Public satisfaction with health system coverage, empirical evidence from SHARE data
AbstractPeople ’s satisfaction with the health system, including the coverage provided, has been a concern for some years now but research into the main explanatory factors is in progress. This work focuses on European countries plus Israel, using the SHARE database to find what determines people’s satisfactio n with the basic coverage provided by the health system of each country. On top of the usual individual socioeconomic characteristics, other explanatory factors were also considered. These include, at individual level, trust in others, political positioning, and risk aversion; at country level, they inclu...
Source: International Journal of Health Care Finance and Economics - February 14, 2020 Category: Health Management Source Type: research

Effects of pay-for-performance on prescription of hypertension drugs among public and private primary care providers in Sweden
This study exploits policy reforms in Swedish primary care to examine the effect of pay-for-performance (P4P) on compliance with hypertension drug guidelines among public and private health care providers. Using provider-level outcome data for 2005 –2013 from the Swedish Prescription Register, providers in regions using P4P were compared to providers in other regions in a difference-in-differences analysis. The results indicate that P4P improved guideline compliance regarding prescription of angiotensin converting enzyme inhibitors and angio tensin receptor blockers. The effect was mainly driven by private providers,...
Source: International Journal of Health Care Finance and Economics - January 20, 2020 Category: Health Management Source Type: research

Competition and market structure in the dental industry
AbstractWe use Survey of Dental Practice data from 1983 to 2012 to examine market power of dentists and hygienists in private practice. Our findings are consistent with a dental market wherein practices use hygienist services as a “loss leader” in order to steer patients into more lucrative dental services, which exhibit the ability to markup price above marginal cost. Both dental care exhibits an elasticity of demand of roughly − 0.2, while hygienist care exhibits and elasticity of demand of nearly − 0.6. Another theme that emerged from our findings is the evidence for significant eco...
Source: International Journal of Health Care Finance and Economics - January 8, 2020 Category: Health Management Source Type: research

Quality information disclosure and health insurance demand: evidence from VA hospital report cards
This study examines the effect of public reporting of quality information on the demand for public insurance. In particular, we examine the effect of the introduction of Veterans Affairs (VA) hospital quality report cards in 2008. Using data from the Current Population Survey in 2005 –2015, we find that new information about the quality of a VA hospital had a significant effect on VA coverage among veterans living in the same Metropolitan Statistical Area (MSA). Despite the significant effect on VA coverage, the quality report did not have a spillover effect on veterans’ lab or supply. Moreover, updated quality...
Source: International Journal of Health Care Finance and Economics - November 14, 2019 Category: Health Management Source Type: research

Health expenditure, human capital, and economic growth: an empirical study of developing countries
This study provides reliable analysis and can be used by developing countries to maintain a long-term sustainable social security system. (Source: International Journal of Health Care Finance and Economics)
Source: International Journal of Health Care Finance and Economics - October 21, 2019 Category: Health Management Source Type: research

Consolidation in the dental industry: a closer look at dental payers and providers
AbstractWe examine the effect of commercial dental insurance concentration on the size of dental practices, the decision of dentists to own a practice, and the choice of dentists to work at a dental management service organization —a type of corporate group practice that has become more prevalent in the United States in recent years. Using 2013–2015 dentist-level data from the American Dental Association, county-level data on firms and employment from the United States Census, and commercial dental insurance market concen tration data from FAIR Health®, we find a modest effect of dental insurance market con...
Source: International Journal of Health Care Finance and Economics - October 3, 2019 Category: Health Management Source Type: research

The individual welfare effects of the Affordable Care Act for previously uninsured adults
AbstractThe Affordable Care Act (ACA) improved welfare by expanding, subsidizing, and standardizing healthcare coverage. At the same time, the law also penalizes the remaining uninsured and establishes a benchmark private policy that charges premiums and cost-sharing expenses in the non-group market. This paper introduces a conceptual and empirical framework for evaluating the net effects of ACA coverage expansions for the individual welfare of previously uninsured adults. Using restricted-access data from the 2010 –2012 Medical Expenditure Panel Survey, I evaluate the short-term welfare effect as a function of healt...
Source: International Journal of Health Care Finance and Economics - September 10, 2019 Category: Health Management Source Type: research

