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An economic analysis of a wearable patient sensor for preventing hospital-acquired pressure injuries among the acutely ill patients Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-04-09 Leo Nherera, Barrett Larson, Annemari Cooley, Patrick Reinhard
More than 2.5 million people in the United States develop pressure injuries annually, which are one of the most common complications occurring in hospitals. Despite being common, hospital-acquired pressure injuries (HAPIs) are largely considered preventable by regular patient turning. Although current methodologies to prompt on-time repositioning have limited efficacy, a wearable patient sensor has
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Non-profit hospital mergers: the effect on healthcare costs and utilization Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-04-05 Maysam Rabbani
I use a 2010 non-profit hospital merger in Ohio to study the effect of market concentration on market outcomes. Using the Synthetic Control Method and Truven MarketScan data, I document three findings. First, courts are lenient to non-profit mergers, and I cast doubt on this practice by showing that the studied merger led to a 123% increase in the payments for inpatient childbirth services. Second
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The impact of the non-essential business closure policy on Covid-19 infection rates Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-04-01 Hummy Song, Ryan McKenna, Angela T. Chen, Guy David, Aaron Smith-McLallen
In response to the Covid-19 pandemic, many localities instituted non-essential business closure orders, keeping individuals categorized as essential workers at the frontlines while sending their non-essential counterparts home. We examine the extent to which being designated as an essential or non-essential worker impacts one’s risk of being Covid-positive following the non-essential business closure
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Determinants of prepaid systems of healthcare financing: a worldwide country-level perspective Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-03-31 Andrea M. Leiter, Engelbert Theurl
In this paper we examine determinants of prepaid modes of health care financing in a worldwide cross-country perspective. We use three different indicators to capture the role of prepaid modes in health care financing: (i) the share of total prepaid financing as percent of total current health expenditures, (ii) the share of voluntary prepaid financing as percent of total prepaid financing, and (iii)
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Wealth and the utilization of long-term care services: evidence from the United States Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-03-30 Jing Dong, Daifeng He, John A. Nyman, R. Tamara Konetzka
Long-term care (LTC) provision and financing has become a major challenge for policymakers in the United States and worldwide. To inform associated policies and more efficiently allocate LTC resources, it is important to understand how demand for different types of LTC services responds to increased wealth. We use data from the United States Health and Retirement Study to examine the use of LTC services
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Geographic variation in Part B reimbursement and physician offsetting behavior: a physician matching approach Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-03-18 Christopher S. Brunt, Joshua R. Hendrickson
Historically, Medicare has operated under the assumption that providers respond to reductions in reimbursement through increased provision of services in an effort to offset declining practice revenue; however, some recent empirical work examining fee reductions has found evidence of either small offsetting effects or reductions in the quantity supplied. Using a distance matching approach that matches
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Cost-efficiency in the patient centered medical home model: New evidence from federally qualified health centers Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-02-27 Sudip Chattopadhyay
This research analyzes the cost-efficiency of the Patient Centered Medical Home (PCMH) model vis-à-vis the traditional care delivery model in the Federally Qualified Health Centers (FQHC). We apply the three-stage least squares modeling approach on 2014 UDS data on all FQHCs to estimate per-visit and per-patient cost functions. Log-quadratic and linear-quadratic functional forms of cost are used for
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The association of insurance plan characteristics with physician patient-sharing network structure Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-02-26 Kimberley H. Geissler, Benjamin Lubin, Keith M. Marzilli Ericson
Professional and social connections among physicians impact patient outcomes, but little is known about how characteristics of insurance plans are associated with physician patient-sharing network structure. We use information from commercially insured enrollees in the 2011 Massachusetts All Payer Claims Database to construct and examine the structure of the physician patient-sharing network using
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Choice, quality and patients’ experience: evidence from a Finnish physiotherapy service Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-01-19 Visa Pitkänen, Ismo Linnosmaa
