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Developments in health economics and public policy最新文献

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Hospital cost analysis. 医院成本分析。
Pub Date : 1995-01-31 DOI: 10.2307/253483
Avi Dor, James R. G. Butler
List of Figures. List of Tables. Preface. 1. Introduction. Part A: Theoretical Considerations. 2. The Economic Theory of Production and Cost in the Multiproduct Firm. 3. The Concept, Measurement and Classification of Hospital Output. Part B: Empirical Results. 4. The Queensland Public Hospital System -- an Overview. 5. The Effect of Case Mix on Hospital Costs -- Evidence from Queensland. 6. The Effects of Scale, Utilisation and Input Prices on Hospital Costs -- Evidence from Queensland. 7. A Comparison of the Costs of Teaching and Non-Teaching Public Hospitals in Queensland. 8. A Comparison of Public and Private Hospital Costs in Queensland. 9. A Comparison of Public Hospital Costs in Queensland and New South Wales. Part C: Hospital Cost Analysis and Hospital Payment Schemes. 10. A Hospital Performance Appraisal and Payment Scheme based on Estimated Cost Functions. 11. The DRG Hospital Payment Scheme: Some Economic Aspects. References. Index of Names. Index of Subjects.
图表列表。表格列表。前言。1。介绍。Part A:理论思考。多产品企业生产与成本的经济学理论。医院产出的概念、计量与分类。B部分:实证结果。昆士兰公立医院系统——概述。病例组合对医院费用的影响——来自昆士兰州的证据。规模、利用和投入价格对医院成本的影响——来自昆士兰州的证据。8.昆士兰公立教学医院与非教学医院成本比较昆士兰公立和私立医院费用的比较。昆士兰州与新南威尔士州公立医院费用比较C部分:医院成本分析和医院支付方案。基于估算成本函数的医院绩效考核与支付方案。DRG医院支付计划:一些经济方面。参考文献名称索引。主题索引。
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引用次数: 60
Hospital cost analysis. 医院成本分析。
J R Butler
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引用次数: 0
Bonus options in health insurance. 健康保险的奖金选项。
Pub Date : 1992-05-31 DOI: 10.1007/978-94-011-2530-7
P. Zweifel, Otto Waser
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引用次数: 46
Excess demand and patient selection for heart and liver transplantation. 心脏和肝脏移植的过度需求和患者选择。
Pub Date : 1992-01-01 DOI: 10.1007/978-94-011-2392-1_8
B Friedman, R J Ozminkowski, Z Taylor
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引用次数: 6
Cost containment in health care: justification and consequences. 医疗保健的成本控制:理由和后果。
Pub Date : 1992-01-01 DOI: 10.1007/978-94-011-2392-1_12
K D Henke
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引用次数: 4
The normative and positive economics of minimum health benefits. 最低健康福利的规范和积极经济学。
Pub Date : 1992-01-01 DOI: 10.1007/978-94-011-2392-1_4
M V Pauly
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引用次数: 10
Bonus options in health insurance. 健康保险的奖金选项。
P Zweifel, O Waser
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引用次数: 0
The impact of utilization review on costs and utilization. 利用审查对成本和利用的影响。
Pub Date : 1992-01-01 DOI: 10.1007/978-94-011-2392-1_3
R K Khandker, W G Manning

This paper examines the performance of a utilization review program using data from Aetna's utilization review (UR) customers compared to a representative sample of its customers which had no utilization review during the study period. Statistical adjustments were made for the utilization management status, employee demographics, plan benefits, group size, year effects and seasonality. The study period covered from the first quarter of 1987 through the last quarter of 1988. The data suggest that UR reduces overall medical expenses by 4.4 percent, and inpatient expenses by 8.1 percent after a year of experience, largely by reducing length of stay.

