities.</p><p><strong>Methods: </strong>A discrete-choice-experiment (DCE) that was developed using a mixed methods approach was administered to AYP from Ogun State, Southwest Nigeria. The DCE attributes were: the type of staff; physical environment; health worker attitude; cost; waiting time; contraceptive availability; and opening hours. The choice tasks had two unlabeled alternatives and an opt-out option. Panel mixed logit choice model was used to fit the choice data, along with estimation of willingness to pay (WTP). Also, a latent class logit model was used to detect underlying preference heterogeneity among the respondents. Finally, the uptake of the services in health facilities was investigated by estimating the probabilities for selecting hypothetical health facilities under different scenarios.</p><p><strong>Results: </strong>A total of 859 AYP participated resulting in 6872 choice observations. The physical environment attribute had the highest utility rating relative to the other attributes, followed by preference for a doctor and for a service provider who was open and friendly. The cost and time coefficients were negative, revealing preference for lower cost and shorter waiting time. The latent class model had three classes that varied by their background characteristics. Probability of choosing any of the facility alternatives increased with introduction of more favorable facility characteristics.</p><p><strong>Conclusion: </strong>The pattern of preferences identified are potential targets for service design and delivery optimization that may result in improvements in service acceptability and utilization. These results strengthen the call for involving AYP in decision-making in health interventions for them and developing context-specific SRH programs for AYP in public health facilities.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"24"},"PeriodicalIF":2.4,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10958931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185990","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}
引用次数: 0
Insurance barriers and inequalities in health care access: evidence from dual practice. 保险障碍与获得医疗服务的不平等:来自双重实践的证据。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-03-21 DOI: 10.1186/s13561-024-00500-y
Eva Goetjes, Katharina E Blankart
{"title":"Insurance barriers and inequalities in health care access: evidence from dual practice.","authors":"Eva Goetjes, Katharina E Blankart","doi":"10.1186/s13561-024-00500-y","DOIUrl":"10.1186/s13561-024-00500-y","url":null,"abstract":"<p><strong>Background: </strong>We investigate access disparities in pharmaceutical care among German patients with type 2 diabetes, focusing on differences between public and private health insurance schemes. The primary objectives include investigating whether patients with private health insurance experience enhanced access to antidiabetic care and analyzing whether the treatment received by public and private patients is influenced by the practice composition, particularly the proportion of private patients.</p><p><strong>Methods: </strong>We estimate fixed effect regression models, to isolate the effect of insurance schemes on treatment choices. We utilize data from a prescriber panel comprising 681 physicians collectively serving 68,362 patients undergoing antidiabetic treatments.</p><p><strong>Results: </strong>The analysis reveals a significant effect of the patient's insurance status on antidiabetic care access. Patients covered by private insurance show a 10-percentage-point higher likelihood of receiving less complex treatments compared to those with public insurance. Furthermore, the composition of physicians' practices plays a crucial role in determining the likelihood of patients receiving less complex treatments. Notably, the most pronounced disparities in access are observed in practices mirroring the regional average composition.</p><p><strong>Conclusions: </strong>Our findings underscore strategic physician navigation across diverse health insurance schemes in ambulatory care settings, impacting patient access to innovative treatments.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"23"},"PeriodicalIF":2.4,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10956272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185989","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}
引用次数: 0
The economic effect of financial compensation in China's healthcare system: comprehensive insights regarding supply and demand factors. 中国医疗体系中经济补偿的经济效应:对供需因素的全面洞察。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-03-16 DOI: 10.1186/s13561-024-00496-5
Yi Guo, Xuezhi Hong, Dongmei Li, Qiannan An, Wenwen Fan, Minghe Yang, Luyang Xiao
