International Journal of Health Care Finance and Economics This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Value for money: an evaluation of health spending in Canada
AbstractThe long-term increase in international health spending sparked concerns about sustainability of health care systems but also the impact of such spending and the value for money from health spending. The period since 1975 has witnessed an increase in per capita health spending in Canada along with improvements in health outcomes. This paper is an economic evaluation of health spending in Canada —an analysis of the cost-effectiveness of aggregate health spending. Estimates of the cost per quality-adjusted life-year (QALY) are made for the whole 1980–2012 period and for four sub-periods of time—1980–1989; 198...
Source: International Journal of Health Care Finance and Economics - January 2, 2017 Category: Health Management Source Type: research

Combined social and private health insurance versus catastrophic out of pocket payments for private hospital care in Greece
AbstractThe high level of out of pocket (OOP) payments constitutes a major concern for Greece and several other European and OECD countries as a result of the significant down turning of their public health finances due to the 2008 financial crisis. The basic objective of this study is to provide empirical evidence on the effect of combining social health insurance (SHI) and private health insurance (PHI) on OOP payments. Further, this study examines the catastrophic impact of OOP payments on insured ’s welfare using the incidence and intensity methodological approach of measuring catastrophic health care expenditures. C...
Source: International Journal of Health Care Finance and Economics - January 2, 2017 Category: Health Management Source Type: research

Means-tested public support and the interaction between long-term care insurance and informal care
AbstractThis paper investigates theoretically how the structure of means-tested public long-term care (LTC) support influences the relationship between LTC insurance and informal care. Three types of public support encountered in various means-tested LTC schemes are examined. First, the level to be considered for means-testing only takes into account the level of wealth of the recipient without considering the cost of LTC or the possible insurance benefits. Second, the public support also considers the LTC needs of the recipient. Third, the means-test structure takes into consideration insurance benefits as well. Our resul...
Source: International Journal of Health Care Finance and Economics - December 23, 2016 Category: Health Management Source Type: research

Product safety spillovers and market viability for biologic drugs
AbstractWhen a pharmaceutical manufacturer experiences a safety problem, negative impacts on profitability can spread to its competitors. Reduced consumer confidence, product recalls, and litigation are limited to the responsible manufacturer only if that manufacturer can be clearly linked to the safety problem. We analyze the impact of “accountability” for safety problems on manufacturer entry decisions and investments to mitigate risk. Consistent with prior research, we find investment levels increase with accountability in a duopoly market, and that accountability can thus enhance market viability and improve consum...
Source: International Journal of Health Care Finance and Economics - December 22, 2016 Category: Health Management Source Type: research

Effect of pay-for-performance on cervical cancer screening participation in France
In this study, we investigated the effect of a nationwide P4P scheme for general practitioners implemented in 2012 in France, on cervical cancer screening practices. Using data from a nationally representative permanent sample of health insurance beneficiaries, we analyzed smear test use of eligible women for the years 2006 –2014. Our longitudinal sample was an unbalanced panel comprising 180,167 women eligible from 1 to 9 years each. We took into account that during our study period some women were exposed to another incentive for screening participation: the implementation in 2010 of organized screening (OS) in a l imi...
Source: International Journal of Health Care Finance and Economics - December 21, 2016 Category: Health Management Source Type: research

Rationing in health care provision: a welfare approach
AbstractWe study the welfare properties of direct restrictions based on cost-effectiveness and indirect methods represented by waiting lists in a public health care system. Health care is supplied for free by the public health sector, but patients can choose to address their demand elsewhere by stipulating a private health care insurance policy to avoid restrictions. Our model shows that if the individual response to treatment is independent of income and cannot be observed by the patient, the choice of opting out simply depends on income, and the redistributive effects of both instruments are quite similar. In general, re...
Source: International Journal of Health Care Finance and Economics - December 20, 2016 Category: Health Management Source Type: research

Drug innovation, price controls, and parallel trade
AbstractWe study the long-run welfare effects of parallel trade (PT) in pharmaceuticals. We develop a two-country model of PT with endogenous quality, where the pharmaceutical firm negotiates the price of the drug with the government in the foreign country. We show that, even though the foreign government does not consider global R&D costs, (the threat of) PT improves the quality of the drug as long as the foreign consumers ’ valuation of quality is high enough. We find that the firm’s short-run profit may be higher when PT is allowed. Nonetheless, this is neither necessary nor sufficient for improving drug quality...
Source: International Journal of Health Care Finance and Economics - December 20, 2016 Category: Health Management Source Type: research

Do tort reforms impact the incidence of birth by cesarean section? A reassessment
AbstractInvestigations into the existence and impact of defensive medicine in obstetrics have produced mixed and often conflicting implications. The most widely-cited and accepted results in this literature find that less severe malpractice environments cause an increase in the use of cesarean section. This has been interpreted as “offensive medicine”; taking advantage of lenient malpractice environments by providing unnecessary services in order to raise revenue. In this article we show that an assumption concerning births with an unknown method of delivery, which is not explicitly stated in the literature, is pivotal...
Source: International Journal of Health Care Finance and Economics - October 31, 2016 Category: Health Management Source Type: research