本文使用来自Aetna的利用率审查(UR)客户的数据,与在研究期间没有利用率审查的客户的代表性样本进行比较,检验了利用率审查计划的绩效。对利用管理状况、员工人口统计、计划福利、群体规模、年度效应和季节性进行了统计调整。研究期间从1987年第一季度到1988年最后一季度。数据显示,通过缩短住院时间,在一年的经验后,UR减少了4.4%的总体医疗费用,住院费用减少了8.1%。
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引用次数: 22
Health economics worldwide. 全球卫生经济学。
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引用次数: 0
The validity of the MIMIC (Multiple Indicators/MultIple Causes) health index--some empirical evidence. 多指标/多原因健康指数的有效性——一些经验证据。
Pub Date : 1992-01-01 DOI: 10.1007/978-94-011-2392-1_6
R E Leu, M Gerfin, S Spycher

This study evaluates the potential of econometric models with latent (unobservable) variables for measuring health or health impairment due to a specific disease. A MIMIC disability index is estimated for a sample of 145 adults with chronic bronchitis, expressing their self-reported disability caused by the disease on a one-dimensional scale. The index is determined up to a linear transformation. Disability is thus measured on an interval scale. The data were collected by interviews. The questionnaire used for this purpose is based on a number of in-depth interviews with selected bronchitis patients conducted beforehand. The study therefore focuses directly on the patients' perceptions of their disease. The validity of the index is evaluated in three different ways. First, construct validity is assessed performing groupwise analysis and testing for differences in the index values by subgroup. To a large extent, the index is consistent with a priori expectations. Therefore, we conclude that it has high construct validity. Second, validity of the index is assessed by comparing its results to a direct rating scale produced by 21 physicians with various medical backgrounds. The MIMIC index turns out to be related in a systematic, but nonlinear way to this direct rating scale. This can be interpreted in two different ways. If one accepts the preferences of health providers as the ultimate yardstick when it comes to ranking health or chronic states the result suggests that the MIMIC index estimated in this way is not a valid measure of treatment success. By contrast, if patients' preferences are considered to be decisive, it suggests that physician-based ratings should be substituted for or at least complemented with patient-based indices (such as the MIMIC disability index estimated here) when evaluating medical services in terms of cost-effectiveness. Third we explore the extent to which the MIMIC index reflects utility associated with different states of disability, using a modified Torrance Standard Gamble approach. The above-mentioned physicians are used as experts in this procedure. The results indicate that the MIMIC index as estimated here is related in a systematic, but nonlinear way to the Standard Gamble risk index as well. The fact that this relationship is nonlinear indicates that the MIMIC index does not measure utility as derived from the experts' preferences directly. How this index would fare compared to a Standard Gamble risk index provided by patients (bronchitis subjects) is a question which remains open.(ABSTRACT TRUNCATED AT 400 WORDS)

本研究评估了具有潜在(不可观察)变量的计量经济模型的潜力,用于测量由特定疾病引起的健康或健康损害。对145名慢性支气管炎成人患者的样本进行MIMIC残疾指数估计,在一维尺度上表达他们自我报告的由该疾病引起的残疾。这个指标是由一个线性变换决定的。因此,残疾是用间隔尺度来衡量的。数据是通过访谈收集的。用于此目的的问卷是基于事先对选定的支气管炎患者进行的一些深入访谈。因此,这项研究直接关注患者对其疾病的看法。该指标的有效性通过三种不同的方式进行评估。首先,对结构效度进行分组分析,并对各子组指数值的差异进行检验。该指数在很大程度上符合先验预期。因此,我们认为它具有较高的构念效度。其次,通过将其结果与21名具有不同医学背景的医生制作的直接评级量表进行比较,来评估该指数的有效性。结果表明,MIMIC指数与这一直接评级量表的关系是系统的,但却是非线性的。这可以用两种不同的方式来解释。如果人们接受医疗服务提供者的偏好作为对健康或慢性疾病进行排名的最终标准,结果表明,以这种方式估计的MIMIC指数并不是衡量治疗成功的有效指标。相比之下,如果患者的偏好被认为是决定性的,那么在评估医疗服务的成本效益时,以医生为基础的评分应该取代或至少补充以患者为基础的指数(如这里估计的MIMIC残疾指数)。第三,我们探讨了MIMIC指数在多大程度上反映了与不同残疾状态相关的效用,使用了改进的托伦斯标准赌博方法。上述医生在这一过程中被用作专家。结果表明,本文估计的MIMIC指数与标准赌博风险指数也存在系统的非线性关系。这种关系是非线性的,这一事实表明,MIMIC指数并不能直接衡量从专家偏好中得出的效用。该指数与由患者(支气管炎受试者)提供的标准赌博风险指数相比如何,仍是一个悬而未决的问题。(摘要删节为400字)
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引用次数: 9
期刊
Developments in health economics and public policy
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