In the present model author finds econometrically with panel data that health care is effective. This empirical analysis covers many western European countries during the period (2001-2010) and can be applied in any country no matter what the health care system is. Eviews software is used throughout this analysis.
{"title":"Is Healthcare System Effective? A Panel Data Analysis in EU","authors":"M. Georgiou","doi":"10.2139/ssrn.2512611","DOIUrl":"https://doi.org/10.2139/ssrn.2512611","url":null,"abstract":"In the present model author finds econometrically with panel data that health care is effective. This empirical analysis covers many western European countries during the period (2001-2010) and can be applied in any country no matter what the health care system is. Eviews software is used throughout this analysis.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84044923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In a laboratory experiment designed to capture key aspects of the interaction between physicians and patients in a stylized way, we study the effects of medical insurance and competition in the guise of free choice of physician. Medical treatment is an example of a credence good: only the physician (but not the patient) knows the appropriate treatment, and even after consulting, the patient is not sure whether he got proper treatment or got an unnecessary treatment, i.e. was overtreated. We find that with insurance, moral hazard looms on both sides of the market: patients consult more often and physicians overtreat more often than in the baseline condition. Competition decreases overtreatment compared to the baseline and patients therefore consult more often. When the two institutions are combined, competition is found to partially offset the adverse effects of insurance: most patients seek treatment, but overtreatment is moderated.
{"title":"Medical Insurance and Free Choice of Physician Shape Patient Overtreatment: A Laboratory Experiment","authors":"S. Huck, Gabriele K. Lünser, F. Spitzer, J. Tyran","doi":"10.2139/ssrn.2508158","DOIUrl":"https://doi.org/10.2139/ssrn.2508158","url":null,"abstract":"In a laboratory experiment designed to capture key aspects of the interaction between physicians and patients in a stylized way, we study the effects of medical insurance and competition in the guise of free choice of physician. Medical treatment is an example of a credence good: only the physician (but not the patient) knows the appropriate treatment, and even after consulting, the patient is not sure whether he got proper treatment or got an unnecessary treatment, i.e. was overtreated. We find that with insurance, moral hazard looms on both sides of the market: patients consult more often and physicians overtreat more often than in the baseline condition. Competition decreases overtreatment compared to the baseline and patients therefore consult more often. When the two institutions are combined, competition is found to partially offset the adverse effects of insurance: most patients seek treatment, but overtreatment is moderated.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87133868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pay-for-performance attempts to tie physician payment to quality of care. In a controlled laboratory experiment, we investigate the effect of pay-for-performance on physician provision behavior and patient benefit. For that purpose, we compare a traditional fee-for-service payment system to a hybrid system that blends fee-for-service and pay-for-performance incentives. Physicians are found to respond to pay-for-performance incentives. Approximately 89 percent of the participants qualify for a pay-for-performance bonus payment in the experiment. It follows that a patient treated under the hybrid payment system is significantly more likely to receive optimal treatment than a similar fee-for-service patient. Pay-for-performance generally tends to alleviate over- and under-provision of medical treatment relative to fee-for-service. Irrespective of the payment system, we observe unethical treatment behavior, i.e., the provision of medical services with zero benefit to the patient.
{"title":"Money Talks - Paying Physicians for Performance","authors":"C. Keser, Emmanuel Peterlé, Cornelius Schnitzler","doi":"10.2139/ssrn.2357326","DOIUrl":"https://doi.org/10.2139/ssrn.2357326","url":null,"abstract":"Pay-for-performance attempts to tie physician payment to quality of care. In a controlled laboratory experiment, we investigate the effect of pay-for-performance on physician provision behavior and patient benefit. For that purpose, we compare a traditional fee-for-service payment system to a hybrid system that blends fee-for-service and pay-for-performance incentives. Physicians are found to respond to pay-for-performance incentives. Approximately 89 percent of the participants qualify for a pay-for-performance bonus payment in the experiment. It follows that a patient treated under the hybrid payment system is significantly more likely to receive optimal treatment than a similar fee-for-service patient. Pay-for-performance generally tends to alleviate over- and under-provision of medical treatment relative to fee-for-service. Irrespective of the payment system, we observe unethical treatment behavior, i.e., the provision of medical services with zero benefit to the patient.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81812288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For those looking to design policies that mitigate the deleterious consequences of alcohol abuse, understanding how consumer demand for alcohol responds to changes in the local economic conditions is of great importance. We use high-frequency purchase data from a large panel of US households between 2004 and 2011 to examine how alcohol demand changes over the business cycle in a dynamic panel-data estimation framework. We find strong evidence that demand for packaged alcohol is procyclical. Changes in the state-level unemployment rate and personal per capita income between the most recent business cycle peak and trough imply a 6.5 percent decrease in the demand for packaged alcohol (ethanol by volume). The results also show that the decline in alcohol expenditures is primarily due to a decrease in quantity rather than an overall decrease in the price per ounce of ethanol purchased. Moreover, we improve on the related literature methodologically by accounting for consumption dynamics, as long-run demand fo...