Health expenditure, longevity, and child mortality: dynamic panel data approach with global data
In this study, effects of public and private health expenditures on life expectancy at birth and infant mortality are analysed on a global scale with 195 countries in the years 1995 –2014. The global data set is divided into country categories according to growth in life expectancy, decrease in infant mortality rate, and level of gross national income per capita. Some new dynamic panel model estimators, argued to be more efficient with high persistence series and predetermina tion compared to popular but complexGMM estimators, show that public health expenditures are generally more health-promoting than private expen...
Source: International Journal of Health Care Finance and Economics - September 6, 2019 Category: Health Management Source Type: research

Health expenditure and gross domestic product: causality analysis by income level
This study examines if the direction of causality and income elasticity of health expenditure varies with income level. It uses the 1995 –2014 panel data of 161 countries divided into four income groups. Unit root, cointegration and causality tests were employed to examine the relationship between GDP and health expenditure. Impulse-response functions and forecast-error variance decomposition tests were conducted to measure the res ponsiveness of health expenditure to changes in GDP. Finally, the common correlated effects mean group method was used to examine the income elasticity of health expenditure. Findings show...
Source: International Journal of Health Care Finance and Economics - July 16, 2019 Category: Health Management Source Type: research

Reasons for unmet needs for health care: the role of social capital and social support in some western EU countries
AbstractThis paper focuses on the demand side factors that determine access to health care and analyses the issues of unmet needs for health care and the reasons thereof in western EU countries. A probit model is estimated from a sample of the whole population, accounting for the possibility of individual selection in unmet needs for health care (UN) (selection equation). Expanded probit models (including the inverse Mills ratio) are then used on the reasons for unmet needs (RUN) with social capital and social support as determinants and using the European Union Statistics on Income and Living Conditions dataset from 2006....
Source: International Journal of Health Care Finance and Economics - July 11, 2019 Category: Health Management Source Type: research

Motivation structures of blood donation: a means-end chain approach
AbstractUnderstanding blood donation behaviours is pivotal to recruiting and retaining blood donors. Despite rich literature, this is the first study investigating the content and structure of motivations that underlie blood donation using a means-end chain approach. Based on soft laddering interviews with 227 respondents (31 first-time blood donors and 196 repeat blood donors) in the Klang Valley of Malaysia, we identified that their blood donation was primarily driven by the attribute ‘help people’, the consequences ‘increase blood supply’ (as perceived by first-time blood donors) and ‘indir...
Source: International Journal of Health Care Finance and Economics - June 24, 2019 Category: Health Management Source Type: research

The distributive fairness of out-of-pocket healthcare expenditure in the Russian Federation
This article examines the effects of socioeconomic position and urban –rural settlement on the distribution of out-of-pocket expenditure (OPE) for health in the Russian Federation. Data comes from 2005 to 2016 waves of the Russian Longitudinal Monitoring Survey. Concentration index reflects changes in the distribution of OPE between the worse-off and the better-off Russians over a 12-year period. Finally, unconditional quantile regression—a recentred influence function approach estimates differential impacts of covariates along the distribution of OPE. OPE is concentrated amongst the better-off Russians in 2016...
Source: International Journal of Health Care Finance and Economics - June 13, 2019 Category: Health Management Source Type: research

The impact of hospital-acquired infections on the patient-level reimbursement-cost relationship in a DRG-based hospital payment system
AbstractHospital-acquired infections (HAIs) are a common complication in inpatient care. We investigate the incentives to prevent HAIs under the German DRG-based reimbursement system. We analyze the relationship between resource use and reimbursements for HAI in 188,731 patient records from the University Medical Center Freiburg (2011 –2014), comparing cases to appropriate non-HAI controls. Resource use is approximated using national standardized costing system data. Reimbursements are the actual payments to hospitals under the G-DRG system. Timing of HAI exposure, cost-clustering within main diagnoses and risk-adjus...
Source: International Journal of Health Care Finance and Economics - June 5, 2019 Category: Health Management Source Type: research

Using disability adjusted life years to value the treatment of thirty chronic conditions in the U.S. from 1987 to 2010: a proof of concept
AbstractHealth care spending in the U.S. grew two trillion dollars from 1987 to 2010, a 400% increase, but our understanding of the value of that increase is limited. In this paper we estimate the net value of spending for thirty chronic diseases between 1987 and 2010 by assigning a monetary value to changes in health outcomes and relating it to the costs of treating each disease. Changes in health outcomes are measured using a newly-available time series of disability adjusted life years (DALYs) data from the Institute for Health Metrics and Evaluation. Spending on treatments are determined using health care expenditure d...
Source: International Journal of Health Care Finance and Economics - April 8, 2019 Category: Health Management Source Type: research

