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.

The effect of social health insurance on prenatal care: the case of Ghana
Abstract Many developing countries have introduced social health insurance programs to help address two of the United Nations’ millennium development goals—reducing infant mortality and improving maternal health outcomes. By making modern health care more accessible and affordable, policymakers hope that more women will seek prenatal care and thereby improve health outcomes. This paper studies how Ghana’s social health insurance program affects prenatal care use and out-of-pocket expenditures, using the two-part model to model prenatal care expenditures. We test whether Ghana’s social health ins...
Source: International Journal of Health Care Finance and Economics - September 30, 2014 Category: Health Management Source Type: research

Health care expenditure disparities in the European Union and underlying factors: a distribution dynamics approach
Abstract This paper examines health care expenditure (HCE) disparities between the European Union countries over the period 1995–2010. By means of using a continuous version of the distribution dynamics approach, the key conclusions are that the reduction in disparities is very weak and, therefore, persistence is the main characteristic of the HCE distribution. In view of these findings, a preliminary attempt is made to add some insights into potentially main factors behind the HCE distribution. The results indicate that whereas per capita income is by far the main determinant, the dependency ratio an...
Source: International Journal of Health Care Finance and Economics - September 1, 2014 Category: Health Management Source Type: research

Does managed care reduce health care expenditure? Evidence from spatial panel data
Abstract Similar to, for example, the US, Switzerland or Great Britain the German health care sector has recently undergone a series of reforms towards managed care. These measures are intended to yield both a higher quality of care and cost containment. In our study we ask whether managed care reduces health care expenditure at the market level. We apply a macroeconomic evaluation approach based on a regional panel data set which is as yet unique in the context of managed care. Econometrically, we account for both unobserved heterogeneity and spatial dependence, i.e. regional interrelations in health c...
Source: International Journal of Health Care Finance and Economics - September 1, 2014 Category: Health Management Source Type: research

Do the Medicaid and Medicare programs compete for access to health care services? A longitudinal analysis of physician fees, 1998–2004
Abstract As the demand for publicly funded health care continues to rise in the U.S., there is increasing pressure on state governments to ensure patient access through adjustments in provider compensation policies. This paper longitudinally examines the fees that states paid physicians for services covered by the Medicaid program over the period 1998–2004. Controlling for an extensive set of economic and health care industry characteristics, the elasticity of states’ Medicaid fees, with respect to Medicare fees, is estimated to be in the range of 0.2–0.7 depending on the type of physician service...
Source: International Journal of Health Care Finance and Economics - September 1, 2014 Category: Health Management Source Type: research

Supply and demand in physician markets: a panel data analysis of GP services in Australia
This study uses aggregate panel data on general practitioner (GP) services at the Statistical Local Area level in Australia spanning eight years to estimate supply and demand equations for GP services. The structural equations of the model are estimated separately using population-weighted fixed effects panel modelling with the two stage least squares formulation of the generalised method of moments approach (GMM (2SLS)). The estimated price elasticity of demand of \(-0.19\) is comparable with other studies. The direct impact of GP density on demand, ...
Source: International Journal of Health Care Finance and Economics - September 1, 2014 Category: Health Management Source Type: research

Socialized medicine and mortality
Abstract Over the last century life expectancy has increased substantially and so has the share of health care expenditures financed by governments. In cross-country comparisons, the US, which has the lowest government health expenditure share, often has the poorest health outcomes. Is there a plausible connection between health outcomes and government financing of health care? This paper addresses this question with panel data from 20 developed countries from 1950 to 2010. I review the history of government involvement in health care financing over this period. Then I use panel regression methods to ex...
Source: International Journal of Health Care Finance and Economics - September 1, 2014 Category: Health Management Source Type: research

Competitive bidding for Medicare Part B clinical laboratory services
This article provides a summary and review of the final design of the laboratory competitive bidding demonstration mandated by the Medicare Modernization Act of 2003. The design was analogous to a sealed bid (first price), clearing price auction. Design elements presented include covered laboratory tests and beneficiaries, laboratory bidding and payment status under the demonstration, composite bids, determining bidding winners and the demonstration fee schedule, and quality under the demonstration. Expanded use of competitive bidding in Medicare, including specifically for clinical laboratory tests, has been recommended i...
Source: International Journal of Health Care Finance and Economics - June 1, 2014 Category: Health Management Source Type: research

Stability of children’s insurance coverage and implications for access to care: evidence from the Survey of Income and Program Participation
Abstract Even as the number of children with health insurance has increased, coverage transitions—movement into and out of coverage and between public and private insurance—have become more common. Using data from 1996 to 2005, we examine whether insurance instability has implications for access to primary care. Because unobserved factors related to parental behavior and child health may affect both the stability of coverage and utilization, we estimate the relationship between insurance and the probability that a child has at least one physician visit per year using a model that includes child fixe...
Source: International Journal of Health Care Finance and Economics - June 1, 2014 Category: Health Management Source Type: research