{"title":"The Great Recession and Consumer Demand for Alcohol: A Dynamic Panel-Data Analysis of U.S. Households","authors":"Chad Cotti, R. Dunn, Nathan Tefft","doi":"10.2139/ssrn.2184415","DOIUrl":"https://doi.org/10.2139/ssrn.2184415","url":null,"abstract":"For those looking to design policies that mitigate the deleterious consequences of alcohol abuse, understanding how consumer demand for alcohol responds to changes in the local economic conditions is of great importance. We use high-frequency purchase data from a large panel of US households between 2004 and 2011 to examine how alcohol demand changes over the business cycle in a dynamic panel-data estimation framework. We find strong evidence that demand for packaged alcohol is procyclical. Changes in the state-level unemployment rate and personal per capita income between the most recent business cycle peak and trough imply a 6.5 percent decrease in the demand for packaged alcohol (ethanol by volume). The results also show that the decline in alcohol expenditures is primarily due to a decrease in quantity rather than an overall decrease in the price per ounce of ethanol purchased. Moreover, we improve on the related literature methodologically by accounting for consumption dynamics, as long-run demand fo...","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81726146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claudine de Meijer, E. van Doorslaer, M. Koopmanschap, P. Bakx
The use of long term care (LTC) is changing rapidly. In the Netherlands, rates of institutional LTC use are falling, while homecare use is growing. Important questions are: are these changes attributable to declining disability rates, or has LTC use given disability changed? And have institutionalization rates fallen regardless of disability level or has LTC use become better tailored to needs? We answer these questions by explaining trends in LTC use for the Dutch 65 population in the period 2000-2008 using a non-linear variant of the Oaxaca-Blinder decomposition. We find that changes in LTC use are not due to shifts in the disability distribution but can be traced back almost entirely to changes in the way the system treats disability. Elderly with mild disability are more likely to be treated at home than before, while severely disabled individuals continue to receive institutional LTC. As a result, LTC use has become better tailored to the needs for such care. The finding suggests that policies that promote LTC in the community rather than in institutions can effectively mitigate the consequences of population aging on LTC spending.
{"title":"Explaining Declining Rates of Institutional LTC Use in the Netherlands: A Decomposition Approach","authors":"Claudine de Meijer, E. van Doorslaer, M. Koopmanschap, P. Bakx","doi":"10.2139/ssrn.2460739","DOIUrl":"https://doi.org/10.2139/ssrn.2460739","url":null,"abstract":"The use of long term care (LTC) is changing rapidly. In the Netherlands, rates of institutional LTC use are falling, while homecare use is growing. Important questions are: are these changes attributable to declining disability rates, or has LTC use given disability changed? And have institutionalization rates fallen regardless of disability level or has LTC use become better tailored to needs? We answer these questions by explaining trends in LTC use for the Dutch 65 population in the period 2000-2008 using a non-linear variant of the Oaxaca-Blinder decomposition. We find that changes in LTC use are not due to shifts in the disability distribution but can be traced back almost entirely to changes in the way the system treats disability. Elderly with mild disability are more likely to be treated at home than before, while severely disabled individuals continue to receive institutional LTC. As a result, LTC use has become better tailored to the needs for such care. The finding suggests that policies that promote LTC in the community rather than in institutions can effectively mitigate the consequences of population aging on LTC spending.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86959700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In a data-rich environment, forecasting economic variables amounts to extracting and organizing useful information from a large number of predictors. So far, the dynamic factor model and its variants have been the most successful models for such exercises. In this paper, we investigate a category of LASSO-based approaches and evaluate their predictive abilities for forecasting twenty important macroeconomic variables. These alternative models can handle hundreds of data series simultaneously, and extract useful information for forecasting. We also show, both analytically and empirically, that combing forecasts from LASSO-based models with those from dynamic factor models can reduce the mean square forecast error (MSFE) further. Our three main findings can be summarized as follows. First, for most of the variables under investigation, all of the LASSO-based models outperform dynamic factor models in the out-of-sample forecast evaluations. Second, by extracting information and formulating predictors at economically meaningful block levels, the new methods greatly enhance the interpretability of the models. Third, once forecasts from a LASSO-based approach are combined with those from a dynamic factor model by forecast combination techniques, the combined forecasts are significantly better than either dynamic factor model forecasts or the naive random walk benchmark.