Economic incentives and diagnostic coding in a public health care system
We examined pairs of DRGs where the addition of one or more specific diagnoses places the patient in a complicated rather than an uncomplicated group, yielding higher reimbursement. The economic incen tive was measured as the potential gain in income by coding a patient as complicated, and we analysed the association between this gain and the share of complicated discharges within the DRG pairs. Using multilevel linear regression modelling, we estimated both differences between hospitals for each DRG pair and changes within hospitals for each DRG pair over time. Over the whole period, a one-DRG-point difference in price wa...
Source: International Journal of Health Care Finance and Economics - October 13, 2016 Category: Health Management Source Type: research

Effects of formal home care on hospitalizations and doctor visits
This study estimates the effects of formal home care, provided by paid professionals, on hospitalizations and doctor visits. We look at different lengths-of-stay (LOS) and types of doctor visits —general practitioners (GP) and specialists—and investigate heterogeneous effects by age groups and informal care availability. Two-part generalized linear models are estimated, using data from Switzerland. In this federal country, home care policy is decentralized into 26 cantons. Home care is measured at the canton level and its endogeneity is addressed by using an instrumental variable strategy combined with canton and time ...
Source: International Journal of Health Care Finance and Economics - October 12, 2016 Category: Health Management Source Type: research

Is medicines parallel trade ‘regulatory arbitrage’?
AbstractParallel trade (PT) is a phenomenon that takes place at the distribution level, when a patented product is diverted from the official distribution chain to another one where it competes as a parallel distributor. Although some research regards PT in Europe as a ‘common’ form of arbitrage, there are reasons to believe that it is a type of ‘regulatory arbitrage’ that does not necessarily produce equivalent welfare effects. We draw upon a unique dataset that contains source country records of parallel imported medicine sales to the Netherlands for one therapeutic group (statins), that accounts for 5 % of the ...
Source: International Journal of Health Care Finance and Economics - September 22, 2016 Category: Health Management Source Type: research

Medical employment growth, unemployment, and the opportunity cost of health care
AbstractThis policy note examines the relationship between the growth in the share of the workforce in medical care and the shares of workers who are unemployed, working in services or government employment, or working elsewhere in the economy. These changes provide measures of the opportunity cost of higher medical care spending, the majority of which is on labor. Using state data over the period 1990 –2010, we find that, in years of high economy-wide unemployment, growth in medical employment in a state reduces the unemployment rate significantly; it does not appear to displace employment in other services or governmen...
Source: International Journal of Health Care Finance and Economics - September 9, 2016 Category: Health Management Source Type: research

Is technology still a major driver of health expenditure in the United States? Evidence from cointegration analysis with multiple structural breaks
AbstractUsing a longer span of available time series data and employing powerful unit root and cointegration tests that allow for multiple structural breaks, developed recently by Carrion-i-Silvestre et al. (Econ Theory 25:1754 –1792,2009), Perron and Yabu (J Bus Econ Stat 27:369 –396,2009), Kejriwal and Perron (J Econ 146(1):59 –73,2008; J Bus Econ Stat 28(4):503 –522,2010a; J Time Ser Anal 31:305 –328,2010b) and Maki (Econ Model 29:2011 –2015,2012), this paper empirically investigates, whether technology continues to be a major driver of real per capita health expenditure, along with some control variables su...
Source: International Journal of Health Care Finance and Economics - September 6, 2016 Category: Health Management Source Type: research

Healthcare utilization, bypass, and multiple visits: the case of Bhutan
AbstractThis paper uses the Bhutan Living Standards Survey 2012 to assess factors that affect the decision to use outpatient care when ill, outpatient utilization choice, and bypassing decision. Our attention is placed on geographical factors because of the unique geographical landscape in Bhutan, which may act as an important barrier for access to care in the country. We further analyze the pattern of multiple healthcare visits of individuals with the same health symptom. The methods employed for this study consist of binary logit and multinomial logit regressions as well as descriptive statistical approach. The results s...
Source: International Journal of Health Care Finance and Economics - September 1, 2016 Category: Health Management Source Type: research

Can patent duration hinder medical innovation
AbstractWe argue that, in the pharmaceutical industry, excessive patent duration can deter investments in innovative treatments in favor of me-too drugs. The point is that too-long durations foster incentives to collude to delay investments in R&D for innovative treatments. We give a set of sufficient conditions for which collusion is a subgame-perfect equilibrium; that is, the threat of punishing any deviator is credible. We then show that reducing current duration always breaks down market discipline, and so does an increase in duration for innovative treatments. Optimal patent duration must then be a trade-off betwe...
Source: International Journal of Health Care Finance and Economics - September 1, 2016 Category: Health Management Source Type: research