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.

Trends in out-of-pocket expenditure on facility-based delivery and financial protection of health insurance: findings from Vietnam ’s Household Living Standard Survey 2006–2018
AbstractMuch of the existing empirical literature on the association between health insurance and out-of-pocket (OOP) expenditures on facility-based delivery in low- and middle-income countries is cross sectional in nature. Comparatively little is known about the dynamic shifts in OOP expenditures and the health insurance nexus. Using seven biennial waves of Vietnam ’s Household Living Standard Survey covering the period 2006–2018 and a generalized linear model this study examines trends in OOP expenditures on facility-based delivery and financial protection afforded by Vietnam’s social health insurance system. Over ...
Source: International Journal of Health Care Finance and Economics - April 13, 2022 Category: Health Management Source Type: research

Eliciting relative preferences for the attributes of health insurance schemes among rural consumers in India
AbstractThere is a limited understanding of the preferences of rural consumers in India for health insurance schemes. In this article, we investigate the preferences of the rural population for the attributes of a health insurance scheme by implementing a discrete choice experiment (DCE). We identified six attributes through qualitative and quantitative study: enrollment, management, benefit package, coverage, transportation facility, and monthly premium. A D-efficient design of 18 choices has been constructed, each comprising two health insurance choices. We collected the representative sample from 675 household heads of ...
Source: International Journal of Health Care Finance and Economics - April 8, 2022 Category: Health Management Source Type: research

Combining remaining life expectancy and time to death as a measure of old-age dependency related to health care needs
AbstractPublic concern about the rising number of older dependent citizens is still based mainly on standard population aging indicators. This includes the old-age dependency ratio (OADR), which divides the state pension age population by the working age population. However, the OADR counts neither the dependent elderly nor those who provide for them. This paper builds on previous research to propose several alternative indicators, including the health care (HC) need-adjusted real elderly dependency ratio and the HC need-adjusted dependent population-to-tax rate. These indicators consider improvements in old-age survival a...
Source: International Journal of Health Care Finance and Economics - April 6, 2022 Category: Health Management Source Type: research

Does supplemental private health insurance incentivize household risky financial asset investment? Evidence from the China Household Financial Survey
AbstractPrivate health insurance (PHI) is considered a supplement to public medical insurance schemes in China. To the extent that PHI coverage may offset background risk by decreasing medical expenditure risk, it may also incentivize risky financial behaviors. However, empirical evidence confirming this theory is absent in China. We fill this void by examining the impact of supplemental PHI on household risky financial investment using data from the China Household Financial Survey (CHFS). In the first set of analyses, we used bivariate probit (BVP) models with instrumental variables (IVs) to examine the effects of PHI on...
Source: International Journal of Health Care Finance and Economics - March 31, 2022 Category: Health Management Source Type: research

The heterogeneous effects of the great recession on informal care to the elderly
AbstractThis paper studies the role of unobserved factors to measure the impact of the economic downturn on informal care availability to the elderly in Europe. We use the Survey of Health, Ageing and Retirement in Europe (SHARE), which allows controlling for socio-demographic variables. Our results show that the impact of the Great Recession on care receipt depends not only on observed, but also on unobserved characteristics. For 21% of the sample, the effect is three to four times larger than the average effect for the entire sample. For 57% of the sample, there is no effect of the economic crisis, and this is related to...
Source: International Journal of Health Care Finance and Economics - March 7, 2022 Category: Health Management Source Type: research

The impact of the repeal of the federal individual insurance mandate on uninsurance
AbstractThe federal individual mandate of the Affordable Care Act, which required people to pay a tax penalty if they did not have health insurance, was repealed in 2019. However, some states implemented state-level insurance mandates which essentially replaced the federal mandate. I use nationally representative survey data from the 2015 –19 Annual Social and Economic Supplement to the Current Population Survey to compare the probability of becoming newly uninsured among people living in states without state-level insurance mandates versus states with a mandate, before and after the 2019 repeal. In a sample of 214,821 l...
Source: International Journal of Health Care Finance and Economics - March 1, 2022 Category: Health Management Source Type: research

Catastrophic health expenditure and its determinants among Nigerian households
This study uses recent data to evaluate the extent to which Nigerian households suffer from catastrophic health expenditure (CHE) and evaluates its determinants. We used the Living Standards Survey 2018–2019 to estimate the headcount of Nigerian households that experience CHE—the proportion of health expenditures exceeding a certain ratio of such expenditures to non-food expenditures. To evaluate the determinants of CHE, we used ordinary least square regression with state fixed effects. The total sample was 22,110 nationally representative households. Many households, espec ially poorer ones, do not have any health c...
Source: International Journal of Health Care Finance and Economics - February 14, 2022 Category: Health Management Source Type: research