Who cares about a label? The effect of pediatric labeling changes on prescription drug utilization
AbstractOff-label drug use is common, particularly in pediatric populations. In response, legislation requires and/or provides financial incentives for drug manufacturers to perform pediatric clinical trials. Using New Hampshire ’s all-payer claims database, we examine the impact of subsequent changes to drug labeling on pediatric drug utilization. To separate changes in utilization induced by labeling changes from other temporal factors, we estimate difference-in-differences models that compare utilization trends for ped iatric patients to those of adults. We estimate that establishing safety and efficacy increases ...
Source: International Journal of Health Care Finance and Economics - March 18, 2019 Category: Health Management Source Type: research

Impact of medicaid policy changes on immigrant parents
AbstractDuring the 1990s and early 2000s many states expanded Medicaid eligibility for parents particularly after the 1996 welfare reform. At the same time, welfare reform also put in place policies that limited the eligibility of recent immigrants for public programs including Medicaid. This paper evaluates the effects of these changes in Medicaid eligibility policy on the private and public health insurance coverage of immigrants as well as the overall insurance rate. It also looks at the effect on health care use and measures of health status. The findings indicate a significant increase in Medicaid coverage and an incr...
Source: International Journal of Health Care Finance and Economics - January 31, 2019 Category: Health Management Source Type: research

Attitudes to reform: Could a cooperative health insurance scheme work in Russia?
AbstractAs for all health systems, in Russia, the demand for medical care is greater than its health system is able to guarantee the supply of. In this context, removing services from the state guaranteed package is an option that is receiving serious consideration. In this paper, we examine the attitudes of the Russian population to such a reform. Exploiting a widely-used methodology, we explore the population ’s willingness to pay for cooperative health insurance. Distinguishing between socioeconomic and demographic factors, health-related indicators and risk aversion we find, consistent with other literature, posi...
Source: International Journal of Health Care Finance and Economics - January 22, 2019 Category: Health Management Source Type: research

Do government audits reduce dengue? Estimating the impact of federal monitoring lotteries program on dengue incidence
AbstractThe paper examines the relationship between the supervision carried out in the municipalities by the main Brazilan supervisory institution (Controladoria Geral da Uni ão—CGU, in portuguese) and the incidence of dengue cases in them. Since the audited municipalities were randomized, this allows the identification of a control group that adequately represents the counterfactual of the treated group. The sample was composed of all municipalities that could be selected for that CGU inspection cycle, that is, 1520 municipalities, of which 70 were drawn and therefore belong to the study treatment group. We i...
Source: International Journal of Health Care Finance and Economics - December 17, 2018 Category: Health Management Source Type: research

The impact of Medicaid expansion on employer provision of health insurance
AbstractUsing the 2010 –2015 Medical Expenditure Panel Survey-Insurance Component, this study investigates the effect of the Affordable Care Act’s Medicaid eligibility expansion on four employer-sponsored insurance (ESI) outcomes: offers of health insurance, eligibility, take-up, and the out-of-pocket premium paid by employees for single coverage. Using a difference-in-differences identification strategy, we cannot reject the hypothesis of a zero effect of the Medicaid eligibility expansion on an establishment’s probability of offering ESI, the percentage of an establishment’s workforce that takes u...
Source: International Journal of Health Care Finance and Economics - December 15, 2018 Category: Health Management Source Type: research

Consumption of salt rich products: impact of the UK reduced salt campaign
We present an econometric analysis of purchase data to assess the effectiveness of the Food Standard Agency’s (FSA) ‘reduced salt campaign’. We adopt a general approach to determining struct ural breaks in the time series of purchase data, using unit root tests whereby structural breaks are endogenously determined from the data. We find only limited evidence supporting the effectiveness of the FSA’s reduced salt campaign. Our results support existing findings in the literature that ha ve used alternative methodologies to examine the impact of information campaigns on consumer choice of products with...
Source: International Journal of Health Care Finance and Economics - December 14, 2018 Category: Health Management Source Type: research

Genetic variation in health insurance coverage
AbstractWe provide the first investigation into whether and how much genes explain having health insurance coverage or not and possible mechanisms for genetic variation. Using a twin-design that compares identical and non-identical twins from a national sample of US twins from the National Survey of Midlife Development in the United States, we find that genetic effects explain over 40% of the variation in whether a person has any health coverage versus not, and nearly 50% of the variation in whether individuals younger than 65 have private coverage versus whether they have no coverage at all. Nearly one third of the geneti...
Source: International Journal of Health Care Finance and Economics - November 12, 2018 Category: Health Management Source Type: research