{"title":"The economic effect of financial compensation in China's healthcare system: comprehensive insights regarding supply and demand factors.","authors":"Yi Guo, Xuezhi Hong, Dongmei Li, Qiannan An, Wenwen Fan, Minghe Yang, Luyang Xiao","doi":"10.1186/s13561-024-00496-5","DOIUrl":"10.1186/s13561-024-00496-5","url":null,"abstract":"<p><strong>Objectives: </strong>We aim to analyse the effects of government subsidies on residents' health and healthcare expenditure from the perspectives of supply and demand.</p><p><strong>Data and methods: </strong>According to the regional division adopted in the data query system of the National Bureau of Statistics, this study divides 31 provinces and cities into three regions: eastern, central, and western. The data used are from public databases, such as the \"China Statistical Yearbook,\" \"China Health Statistical Yearbook,\" and \"Government Final Account Report\". In this study, mathematical model derivation is used to construct a fixed effects model, and an empirical study based on cross-sectional data and general linear regression is conducted. To prevent endogeneity issues, this study introduces instrumental variables and uses 2SLS regression to further analyse the output results.</p><p><strong>Results: </strong>For every 1% increase in supplementary funding on the supply side, the perinatal mortality rate decreases by 1.765%, while for every 1% increase in financial compensation on the demand side, per capita outpatient expenses increase by 0.225% and per capita hospitalization expenses increase by 0.196%. Regarding medical resources, for every 1% increase in the number of beds per 1,000 people, per capita hospitalization expenses decrease by 0.099%. In the central and eastern regions, where economic levels are higher, supply-side government funding is more effective than demand-side funding. In contrast, demand-side funding is more effective in the western region.</p><p><strong>Conclusions: </strong>The roles of multiple influencing factors and significant regional heterogeneity are clarified. Increasing financial compensation to providers positively impacts perinatal mortality but leads to higher per capita outpatient and hospital expenditures. Finally, this study provides targeted policy recommendations and solid theoretical support for policymakers.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"21"},"PeriodicalIF":2.4,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140918","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}
引用次数: 0
Impact of reimbursement systems on patient care - a systematic review of systematic reviews. 报销制度对病人护理的影响--系统综述的系统综述。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-03-16 DOI: 10.1186/s13561-024-00487-6
Eva Wagenschieber, Dominik Blunck
{"title":"Impact of reimbursement systems on patient care - a systematic review of systematic reviews.","authors":"Eva Wagenschieber, Dominik Blunck","doi":"10.1186/s13561-024-00487-6","DOIUrl":"10.1186/s13561-024-00487-6","url":null,"abstract":"<p><strong>Background: </strong>There is not yet sufficient scientific evidence to answer the question of the extent to which different reimbursement systems influence patient care and treatment quality. Due to the asymmetry of information between physicians, health insurers and patients, market-based mechanisms are necessary to ensure the best possible patient care. The aim of this study is to investigate how reimbursement systems influence multiple areas of patient care in form of structure, process and outcome indicators.</p><p><strong>Methods: </strong>For this purpose, a systematic literature review of systematic reviews is conducted in the databases PubMed, Web of Science and the Cochrane Library. The reimbursement systems of salary, bundled payment, fee-for-service and value-based reimbursement are examined. Patient care is divided according to the three dimensions of structure, process, and outcome and evaluated in eight subcategories.</p><p><strong>Results: </strong>A total of 34 reviews of 971 underlying primary studies are included in this article. International studies identified the greatest effects in categories resource utilization and quality/health outcomes. Pay-for-performance and bundled payments were the most commonly studied models. Among the systems examined, fee-for-service and value-based reimbursement systems have the most positive impact on patient care.</p><p><strong>Conclusion: </strong>Patient care can be influenced by the choice of reimbursement system. The factors for successful implementation need to be further explored in future research.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"22"},"PeriodicalIF":2.4,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140917","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}