We study the relationship between patient choices and provider quality in a rehabilitation service for disabled patients who receive the service frequently but do not have access to quality information. Previous research has found a positive relationship between patient choices and provider quality in health services that patients typically do not have previous experience or use frequently. We contribute
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Do companies in the pharmaceutical supply chain earn excess returns? Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-01-04 Neeraj Sood, Karen Mulligan, Kimberly Zhong
Rising drug spending has led to increased calls to curtail drug costs. However, it is unclear where to target policy solutions. We estimated excess returns (the extent to which a firm’s profits are higher than expected given the risk associated with their investments) for manufacturers and middlemen in the pharmaceutical supply chain to determine who is making excessive profits. Excess returns were
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Socioeconomic inequality in tobacco use in Kenya: a concentration analysis Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2021-01-04 Hermann Pythagore Pierre Donfouet, Shukri F. Mohamed, Eric Malin
This paper aims at assessing and exploring socioeconomic inequalities in tobacco use in Kenya. Using the theory of fundamental causes, and concentration index, we investigate the determinants of tobacco use, and whether it disproportionately affects the poor. All data used in this study emanated from the 2014 Global Adult Tobacco Survey implemented in Kenya on a nationally representative sample of
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Implementation of personalized medicine in a context of moral hazard and uncertainty about treatment efficacy Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-11-17 Stéphane Alcenat, François Maréchal, Florence Naegelen
This paper analyzes the decision of a health authority to implement personalized medicine. We consider a model in which the health authority has three possibilities. It can apply either the same treatment (a standard or a new treatment) to the whole population or implement personalized medicine, i.e., use genetic information to offer the most suitable treatment to each patient. We first characterize
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From downcoding to upcoding: DRG based payment in hospitals Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-10-31 Carine Milcent
A prospective disease group-based payment is a reimbursement rule used in a wide array of countries. It turns to be the hospital’s payment rule to imply. The secret of this payment is a fee payment as well as a hospital’s activity based payment. There is a consensus to consider this rule of payment as the least likely to be manipulated by the actors. However, the defined fee per group depends on recorded
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Asymmetric behavior of tobacco consumption in Spain across the business cycle: a long-term regional analysis Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-10-06 Juan M. Martín Álvarez, Alejandro Almeida, Aida Galiano, Antonio A. Golpe
Many theoretical and empirical studies have analyzed the relationship between the economic cycle and tobacco consumption using the GDP and unemployment rates as the key variables for measuring economic phases. However, few studies focus on the pathways that cause tobacco consumption to be linked with the economic cycle, and there are no studies analyzing the heterogeneous effects underlying this relationship
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Aging out of dependent coverage and the effects on the use of inpatient medical care. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-09-17 Tu T Nguyen,Barış K Yörük
We investigate the impact of losing health insurance coverage at age 26 due to aging out of the Affordable Care Act’s dependent coverage on health insurance coverage rates and various indicators of inpatient medical care. We find that the probability of being covered under any type of health insurance plan decreases by 2.5–6.2 percentage points at age 26. However, the effects of this discrete change
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Efficiency and profitability in US not-for-profit hospitals. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-08-20 Michael Rosko,Mona Al-Amin,Manouchehr Tavakoli
This article examines the relationship between hospital profitability and efficiency. A cross-section of 1317 U.S. metropolitan, acute care, not-for-profit hospitals for the year 2015 was employed. We use a frontier method, stochastic frontier analysis, to estimate hospital efficiency. Total margin and operating margin were used as profit variables in OLS regressions that were corrected for heteroskedacity
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Value of new performance information in healthcare: evidence from Japan. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-08-18 Susanna Gallani,Takehisa Kajiwara,Ranjani Krishnan
Mandatory measurement and disclosure of outcome measures are commonly used policy tools in healthcare. The effectiveness of such disclosures relies on the extent to which the new information produced by the mandatory system is internalized by the healthcare organization and influences its operations and decision-making processes. We use panel data from the Japanese National Hospital Organization to
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Patient and provider-level factors associated with changes in utilization of treatments in response to evidence on ineffectiveness or harm. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-04-30 Laura Barrie Smith,Nihar R Desai,Bryan Dowd,Alexander Everhart,Jeph Herrin,Lucas Higuera,Molly Moore Jeffery,Anupam B Jena,Joseph S Ross,Nilay D Shah,Pinar Karaca-Mandic