Private equity ownership and nursing home quality: an instrumental variables approach
AbstractSince the 2000s, private equity (PE) firms have been actively acquiring nursing homes (NH). This has sparked concerns that with stronger profit motive and aggressive use of debt financing, PE ownership may tradeoff quality for higher profits. To empirically address this policy concern, we construct a panel dataset of all for-profit NHs in Ohio from 2005 to 2010 and link it with detailed resident-level data. We compare the quality of care provided to long-stay residents at PE NHs and other for-profit (non-PE) NHs. To account for unobservable resident selection, we use differential distance to the nearest PE NH relat...
Source: International Journal of Health Care Finance and Economics - October 24, 2018 Category: Health Management Source Type: research

Health care expenditures and GDP in Latin American and OECD countries: a comparison using a panel cointegration approach
We present conclusive evidence of the cross-country dependence of the analyzed series, and consequently we used panel unit root tests, panel cointegration tests, and long-run estimates that are robust to such dependence. Specifically, we use the CIPS panel unit root te st and the panel Common Correlated Effects estimator. We also show that the results obtained by mistakenly using methods that assume cross-section independence are unstable. (Source: International Journal of Health Care Finance and Economics)
Source: International Journal of Health Care Finance and Economics - September 28, 2018 Category: Health Management Source Type: research

The effects of the economic recession on spending on private health insurance in Spain
AbstractThe paper seeks to analyse the evolution of expenditure on private health insurance (PHI) in Spain. We consider the factors that influence PHI demand and level of spending before and during the economic recession, along with identifying the effect of the recession on these factors. The data is obtained from the Spanish Family Budget Survey (SFBS) for 2006 and 2012. Due to the data structure and the demand function, the analysis is performed using a sample selection model in order to avoid sample selection bias. We estimate three models: a pre-recession model (2006), a model for the recession period (2012) and a thi...
Source: International Journal of Health Care Finance and Economics - September 22, 2018 Category: Health Management Source Type: research

Is health care a luxury or necessity good? Evidence from Asian countries
This study investigates long run relationship between health care expenditure and real income in fifteen selected Asian countries over the period 1995 –2014 using the panel cointegration tests and controlling for cross-sectional dependence through unobserved common correlated factors (UCFs). The results show that health care expenditure and income are cointegrated. It is found that the income elasticity scales down when UCFs are controlled, whic h implies that ignoring UCFs produces biased and inconsistent estimates. The Mean Group and Common Correlated Effects Mean Group estimates reveal that long run income elastic...
Source: International Journal of Health Care Finance and Economics - September 21, 2018 Category: Health Management Source Type: research

Critical Illness Insurance to alleviate catastrophic health expenditures: new evidence from China
AbstractCurrently, a high percentage of China ’s households face financial catastrophe as a direct result of excessive out-of-pocket (OOP) health expenditures. To alleviate this, China has set up the Critical Illness Insurance (CII) program since 2012. However, the current CII is still in an experimental phase and tested in 8 (out of 34) prov inces, which has not been proved to be effective. This paper develops a health financing system for reducing catastrophic medical spending using a two-layer model for CII. This model partly compensates expenses exceeding the cap line of the Social Resident Basic Medical Insuranc...
Source: International Journal of Health Care Finance and Economics - September 21, 2018 Category: Health Management Source Type: research

Is health care a luxury or necessity good? Evidence from Asian countries
This study investigates long run relationship between health care expenditure and real income in fifteen selected Asian countries over the period 1995 –2014 using the panel cointegration tests and controlling for cross-sectional dependence through unobserved common correlated factors (UCFs). The results show that health care expenditure and income are cointegrated. It is found that the income elasticity scales down when UCFs are controlled, whic h implies that ignoring UCFs produces biased and inconsistent estimates. The Mean Group and Common Correlated Effects Mean Group estimates reveal that long run income elastic...
Source: International Journal of Health Care Finance and Economics - September 21, 2018 Category: Health Management Source Type: research

Impact of commercial over-reimbursement on hospitals: the curious case of central Indiana
AbstractAn employer coalition in Indiana sponsored a study by the Rand Corporation examining commercial insurer payments as a percent of Medicare. The employers sought to understand why their health care costs were high and increasing. The study showed that, on average, their insurer was paying three times what Medicare pays for the same services. In this, a follow-up study, we demonstrate that these high payments resulted in very high profit margins for central Indiana ’s major health systems, along with elevated costs and poor performance on key efficiency measures. We also see indications that hospitals appear to ...
Source: International Journal of Health Care Finance and Economics - September 6, 2018 Category: Health Management Source Type: research