引用次数: 0
Correction: Universal health coverage in the context of population ageing: catastrophic health expenditure and unmet need for healthcare 更正:人口老龄化背景下的全民医保:灾难性医疗支出和未满足的医疗需求
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-03-11 DOI: 10.1186/s13561-024-00495-6
Shohei Okamoto, Mizuki Sata, Megumi Rosenberg, Natsuko Nakagoshi, Kazuki Kamimura, Kohei Komamura, Erika Kobayashi, Junko Sano, Yuzuki Hirazawa, Tomonori Okamura, Hiroyasu Iso
{"title":"Correction: 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/s13561-024-00495-6","DOIUrl":"https://doi.org/10.1186/s13561-024-00495-6","url":null,"abstract":"&lt;p&gt;&lt;b&gt;Correction to&lt;/b&gt;: &lt;b&gt;&lt;i&gt;Health Econ Rev &lt;/i&gt;&lt;/b&gt;&lt;b&gt;14, 8 (2024)&lt;/b&gt;&lt;/p&gt;&lt;p&gt;https://doi.org/10.1186/s13561-023-00475-2&lt;/p&gt;&lt;p&gt;Following the publication of the original article [1], the license copyright has been corrected to CC BY 3.0 IGO instead of Creative Commons Attribution 4.0 International License. The full correct copyright line should read as below:&lt;/p&gt;&lt;p&gt;© World Health Organization 2024. &lt;b&gt;Open Access&lt;/b&gt; This article is licensed under the terms of the Creative Commons Attribution 3.0 IGO License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the World Health Organization, provide a link to the Creative Commons licence and indicate if changes were made. The use of the World Health Organization’s name, and the use of the World Health Organization’s logo, shall be subject to a separate written licence agreement between the World Health Organization and the user and is not authorized as part of this CC-IGO licence. Note that the link provided below includes additional terms and conditions of the licence. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/3.0/igo/.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Old Copyright Line&lt;/b&gt;:&lt;/p&gt;&lt;p&gt;© World Health Organization 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.&lt;/p&gt;&lt;p&gt;The original article [1] has been updated.&lt;/p&gt;&lt;ol data-track-component=\"outbound reference\"&gt;&lt;li data-counter=\"1.\"&gt;&lt;p&gt;Okamoto S, Sata M, Rosenberg M, et al. Universal health coverage in the context of population ageing: catastrophic health exp","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"44 1","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140097943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Inequalities in unmet health care needs under universal health insurance coverage in China. 更正:中国全民医保下未满足医疗需求的不平等。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-03-09 DOI: 10.1186/s13561-024-00494-7
Jingxian Wu, Yongmei Yang, Ting Sun, Sucen He
{"title":"Correction: 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/s13561-024-00494-7","DOIUrl":"10.1186/s13561-024-00494-7","url":null,"abstract":"","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"19"},"PeriodicalIF":2.4,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10924981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068848","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}
引用次数: 0
Catastrophic health expenditures: a disproportionate risk in uninsured ethnic minorities with diabetes. 灾难性医疗支出:未参保的少数民族糖尿病患者面临的过高风险。
IF 2.4 3区 经济学
Health Economics Review Pub Date : 2024-03-06 DOI: 10.1186/s13561-024-00486-7
Sebastian Linde, Leonard E Egede
{"title":"Catastrophic health expenditures: a disproportionate risk in uninsured ethnic minorities with diabetes.","authors":"Sebastian Linde, Leonard E Egede","doi":"10.1186/s13561-024-00486-7","DOIUrl":"10.1186/s13561-024-00486-7","url":null,"abstract":"<p><strong>Background: </strong>Chargemaster prices are the list prices that providers and health systems assign to each of their medical services in the US. These charges are often several factors of magnitude higher than those extended to individuals with either private or public insurance, however, these list prices are billed in full to uninsured patients, putting them at increased risk of catastrophic health expenditures (CHE). The objective of this study was to examine the risk of CHE across insurance status, diabetes diagnosis and to examine disparity gaps across race/ethnicity.</p><p><strong>Methods: </strong>We perform a retrospective observational study on a nationally representative cohort of adult patients from the Medical Expenditure Panel Survey for the years 2002-2017. Using logistic regression models we estimate the risk of CHE across insurance status, diabetes diagnosis and explore disparity gaps across race/ethnicity.