Payment mechanism and GP self-selection: capitation versus fee for service
Abstract This paper analyzes the consequences of allowing gatekeeping general practitioners (GPs) to select their payment mechanism. We model GPs’ behavior under the most common payment schemes (capitation and fee for service) and when GPs can select one among them. Our analysis considers GP heterogeneity in terms of both ability and concern for their patients’ health. We show that when the costs of wasteful referrals to costly specialized care are relatively high, fee for service payments are optimal to maximize the expected patients’ health net of treatment costs. Conversely, when the losses ass...
Source: International Journal of Health Care Finance and Economics - June 1, 2014 Category: Health Management Source Type: research

The US healthcare workforce and the labor market effect on healthcare spending and health outcomes
This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market’s impact on healthcare spending and health outcomes. Data are collected for 50 states and the District of Columbia from 1999–2009. Labor market and healthcare workforce data are obtained from the Bureau of Labor Statistics. Mortality and health status data are collected from the Centers for Disease Control and Prevention’s Vital Statistics program and Behavioral Risk Factor Surveillance System. Healthcare spending data are derived from the Centers for Medicare and Medicaid Services. Dynami...
Source: International Journal of Health Care Finance and Economics - June 1, 2014 Category: Health Management Source Type: research

The effect of extension of benefit coverage for cancer patients on health care utilization across different income groups in South Korea
This study analyzed the extent to which the policy improved income-related equality in outpatient visits, inpatient days, and inpatient and outpatient care expenditure based on triple difference estimator. Using nationwide claims data of the NHI from 2002 to 2004 and from 2006 to 2010, we compared cancer patients as a treatment group with liver disease as a control group and low-income group with the highest-income group. The results showed that the extension of NHI benefits coverage led to an increase in the utilization of outpatient services across all income groups, but with a greater increase for the low-income groups,...
Source: International Journal of Health Care Finance and Economics - June 1, 2014 Category: Health Management Source Type: research

Effect of nursing home ownership on hospitalization of long-stay residents: an instrumental variables approach
Abstract Hospitalizations among nursing home residents are frequent, expensive, and often associated with further deterioration of resident condition. The literature indicates that a substantial fraction of admissions is potentially preventable and that nonprofit nursing homes are less likely to hospitalize their residents. However, the correlation between ownership and hospitalization might reflect unobserved resident differences rather than a causal relationship. Using national minimum data set assessments linked with Medicare claims, we use a national cohort of long-stay residents who were newly admi...
Source: International Journal of Health Care Finance and Economics - March 1, 2014 Category: Health Management Source Type: research

Determinants of health-system efficiency: evidence from OECD countries
Abstract This paper analyzes the most important determinants of healthcare efficiency across OECD countries. As previously documented in the literature, we first provide evidence of significant differences in the cross-country level of efficiency in healthcare provision. We then investigate how improvements in efficiency can be achieved by considering alternative efficiency indices (parametric and non-parametric) and a novel dataset with information on the characteristics of healthcare systems across OECD countries. Our empirical findings suggest a positive correlation between policies such as increasin...
Source: International Journal of Health Care Finance and Economics - March 1, 2014 Category: Health Management Source Type: research

Assessing the effectiveness of health care cost containment measures: evidence from the market for rehabilitation care
This study empirically evaluates the effectiveness of different health care cost containment measures. The measures investigated were introduced in Germany in 1997 to reduce moral hazard and public health expenditures in the market for rehabilitation care. Of the analyzed measures, doubling the daily copayments was clearly the most effective cost containment measure, resulting in a reduction in utilization of about \(20\,\%\) . Indirect measures such as allowing employers to cut federally mandated sick pay or paid vacation during inpatient post-acute ...
Source: International Journal of Health Care Finance and Economics - March 1, 2014 Category: Health Management Source Type: research

Demand for prescription drugs under non-linear pricing in Medicare Part D
Abstract We estimate the price elasticity of prescription drug use in Medicare Part D, which features a non-linear price schedule due to a coverage gap. We analyze patterns of drug utilization prior to the coverage gap, where the “effective price” is higher than the actual copayment for drugs because consumers anticipate that more spending will make them more likely to reach the gap. We find that enrollees’ total pre-gap drug spending is sensitive to their effective prices: the estimated price elasticity of drug spending ranges between \(-\) ...
Source: International Journal of Health Care Finance and Economics - March 1, 2014 Category: Health Management Source Type: research