Contribution of high-technology procedures to public healthcare expenditures: the case of ischemic heart disease in Portugal, 2002-2015.

IF 1.5 4区 经济学 Q3 BUSINESS, FINANCE International Journal of Health Economics and Management Pub Date : 2024-09-01 Epub Date: 2024-03-29 DOI:10.1007/s10754-024-09372-5
Wenkang Ma, Ana Timóteo, Vanessa Ribeiro, Céu Mateus, Julian Perelman
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Abstract

The magnitude of the impact of technological innovations on healthcare expenditure is unclear. This paper estimated the impact of high-technology procedures on public healthcare expenditure for patients with ischemic heart disease (IHD) in Portugal. The Blinder-Oaxaca decomposition method was applied to Portuguese NHS administrative data for IHD discharges during two periods, 2008-2015 vs. 2002-2007 (N = 434,870). We modelled per episode healthcare expenditures on the introduction of new technologies, adjusting for GDP, patient age, and comorbidities. The per episode healthcare expenditure was significantly higher in 2008-2015 compared to 2002-2007 for IHD discharges. The increase in the use of high-technology procedures contributed to 28.6% of this growth among all IHD patients, and to 18.4%, 6.8%, 11.1%, and 29.2% for acute myocardial infarction, unstable angina, stable angina, and other IHDs, respectively. Changes in the use of stents and embolic protection and/or coronary brachytherapy devices were the largest contributors to expenditure growth. High-technology procedures were confirmed as a key driver of public healthcare expenditure growth in Portugal, contributing to more than a quarter of this growth.

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高科技手术对公共医疗支出的贡献:2002-2015 年葡萄牙缺血性心脏病案例。
技术创新对医疗支出的影响程度尚不明确。本文估算了高科技手术对葡萄牙缺血性心脏病(IHD)患者公共医疗支出的影响。布林德-瓦哈卡分解法被应用于葡萄牙国家医疗服务体系(NHS)2008-2015 年与 2002-2007 年两个时期的缺血性心脏病出院管理数据(N = 434,870 例)。我们对引入新技术后的每次医疗支出进行了建模,并对国内生产总值、患者年龄和合并症进行了调整。与2002-2007年相比,2008-2015年IHD出院患者的每次医疗支出明显增加。在所有 IHD 患者中,高科技手术使用的增加占增长的 28.6%,在急性心肌梗死、不稳定型心绞痛、稳定型心绞痛和其他 IHD 患者中分别占 18.4%、6.8%、11.1% 和 29.2%。支架和栓塞保护及/或冠状动脉近距离治疗设备的使用变化是导致支出增长的最大因素。高科技手术被证实是葡萄牙公共医疗支出增长的主要驱动力,占增长的四分之一以上。
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来源期刊
CiteScore
3.60
自引率
0.00%
发文量
18
期刊介绍: The focus of the International Journal of Health Economics and Management is on health care systems and on the behavior of consumers, patients, and providers of such services. The links among management, public policy, payment, and performance are core topics of the relaunched journal. The demand for health care and its cost remain central concerns. Even as medical innovation allows providers to improve the lives of their patients, questions remain about how to efficiently deliver health care services, how to pay for it, and who should pay for it. These are central questions facing innovators, providers, and payers in the public and private sectors. One key to answering these questions is to understand how people choose among alternative arrangements, either in markets or through the political process. The choices made by healthcare managers concerning the organization and production of that care are also crucial. There is an important connection between the management of a health care system and its economic performance. The primary audience for this journal will be health economists and researchers in health management, along with the larger group of health services researchers. In addition, research and policy analysis reported in the journal should be of interest to health care providers, managers and policymakers, who need to know about the pressures facing insurers and governments, with consequences for regulation and mandates. The editors of the journal encourage submissions that analyze the behavior and interaction of the actors in health care, viz. consumers, providers, insurers, and governments. Preference will be given to contributions that combine theoretical with empirical work, evaluate conflicting findings, present new information, or compare experiences between countries and jurisdictions. In addition to conventional research articles, the journal will include specific subsections for shorter concise research findings and cont ributions to management and policy that provide important descriptive data or arguments about what policies follow from research findings. The composition of the editorial board is designed to cover the range of interest among economics and management researchers.Officially cited as: Int J Health Econ ManagFrom 2001 to 2014 the journal was published as International Journal of Health Care Finance and Economics. (Articles published in Vol. 1-14 officially cited as: Int J Health Care Finance Econ)
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