{"title":"Forecasting Macroeconomic Time Series: LASSO-Based Approaches and Their Forecast Combinations with Dynamic Factor Models","authors":"Jiahan Li, Weiye Chen","doi":"10.2139/ssrn.2410214","DOIUrl":"https://doi.org/10.2139/ssrn.2410214","url":null,"abstract":"In a data-rich environment, forecasting economic variables amounts to extracting and organizing useful information from a large number of predictors. So far, the dynamic factor model and its variants have been the most successful models for such exercises. In this paper, we investigate a category of LASSO-based approaches and evaluate their predictive abilities for forecasting twenty important macroeconomic variables. These alternative models can handle hundreds of data series simultaneously, and extract useful information for forecasting. We also show, both analytically and empirically, that combing forecasts from LASSO-based models with those from dynamic factor models can reduce the mean square forecast error (MSFE) further. Our three main findings can be summarized as follows. First, for most of the variables under investigation, all of the LASSO-based models outperform dynamic factor models in the out-of-sample forecast evaluations. Second, by extracting information and formulating predictors at economically meaningful block levels, the new methods greatly enhance the interpretability of the models. Third, once forecasts from a LASSO-based approach are combined with those from a dynamic factor model by forecast combination techniques, the combined forecasts are significantly better than either dynamic factor model forecasts or the naive random walk benchmark.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90507814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A widely discussed shortcoming of long-term care in nursing homes for elderly is the inappropriate or suboptimal drug utilization, in particular the utilization of psychotropic drugs. This paper estimates the effect of institutionalization on the drug intake of frail elderly using administrative data from the largest sickness fund in Germany. Difference-in-differences propensity score matching techniques are used to compare drug prescriptions of frail elderly who entered a nursing home with those who remained in the out-patient care system. The findings suggest that nursing home inhabitants receive more doses of antipsychotics, antidepressants and analgesics. The potential oversupply goes along with estimated drug costs of about € 87 million per year.
{"title":"Drug Oversupply in Nursing Homes: An Empirical Evaluation of Administrative Data","authors":"M. A. Stroka","doi":"10.2139/SSRN.2470553","DOIUrl":"https://doi.org/10.2139/SSRN.2470553","url":null,"abstract":"A widely discussed shortcoming of long-term care in nursing homes for elderly is the inappropriate or suboptimal drug utilization, in particular the utilization of psychotropic drugs. This paper estimates the effect of institutionalization on the drug intake of frail elderly using administrative data from the largest sickness fund in Germany. Difference-in-differences propensity score matching techniques are used to compare drug prescriptions of frail elderly who entered a nursing home with those who remained in the out-patient care system. The findings suggest that nursing home inhabitants receive more doses of antipsychotics, antidepressants and analgesics. The potential oversupply goes along with estimated drug costs of about € 87 million per year.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84520973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study evaluates the mental and physical strain experienced by informal caregivers. Econometric problems due to individuals selecting themselves into informal care provision are tackled by using informative and detailed data from the largest sickness fund in Germany and applying propensity score matching techniques. The findings suggest that carers take more psychoactive drugs as well as analgesics and gastrointestinal agents. Thus, informal caregiving appears to be a burdensome task with implications for both mental and physical health.
