Journal of Health Economics最新文献_第7页

Free-for-all: Does crowding impact outcomes because hospital emergency departments do not prioritise effectively? 自由散漫：医院急诊科没有有效地确定优先次序，拥挤是否会影响治疗效果？

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-04-10 DOI: 10.1016/j.jhealeco.2024.102881

Igor Francetic, Rachel Meacock, Matt Sutton

{"title":"Free-for-all: Does crowding impact outcomes because hospital emergency departments do not prioritise effectively?","authors":"Igor Francetic, Rachel Meacock, Matt Sutton","doi":"10.1016/j.jhealeco.2024.102881","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2024.102881","url":null,"abstract":"<div><p>Unexpected peaks in volumes of attendances at hospital emergency departments (EDs) have been found to affect waiting times, intensity of care and outcomes. We ask whether these effects of ED crowding on patients are caused by poor clinical prioritisation or a quality-quantity trade-off generated by a binding capacity constraint. We study the effects of crowding created by lower-severity patients on the outcomes of approximately 13 million higher-severity patients attending the 140 public EDs in England between April 2016 and March 2017. Our identification approach relies on high-dimensional fixed effects to account for planned capacity. Unexpected demand from low-severity patients has very limited effects on the care provided to higher-severity patients throughout their entire pathway in ED. Detrimental effects of crowding caused by low-severity patients materialise only at very high levels of unexpected demand, suggesting that binding resource constraints impact patient care only when demand greatly exceeds the ED's expectations. These effects are smaller than those caused by crowding induced by higher-severity patients, suggesting an efficient prioritisation of incoming patients in EDs.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"95 ","pages":"Article 102881"},"PeriodicalIF":3.5,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167629624000262/pdfft?md5=ab502b939376982d8ab3e38ec0dc422e&pid=1-s2.0-S0167629624000262-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140555694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Politics and health care spending in the United States: A case study from the passage of the 2003 Medicare Modernization Act 美国的政治与医疗支出：2003 年《医疗保险现代化法案》通过后的案例研究

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-04-04 DOI: 10.1016/j.jhealeco.2024.102878

Zack Cooper , Amanda Kowalski , Eleanor Neff Powell , Jennifer D. Wu

{"title":"Politics and health care spending in the United States: A case study from the passage of the 2003 Medicare Modernization Act","authors":"Zack Cooper , Amanda Kowalski , Eleanor Neff Powell , Jennifer D. Wu","doi":"10.1016/j.jhealeco.2024.102878","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2024.102878","url":null,"abstract":"<div><p>This paper analyzes the interplay between congressional politics, the actions of the executive branch, and hospitals’ regulated Medicare payments. We focus on the 2003 Medicare Modernization Act (MMA) and analyze a provision in the law – Section 508 – that raised certain hospitals’ regulated payments. We show, via our analysis of the Section 508 program, that Medicare payments are malleable and can be influenced by political dynamics. In the cross-section, hospitals represented by members of Congress who voted “yea” on the MMA were more likely to receive Section 508 payment increases. We interviewed the Secretary of Health and Human Services who oversaw the MMA, and he described how these payment increases were designed to win support for the law. The Section 508 payment increases raised hospitals’ activity and spending. Members of Congress representing recipient hospitals received increased campaign contributions after the Section 508 payment increases were extended. Ultimately, our analysis highlights how Medicare payment increases can serve as an appealing tool for legislative leaders working to win votes for wider pieces of legislation.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"95 ","pages":"Article 102878"},"PeriodicalIF":3.5,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140347401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Competition, quality and integrated health care 竞争、质量和综合医疗保健

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-03-28 DOI: 10.1016/j.jhealeco.2024.102880

Kurt R. Brekke , Luigi Siciliani , Odd Rune Straume

{"title":"Competition, quality and integrated health care","authors":"Kurt R. Brekke , Luigi Siciliani , Odd Rune Straume","doi":"10.1016/j.jhealeco.2024.102880","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2024.102880","url":null,"abstract":"<div><p>Integration of health care services has been promoted in several countries to improve the quality and coordination of care. We investigate the effects of such integration in a model where providers compete on quality to attract patients under regulated prices. We identify countervailing effects of integration on quality of care. While integration makes coordination of care more profitable for providers due to bundled payments, it also softens competition as patient choice is restricted. We also identify circumstances due to asymmetries across providers and/or services under which integration either increases or reduces the quality of services provided. In the absence of synergies, integration generally leads to increases in quality for some services and reductions for others. The corresponding effect on health benefits depends largely on whether integration leads to quality dispersion or convergence across services. If the softening of competition effect is weak, integration is likely to improve quality and patient outcomes.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"95 ","pages":"Article 102880"},"PeriodicalIF":3.5,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167629624000250/pdfft?md5=bc4cb0f07aff368f68a3ef2be3a173e5&pid=1-s2.0-S0167629624000250-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140341998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 demand for skills training among Medicaid home-based caregivers 医疗补助家庭护理人员对技能培训的需求