</p><p><strong>Results: </strong>Our fully adjusted results show that the relative odds of having CHE if uninsured is 5.9 (p < 0.01) compared to if insured, and 1.1 (p < 0.01) for patients with a diabetes diagnosis (compared to those without one). We note significant interactions between insurance status and diabetes diagnosis, with uninsured patients with a diabetes diagnosis being 9.5 times (p < 0.01) more likely to experience CHE than insured patients without a diabetes diagnosis. In terms of racial/ethnic disparities, we find that among the uninsured, non-Hispanic blacks are 13% (p < 0.05), and Hispanics 14.2% (p < 0.05), more likely to experience CHE than non-Hispanic whites. Among uninsured patients with diabetes, we further find that Hispanic patients are 39.3% (p < 0.05) more likely to have CHE than non-Hispanic white patients.</p><p><strong>Conclusions: </strong>Our findings indicate that uninsured patients with diabetes are at significantly elevated risks for CHE. These risks are further found to be disproportionately higher among uninsured racial/ethnic minorities, suggesting that CHE may present a channel through which structural economic and health disparities are perpetuated.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"18"},"PeriodicalIF":2.4,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040648","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}
引用次数: 0
End-of-life expenditure on health care for the older population: a scoping review. 老年人口在临终关怀方面的医疗支出:范围界定审查。
IF 2.7 3区 经济学
Health Economics Review Pub Date : 2024-03-01 DOI: 10.1186/s13561-024-00493-8
Ewa Kocot, Azzurra Ferrero, Shibu Shrestha, Katarzyna Dubas-Jakóbczyk
{"title":"End-of-life expenditure on health care for the older population: a scoping review.","authors":"Ewa Kocot, Azzurra Ferrero, Shibu Shrestha, Katarzyna Dubas-Jakóbczyk","doi":"10.1186/s13561-024-00493-8","DOIUrl":"10.1186/s13561-024-00493-8","url":null,"abstract":"<p><strong>Background: </strong>The existing evidence shows that the pattern of health expenditure differs considerably between people at the end-of-life and people in other periods of their lives. The awareness of these differences, combined with a detailed analysis of future mortality rates is one of the key pieces of information needed for health spending prognoses. The general objective of this review was to identify and map the existing empirical evidence on end-of-life expenditure related to health care for the older population.</p><p><strong>Methods: </strong>To achieve the objective of the study a systematic scoping review was performed. There were 61 studies included in the analysis. The project has been registered through the Open Science Framework.</p><p><strong>Results: </strong>The included studies cover different kinds of expenditure in terms of payers, providers and types of services, although most of them include analyses of hospital spending and nearly 60% of analyses were conducted for insurance expenditure. The studies provide very different results, which are difficult to compare. However, all of the studies analyzing expenditure by survivorship status indicate that expenditure on decedents is higher than on survivors. Many studies indicate a strong relationship between health expenditure and proximity to death and indicate that proximity to death is a more important determinant of health expenditure than age per se. Drawing conclusions on the relationship between end-of-life expenditure and socio-economic status would be possible only by placing the analysis in a broader context, including the rules of a health system's organization and financing. This review showed that a lot of studies are focused on limited types of care, settings, and payers, showing only a partial picture of health and social care systems in the context of end-of-life expenditure for the older population.</p><p><strong>Conclusion: </strong>The results of studies on end-of-life expenditure for the older population conducted so far are largely inconsistent. The review showed a great variety of problems appearing in the area of end-of-life expenditure analysis, related to methodology, data availability, and the comparability of results. Further research is needed to improve the methods of analyses, as well as to develop some analysis standards to enhance research quality and comparability.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"17"},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10905877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997835","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}
引用次数: 0
Timing of preventive behavior in the case of a new and evolving health risk: the case of COVID-19 vaccination. 在出现新的、不断变化的健康风险时采取预防行为的时机:COVID-19 疫苗接种案例。
IF 2.7 3区 经济学
Health Economics Review Pub Date : 2024-02-27 DOI: 10.1186/s13561-024-00484-9
Deeksha Gupta, Caroline Rudisill
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