{"title":"The Mental and Physical Burden of Caregiving","authors":"M. A. Stroka","doi":"10.2139/SSRN.2470552","DOIUrl":"https://doi.org/10.2139/SSRN.2470552","url":null,"abstract":"This study evaluates the mental and physical strain experienced by informal caregivers. Econometric problems due to individuals selecting themselves into informal care provision are tackled by using informative and detailed data from the largest sickness fund in Germany and applying propensity score matching techniques. The findings suggest that carers take more psychoactive drugs as well as analgesics and gastrointestinal agents. Thus, informal caregiving appears to be a burdensome task with implications for both mental and physical health.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"14 34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80678600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Dionne, D. Desjardins, M. Lebeau, S. Messier, A. Dascal
The ability and willingness of health care workers to report for work during a pandemic are essential to pandemic response. The main contribution of this article is to examine the relationship between risk perception of personal and work activities and willingness to report for work during an influenza pandemic. Data were collected through a quantitative Web-based survey sent to health care workers on the island of Montreal. Respondents were asked about their perception of various risks to obtain index measures of risk perception. A multinomial logit model was applied for the probability estimations, and a factor analysis was conducted to compute risk perception indexes (scores). Risk perception associated with personal and work activities is a significant predictor of intended presence at work during an influenza pandemic. The average predicted probability of being at work during the worst scenario of an influenza pandemic is 46% for all workers in the sample, 36% for those overestimating risk in personal and work activities (95% CI: 35%-37%), 53% for those underestimating risk in work activities (95% CI: 52%-54%), and 49% for those underestimating risk of personal activities (95% CI: 48%-50%). When given an opportunity to change their intentions, 45% of those who initially did not intend to report for work in the worst scenario would do so if the pandemic resulted in a severe manpower shortage. These results have not been previously reported in the literature. Many organizational variables are also significant.
{"title":"Health Care Workers’ Risk Perceptions of Personal and Work Activities and Willingness to Report for Work During an Influenza Pandemic","authors":"G. Dionne, D. Desjardins, M. Lebeau, S. Messier, A. Dascal","doi":"10.2139/ssrn.2405674","DOIUrl":"https://doi.org/10.2139/ssrn.2405674","url":null,"abstract":"The ability and willingness of health care workers to report for work during a pandemic are essential to pandemic response. The main contribution of this article is to examine the relationship between risk perception of personal and work activities and willingness to report for work during an influenza pandemic. Data were collected through a quantitative Web-based survey sent to health care workers on the island of Montreal. Respondents were asked about their perception of various risks to obtain index measures of risk perception. A multinomial logit model was applied for the probability estimations, and a factor analysis was conducted to compute risk perception indexes (scores). Risk perception associated with personal and work activities is a significant predictor of intended presence at work during an influenza pandemic. The average predicted probability of being at work during the worst scenario of an influenza pandemic is 46% for all workers in the sample, 36% for those overestimating risk in personal and work activities (95% CI: 35%-37%), 53% for those underestimating risk in work activities (95% CI: 52%-54%), and 49% for those underestimating risk of personal activities (95% CI: 48%-50%). When given an opportunity to change their intentions, 45% of those who initially did not intend to report for work in the worst scenario would do so if the pandemic resulted in a severe manpower shortage. These results have not been previously reported in the literature. Many organizational variables are also significant.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81113002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper examines the potential for conflicts of interest to influence managers, specifically in the context of health care. Managers in all types of firms may be expected to have relationships with outside firms such as vendors in the course of performing their duties. Yet these relationships open managers to the possibility of conflicts of interest as well, to the extent that this contact is persuasive rather than informational. The possibility for a conflict of interest becomes particularly concerning in the presence of a financial relationship between a firm’s employees and its suppliers. I examine this possibility in the context of health care, where physician contact with pharmaceutical companies (key vendors for hospitals) is important for clinical decision-making, but also presents the possibility of conflict of interest. I examine physician prescribing behavior after the termination of a financial relationship with a pharmaceutical company in order to identify the persuasive (rather than informational) effect of the relationship, and find that affected physicians do significantly alter their behavior, confirming the presence of a persuasive and non-informational effect.
{"title":"The Persuasive Effect of External Financial Relationships: The Influence of Pharmaceutical Industry Payments on Decision-Making in Hospitals","authors":"Sara Parker-Lue","doi":"10.2139/ssrn.2392547","DOIUrl":"https://doi.org/10.2139/ssrn.2392547","url":null,"abstract":"This paper examines the potential for conflicts of interest to influence managers, specifically in the context of health care. Managers in all types of firms may be expected to have relationships with outside firms such as vendors in the course of performing their duties. Yet these relationships open managers to the possibility of conflicts of interest as well, to the extent that this contact is persuasive rather than informational. The possibility for a conflict of interest becomes particularly concerning in the presence of a financial relationship between a firm’s employees and its suppliers. I examine this possibility in the context of health care, where physician contact with pharmaceutical companies (key vendors for hospitals) is important for clinical decision-making, but also presents the possibility of conflict of interest. I examine physician prescribing behavior after the termination of a financial relationship with a pharmaceutical company in order to identify the persuasive (rather than informational) effect of the relationship, and find that affected physicians do significantly alter their behavior, confirming the presence of a persuasive and non-informational effect.","PeriodicalId":11036,"journal":{"name":"Demand & Supply in Health Economics eJournal","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88905142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：