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-03-26 DOI: 10.1016/j.jhealeco.2024.102877

Christopher J. Cronin , Ethan M.J. Lieber

引用次数: 0

Born on the wrong side of the tracks: Exploring the causal effects of segregation on infant health 生不逢时：探索种族隔离对婴儿健康的因果影响

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-03-20 DOI: 10.1016/j.jhealeco.2024.102876

Hoa Vu , Tiffany L. Green , Laura E.T. Swan

{"title":"Born on the wrong side of the tracks: Exploring the causal effects of segregation on infant health","authors":"Hoa Vu , Tiffany L. Green , Laura E.T. Swan","doi":"10.1016/j.jhealeco.2024.102876","DOIUrl":"10.1016/j.jhealeco.2024.102876","url":null,"abstract":"<div><p>Prior research has found that a high level of residential racial segregation, or the degree to which racial/ethnic groups are isolated from one another, is associated with worsened infant health outcomes, particularly among non-Hispanic (NH) Black infant populations. However, because exposure to segregation is non-random, it is unclear whether and to what extent segregation is causally linked to infant health. To overcome this empirical limitation, we leverage exogenous variation in the placement of railroad tracks in the 19th century to predict contemporary segregation, an approach first introduced by Ananat (2011). In alignment with prior literature, we find that residential segregation has statistically significant associations with negative birth outcomes among Black infant populations in the area. Using OLS methods underestimates the negative impacts of segregation on infant health. We fail to detect comparable effects on health outcomes among NH White infant populations. Further, we identify several key mechanisms by which residential segregation could influence health outcomes among Black infant populations, including lower access to prenatal care during the first trimester, higher levels of anti-Black prejudice, greater transportation barriers, and increased food insecurity. Given that poor birth outcomes have adverse effects on adults’ health and well-being, the findings suggest that in-utero exposure to residential segregation could have important implications for Black–White inequality over the life course.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"95 ","pages":"Article 102876"},"PeriodicalIF":3.5,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Analyzing health outcomes measured as bounded counts 分析以有界计数衡量的健康结果

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-03-17 DOI: 10.1016/j.jhealeco.2024.102875

John Mullahy

引用次数: 0

Pricing above value: Selling to a market with selection problems 定价高于价值：向存在选择问题的市场销售

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-03-01 DOI: 10.1016/j.jhealeco.2024.102868

Jan Boone

引用次数: 0

Effects of nurse visit copayment on primary care use: Do low-income households pay the price? 护士出诊共付额对初级保健使用的影响：低收入家庭是否付出了代价？

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-03-01 DOI: 10.1016/j.jhealeco.2024.102866

Tapio Haaga , Petri Böckerman , Mika Kortelainen , Janne Tukiainen

{"title":"Effects of nurse visit copayment on primary care use: Do low-income households pay the price?","authors":"Tapio Haaga , Petri Böckerman , Mika Kortelainen , Janne Tukiainen","doi":"10.1016/j.jhealeco.2024.102866","DOIUrl":"https://doi.org/10.1016/j.jhealeco.2024.102866","url":null,"abstract":"<div><p>Nurses are increasingly providing primary care, yet the literature on cost-sharing has paid little attention to nurse visits. We employ a staggered difference-in-differences design to examine the effects of adopting a 10-euro copayment for nurse visits on the use of public primary care among Finnish adults. We find that the copayment reduced nurse visits by 9%–10% during a one-year follow-up. There is heterogeneity by income in absolute terms, but not in relative terms. The spillover effects on general practitioner (GP) use are negative but small, with varying statistical significance. We also analyze the subsequent nationwide abolition of the copayment. However, we refrain from drawing causal conclusions from this due to the lack of credibility in the parallel trends assumption. Overall, our analysis suggests that moderate copayments can create a greater barrier to access for low-income individuals. We also provide an example of using a pre-analysis plan for retrospective observational data.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"94 ","pages":"Article 102866"},"PeriodicalIF":3.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0167629624000110/pdfft?md5=f90765e39ac888abea9a4bef3e5877e3&pid=1-s2.0-S0167629624000110-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140000038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Safer sex? The effect of AIDS risk on birth rates 更安全的性行为？艾滋病风险对出生率的影响

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-03-01 DOI: 10.1016/j.jhealeco.2024.102867

Melissa K. Spencer

引用次数: 0

Optimal intertemporal curative drug expenses: The case of hepatitis C in France 最佳时际治疗药物支出：法国丙型肝炎案例

IF 3.5 2区经济学

Journal of Health Economics Pub Date : 2024-02-16 DOI: 10.1016/j.jhealeco.2024.102861

Pierre Dubois, Thierry Magnac

引用次数: 0