High-quality health care not only includes timely access to effective new therapies but timely abandonment of therapies when they are found to be ineffective or unsafe. Little is known about changes in use of medications after they are shown to be ineffective or unsafe. In this study, we examine changes in use of two medications: fenofibrate, which was found to be ineffective when used with statins
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Effects of macroeconomic fluctuations on mental health and psychotropic medicine consumption. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-04-19 Mario Martínez-Jiménez,Judit Vall Castelló
Our aim in this paper is to understand the impact of macroeconomic fluctuations on mental health and psychotropic medicine consumption. In order to do that we exploit differences in the fluctuations of business cycle conditions across regional units in Catalonia. Our findings suggest that, in general, economic fluctuations at the local level had no significant effect on the consumption of psychotropic
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Do the uninsured demand less care? Evidence from Maryland's hospitals. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-03-06 Amanda Cook
Uninsured individuals receive fewer healthcare services for at least three reasons: responsibility for the entire bill, higher prices, and potential provider reductions for concern of nonpayment. I isolate reductions when uninsured patients are solely financially responsible by capitalizing on Maryland’s highly regulated health care system. Prices are set by the state, are uniform across all patients
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Public satisfaction with health system coverage, empirical evidence from SHARE data. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-02-14 Aida Isabel Tavares,Pedro Lopes Ferreira
People’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 satisfaction with the basic coverage provided by the health system of each country. On top of the usual individual
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Effects of pay-for-performance on prescription of hypertension drugs among public and private primary care providers in Sweden. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-01-20 Lina Maria Ellegård
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
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Competition and market structure in the dental industry Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2020-01-08 Thanh An Nguyen Le, Anthony T. Lo Sasso
We 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
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Quality information disclosure and health insurance demand: evidence from VA hospital report cards. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-11-14 Xiaoxue Li
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
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Consolidation in the dental industry: a closer look at dental payers and providers. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-10-03 Kamyar Nasseh,John R Bowblis,Marko Vujicic,Sean Shenghsiu Huang
We 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
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The individual welfare effects of the Affordable Care Act for previously uninsured adults. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-09-10 Naomi Zewde
The 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
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Health expenditure, longevity, and child mortality: dynamic panel data approach with global data. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-09-06 Devdatta Ray,Mikael Linden
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
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Health expenditure and gross domestic product: causality analysis by income level. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-07-16 Rezwanul Hasan Rana,Khorshed Alam,Jeff Gow
The empirical findings on the relationship between gross domestic product (GDP) and health expenditure are diverse. The influence of income levels on this causal relationship is unclear. 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,
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Reasons for unmet needs for health care: the role of social capital and social support in some western EU countries. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-07-11 Damiano Fiorillo
This 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
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Motivation structures of blood donation: a means-end chain approach. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-06-24 Yeong Sheng Tey,Poppy Arsil,Mark Brindal,Sook Kuan Lee,Chi Teen Teoh
Understanding 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
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The distributive fairness of out-of-pocket healthcare expenditure in the Russian Federation. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-06-13 Pavitra Paul
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
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The impact of hospital-acquired infections on the patient-level reimbursement-cost relationship in a DRG-based hospital payment system. Int. J. Health Econ. Manag. (IF 0.977) Pub Date : 2019-06-05 Klaus Kaier,Martin Wolkewitz,Philip Hehn,Nico T Mutters,Thomas Heister
Hospital-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 (2