Provider responses to discontinuous tariffs: evidence from Dutch rehabilitation care
AbstractAbrupt jumps in reimbursement tariffs have been shown to lead to unintended effects in physicians ’ behavior. A sudden change in tariffs at a pre-defined point in the treatment can incentivize health care providers to prolong treatment to reach the higher tariff, and then to discharge patients once the higher tariff is reached. The Dutch reimbursement schedule in hospital rehabilitation care f ollows a two-threshold stepwise-function based on treatment duration. We investigated the prevalence of strategic discharges around the first threshold and assessed whether their share varies by provider type. Our findings ...
Source: International Journal of Health Care Finance and Economics - February 1, 2022 Category: Health Management Source Type: research

The impact of state capacity on the cross-country variations in COVID-19 vaccination rates
AbstractThe initial period of vaccination shows strong heterogeneity between countries ’ vaccinations rollout, both in the terms of the start of the vaccination process and in the dynamics of the number of people that are vaccinated. A predominant thesis for this observation is that a key determinant of the swift and extensive vaccine rollout is state capacity. Here, we utilize two measures that quantify different aspects of the state capacity: (i) the external capacity (measured through the soft power of the country) and (ii) the internal capacity (measured via the country’s government effectiveness) and provide an em...
Source: International Journal of Health Care Finance and Economics - January 29, 2022 Category: Health Management Source Type: research

Impact evaluation of subsidized health insurance programs on utilization of healthcare facilities: evidence from Indonesia
This study found that in general, ASKESKIN and JAMKESMAS had very small impacts on the utility of healthcare facilities measured by outpatient and inpatient visits by program ’s beneficiaries. It implies that being subsidized health insurance holders does not necessarily encourage them to visit formal healthcare facilities. In addition, the comparison of average treatment effect on the treated (ATT) between ASKESKIN and JAMKESMAS also did not show any significant impro vement even though the program had tried to be improved. The results of this study provide the basis for advising policy makers that there needs to revisi...
Source: International Journal of Health Care Finance and Economics - January 14, 2022 Category: Health Management Source Type: research

Competition and physician-induced demand in a healthcare market with regulated price: evidence from Ghana
AbstractUsing panel data of administrative claims spanning 36  months (2017–2019) and an instrumental variable method, this study examines whether physician-induced demand for hypertension disease care exists in Ghana’s healthcare system where price is regulated, and there is no co-payment. We find that an increase in competition—measured as a high doct or-to-population ratio at the district level—leads to an increase in the number of physician visits, suggesting physician-induced demand exists, and that effects are greater for large hospitals and public health providers. This result is further supported by altern...
Source: International Journal of Health Care Finance and Economics - December 17, 2021 Category: Health Management Source Type: research

Medical insurance and physician-induced demand in China: the case of hemorrhoid treatments
AbstractIn October 2015, the Guangdong government of China enacted a so-called unified medical insurance payment for patients residing in Guangdong province, which fundamentally simplifies reimbursement procedures of medical insurance for the involved cross-city in-patients. Using a unique confidential dataset from 2013 to 2018 on hemorrhoid treatments at a renowned hospital in Guangzhou, the provincial capital of Guangdong, and exploiting difference-in-differences estimations based on the abovementioned policy, we document that the physicians ’ incentives are a negative externality of the full medical insurance policy f...
Source: International Journal of Health Care Finance and Economics - November 13, 2021 Category: Health Management Source Type: research

Temporary and persistent overweight and long-term labor market outcomes
AbstractWe study how the duration of being overweight earlier in life is related to subsequent long-term labor market outcomes. Our data on fraternal and identical twins born and raised in the same household contain weight measurements of the twins during their early adulthood measured in 1975, 1981, and 1990 and is linked to register-based administrative data on the earnings and employment from 1990 to 2009. When combined, these data enable an empirical strategy that controls for the family environment and genes shared by twins. We find that being persistently overweight during early adulthood is negatively associated wit...
Source: International Journal of Health Care Finance and Economics - November 9, 2021 Category: Health Management Source Type: research

The weekend effect in stroke mortality: evidence from Austrian acute care hospitals
AbstractMany studies provide evidence for the so-called weekend effect by demonstrating that patients admitted to hospital during weekends show less favourable outcomes such as increased mortality, compared with similar patients admitted during weekdays. The underlying causes for this phenomenon are still discussed controversially. We analysed factors influencing weekend effects in inpatient care for acute stroke in Austria. The study analysed secondary datasets from all 130 public acute care hospitals in Austria between 2010 and 2014 (Austrian DRG Data). The study cohort included 86,399 patient cases admitted with acute i...
Source: International Journal of Health Care Finance and Economics - November 3, 2021 Category: Health Management Source Type: research

Predicting diagnostic coding in hospitals: individual level effects of price incentives
We examined incentives present in part of the hospital funding system. First, we analyse trends in the proxy measures of diagnostic upcoding: can hospital behavioural changes be seen over time with regards to age composition, readmission rates, length of stay, comorbidity and mortality? Secondly, we examine specific patient groups to see if variations in the price incentive are related to probability of being coded as complicated. In the first years (1999–2003) there was an observed increase in the share of episodes coded as complicated, while th e level has become more stable in the years 2004–2012. The analysis showe...
Source: International Journal of Health Care Finance and Economics - October 6, 2021 Category: Health Management Source Type: research