Impacts of chronic non-communicable diseases on households ’ out-of-pocket healthcare expenditures in Sri Lanka
This article examines the effects of chronic non-communicable diseases (NCDs) on households ’ out-of-pocket health expenditures in Sri Lanka. We explore the disease specific impacts on out-of-pocket health care expenses from chronic NCDs such as heart diseases, hypertension, cancer, diabetics and asthma. We use nationwide cross-sectional household income and expenditure survey 2012/2013 data compiled by the department of census and statistics of Sri Lanka. Employing propensity score matching method to account for selectivity bias, we find that chronic NCD affected households appear to spend significantly higher out-o...
Source: International Journal of Health Care Finance and Economics - September 1, 2018 Category: Health Management Source Type: research

Do coverage mandates affect direct-to-consumer advertising for pharmaceuticals? Evidence from parity laws
AbstractDirect-to-consumer advertising (DTCA) for prescription drugs is a relatively unique feature of the US health care system and a source of tens of billions of dollars in annual spending. It has also garnered the attention of researchers and policymakers interested in its implications for firm and consumer behavior. However, few economic studies have explored the DTCA response to public policies, especially those mandating coverage of these products. We use detailed advertising expenditure data to assess if pharmaceutical firms increase their marketing efforts after the implementation of relevant state and federal hea...
Source: International Journal of Health Care Finance and Economics - September 1, 2018 Category: Health Management Source Type: research

Do the more educated utilize more health care services? Evidence from Vietnam using a regression discontinuity design
AbstractIn 1991, Vietnam implemented a compulsory primary schooling reform that provides this study a natural experiment to estimate the causal effect of education on health care utilization with a regression discontinuity design. This paper finds that education causes statistically significant impacts on health care utilization, although the signs of the impacts change with specific types of health care services examined. In particular, education increases the inpatient utilization of the public health sector, but it reduces the outpatient utilization of both the public and private health sectors. The estimates are strong...
Source: International Journal of Health Care Finance and Economics - September 1, 2018 Category: Health Management Source Type: research

The impact of subsidized private health insurance and health facility upgrades on healthcare utilization and spending in rural Nigeria
AbstractThis paper analyzes the quantitative impact of an intervention that provides subsidized low-cost private health insurance together with health facility upgrades in Nigeria. The evaluation, which measures impact on healthcare utilization and spending, is based on a quasi-experimental design and utilizes three population-based household surveys over a 4-year period. After 4 years, the intervention increased healthcare use by 25.2 percentage points in the treatment area overall and by 17.7 percentage points among the insured. Utilization of modern healthcare facilities increased after 4 years by 20.4 percentage points...
Source: International Journal of Health Care Finance and Economics - September 1, 2018 Category: Health Management Source Type: research

Medicaid expansions and labor supply among low-income childless adults: evidence from 2000 to 2013
AbstractMedicaid expansions to low-income childless adults could have unintended effects on labor supply. Using 2000 –2013 current population survey data, we exploit changes in adult Medicaid eligibility across states to estimate its effect on labor supply for three samples of adults most likely to be affected by changes in Medicaid eligibility: those with less than a high school degree, a high school degree onl y, and income less than 300% of the federal poverty line. Medicaid eligibility was associated with a reduction in labor supply for low-income women with a high school degree. In our preferred estimations, the...
Source: International Journal of Health Care Finance and Economics - August 25, 2018 Category: Health Management Source Type: research

Estimating asymmetric information effects in health care with uninsurable costs
AbstractWe use a structural approach to separately estimate moral hazard and adverse selection effects in health care utilization using hospital invoices data. Our model explicitly accounts for the heterogeneity in the non-insurable transactions costs associated with hospital visits which increase the individuals ’ total cost of health care and dampen the moral hazard effect. A measure of moral hazard is derived as the difference between the observed and the counterfactual health care consumption. In the population of patients with non life-threatening diagnoses, our results indicate statistically signific ant and ec...
Source: International Journal of Health Care Finance and Economics - July 14, 2018 Category: Health Management Source Type: research

Does capitated managed care affect budget predictability? Evidence from Medicaid programs
This study is the first to test whether managed care enrollment reduces the variance of Medicaid spending, in contrast to the focus of the existing literature on spending levels. This variance bears directly on whether budget constrained states whether budget constrained states benefit from managed care in the form of stabilized spending, leading to improved budget predictability. Capitated payments stabilize spending at the margin, but the effects may be unobservable in aggregate due to variation in enrollment, which is directly measured in the analysis, or selection bias, which is unobserved. Although the majority of Med...
Source: International Journal of Health Care Finance and Economics - June 1, 2018 Category: Health Management Source Type: research

Quality of diabetes follow-up care and hospital admissions
In conclusion, good adherence to French diabetes guidelines seems to be in line with the prevention of health events, notably complications, that could necessitate hospitalization. (Source: International Journal of Health Care Finance and Economics)
Source: International Journal of Health Care Finance and Economics - June 1, 2018 Category: Health Management Source Type: research

Challenges for nationwide vaccine delivery in African countries
AbstractVaccines are very effective in providing individual and community (herd) immunity against a range of diseases. In addition to protection against a range of diseases, vaccines also have social and economic benefits. However, for vaccines to be effective, routine immunization programmes must be undertaken regularly to ensure individual and community protection. Nonetheless, in many countries in Africa, vaccination coverage is low because governments struggle to deliver vaccines to the most remote areas, thus contributing to constant outbreaks of various vaccine-preventable diseases. African governments fail to delive...
Source: International Journal of Health Care Finance and Economics - June 1, 2018 Category: Health Management Source Type: research

Medicare hospital payment adjustments and nursing wages
This study deals with the hospital wage index (HWI) adjustment to Medicare hospital payments, an area-level adjustment intended to compensate hospitals in high-cost labor markets. Since the HWI adjustment is based on hospital-reported labor costs, some argue that it incentivizes hospitals in concentrated markets to pay higher wages to nurses and other workers (the “circularity” critique). We investigate this critique using market-level data on the relative wages reported by nurses and hospital-level data on the average hourly wage for healthcare workers. For identification, we exploit a 2005 change in the geogr...
Source: International Journal of Health Care Finance and Economics - June 1, 2018 Category: Health Management Source Type: research

The impact of expanding Medicaid on health insurance coverage and labor market outcomes
AbstractExpansions of public health insurance have the potential to reduce the uninsured rate, but also to reduce coverage through employer-sponsored insurance (ESI), reduce labor supply, and increase job mobility. In January 2014, twenty-five states expanded Medicaid as part of the Affordable Care Act to low-income parents and childless adults. Using data from the 2011 –2015 March Current Population Survey Supplements, we compare the changes in insurance coverage and labor market outcomes over time of adults in states that expanded Medicaid and in states that did not. Our estimates suggest that the recent expansion ...
Source: International Journal of Health Care Finance and Economics - June 1, 2018 Category: Health Management Source Type: research

Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys
This study utilises data from consumer surveys of the Irish health insurance market collected between 2009 and 2013 (N\(=\) 1703) to examine consumer-reported benefits and costs to switching insurer. Probit regression models are specified to examine the relationship between consumer characteristics and reported switching costs, and switching behaviour, respectively. Overall evidence suggests that switchers in the Irish market mainly did so out of consideration for price. Transaction cost was the most common switching cost identified, reported by just under 1 in 7 non-switchers. Psychological switching costs may also be imp...
Source: International Journal of Health Care Finance and Economics - May 10, 2018 Category: Health Management Source Type: research

Determinants of catastrophic healthcare expenditure in Peru
AbstractThe aims of this study were to assess factors associated with catastrophic healthcare expenditure (CHE) and the burden of out-of-pocket (OOP) payments for specific healthcare services in Peru. We used data from 30,966 households that participated in the 2016 National Household Survey (Encuesta Nacional de Hogares, ENAHO). Participants reported household characteristics and expenditure on ten healthcare services. CHE was defined as healthcare spending equal to or higher than 40% of the household ’s capacity to pay. The associations of various household characteristics and OOP payments for specific healthcare s...
Source: International Journal of Health Care Finance and Economics - May 9, 2018 Category: Health Management Source Type: research

Payment systems and hospital length of stay: a bunching-based evidence
AbstractDespite the huge attention on the long average hospital length of stay (LOS) in Japan, there are limited empirical studies on the impacts of the payment systems on LOS. In order to shed new light on this issue, we focus on the fact that reimbursement for hospital care is linked to the number of patient bed-days, where a “day” is defined as the period from one midnight to the next. This “midnight-to-midnight” definition may incentivize health care providers to manipulate hospital acceptance times in emergency patients, as patients admitted before midnight would have an additional day for reim...
Source: International Journal of Health Care Finance and Economics - May 4, 2018 Category: Health Management Source Type: research