Developments in health economics and public policy最新文献

英文中文

Non-price allocative procedures: Scottish solutions to a National Health Service problem. 非价格分配程序:苏格兰解决国民保健服务问题的办法。

Developments in health economics and public policy

Pub Date : 1992-01-01 DOI: 10.1007/978-94-011-2392-1_9

R G Milne, B Torsney

Except for a few NHS services, the allocation of resources depends on administrative-cummedical decision-making. At one level the Scottish Home and Health Department allocates funds between the fifteen health boards, at another level clinicians allocate resources between patients. We examine experience at a level intermediate between these two, and focus on the provision of two services--diagnostic radiology and ECG--at health centres. A benefit: cost framework is used to test three hypotheses about how the two services have been allocated. The three hypotheses relate to the benefits from provision and are characterised as 'medical excellence', 'equity' and 'market' orientated. Data on health centre list size and distance to alternative provision are used to test the hypotheses. The conclusions are as follows. The equity and market models are equally valid descriptions for ECG, a service provided by general practitioners. A combination of the equity and/or market model with the medical model is a valid description for diagnostic radiology, a service provided by health boards and the Scottish Home and Health Department.

除了少数NHS服务外，资源的分配取决于行政和医疗决策。在一级，苏格兰家庭和卫生部在15个保健委员会之间分配资金，在另一级，临床医生在病人之间分配资源。我们研究了介于这两者之间的水平的经验，并侧重于在保健中心提供两种服务——诊断放射学和心电图。效益:成本框架用于测试关于两种服务如何分配的三个假设。这三种假设与提供的好处有关，其特点是“医疗卓越”、“公平”和“市场”导向。使用保健中心列表大小和与替代供应的距离的数据来检验假设。研究结论如下。股权模型和市场模型对全科医生提供的心电图服务同样有效。公平和(或)市场模式与医疗模式相结合是诊断放射学的有效描述，这是卫生委员会和苏格兰家庭和卫生部提供的一项服务。

{"title":"Non-price allocative procedures: Scottish solutions to a National Health Service problem.","authors":"R G Milne, B Torsney","doi":"10.1007/978-94-011-2392-1_9","DOIUrl":"https://doi.org/10.1007/978-94-011-2392-1_9","url":null,"abstract":"Except for a few NHS services, the allocation of resources depends on administrative-cummedical decision-making. At one level the Scottish Home and Health Department allocates funds between the fifteen health boards, at another level clinicians allocate resources between patients. We examine experience at a level intermediate between these two, and focus on the provision of two services--diagnostic radiology and ECG--at health centres. A benefit: cost framework is used to test three hypotheses about how the two services have been allocated. The three hypotheses relate to the benefits from provision and are characterised as 'medical excellence', 'equity' and 'market' orientated. Data on health centre list size and distance to alternative provision are used to test the hypotheses. The conclusions are as follows. The equity and market models are equally valid descriptions for ECG, a service provided by general practitioners. A combination of the equity and/or market model with the medical model is a valid description for diagnostic radiology, a service provided by health boards and the Scottish Home and Health Department.","PeriodicalId":79866,"journal":{"name":"Developments in health economics and public policy","volume":"1 ","pages":"187-202"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21024236","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}

引用次数: 2

Political economy of hospital financing. 医院融资的政治经济学。

Developments in health economics and public policy

Pub Date : 1992-01-01 DOI: 10.1007/978-94-011-2392-1_13

F Breyer, F Schneider

In this paper we tried to explain the recent reform in the law of financing German hospitals. We first described five basic types of hospital payment systems which were available as alternatives to the decision on the reform in the early 1980s. In the next step we identified five concerned interest groups whose actions certainly had a great influence on the legislative process. We proposed a simple theoretical model to examine how these groups of actors evaluated the different payment systems. After deriving a preference ranking for each actor, we confronted these rankings with the respective revealed preferences, which could be inferred from their official statements towards the reform. It could also be shown that quite often the actual statements deviated strongly from the theoretically expected preferences because all groups were engaged in a highly interactive lobbying game. In the last step we compared these preferences to the actual outcome of the legislation and found that all groups have at least partly realized their targets. So in contrast to the typical results of interest group theory, the differences in bargaining power do to appear to have led to a solution which unambiguously benefits some groups of actors at the expense of others. It has to be repeated that the empirical analysis was limited to statements from the interest groups in the pre-legislative stage of the whole process. From this point the most promising procedure would appear to be the step-by-step analysis of the statements of the groups during the legislative process as well. This would give the researcher a chance to evaluate whether or not the theoretical hypotheses can be confirmed, whether or not our simple theoretical model is an appropriate way to understand the behavior of the affected groups and what was finally responsible for the outcome of the legislation. Therefore this paper should be seen as a first attempt to apply the framework of public choice theory to the field of health care financing and to demonstrate that much more research is needed.

在本文中，我们试图解释最近改革的法律资助德国医院。我们首先描述了五种基本类型的医院支付系统，这些系统可作为20世纪80年代初改革决定的替代方案。下一步，我们确定了五个相关的利益集团，他们的行动肯定会对立法进程产生重大影响。我们提出了一个简单的理论模型来研究这些参与者群体如何评估不同的支付系统。在得出每个参与者的偏好排名后，我们将这些排名与各自透露的偏好进行比较，这些偏好可以从他们对改革的官方声明中推断出来。还可以证明，实际陈述往往与理论上预期的偏好严重偏离，因为所有群体都参与了一场高度互动的游说游戏。在最后一步中，我们将这些偏好与立法的实际结果进行了比较，发现所有群体至少部分实现了他们的目标。因此，与利益集团理论的典型结果相反，议价能力的差异似乎确实导致了一种解决方案，这种解决方案明确地以牺牲其他行为者群体为代价，使某些群体受益。必须重申的是，经验分析仅限于整个过程立法前阶段各利益集团的发言。从这一点来看，最有希望的程序似乎是在立法过程中逐步分析各集团的声明。这将使研究人员有机会评估理论假设是否可以被证实，我们的简单理论模型是否适合理解受影响群体的行为以及最终导致立法结果的因素。因此，本文应被视为将公共选择理论框架应用于医疗融资领域的第一次尝试，并表明需要进行更多的研究。

{"title":"Political economy of hospital financing.","authors":"F Breyer, F Schneider","doi":"10.1007/978-94-011-2392-1_13","DOIUrl":"https://doi.org/10.1007/978-94-011-2392-1_13","url":null,"abstract":"In this paper we tried to explain the recent reform in the law of financing German hospitals. We first described five basic types of hospital payment systems which were available as alternatives to the decision on the reform in the early 1980s. In the next step we identified five concerned interest groups whose actions certainly had a great influence on the legislative process. We proposed a simple theoretical model to examine how these groups of actors evaluated the different payment systems. After deriving a preference ranking for each actor, we confronted these rankings with the respective revealed preferences, which could be inferred from their official statements towards the reform. It could also be shown that quite often the actual statements deviated strongly from the theoretically expected preferences because all groups were engaged in a highly interactive lobbying game. In the last step we compared these preferences to the actual outcome of the legislation and found that all groups have at least partly realized their targets. So in contrast to the typical results of interest group theory, the differences in bargaining power do to appear to have led to a solution which unambiguously benefits some groups of actors at the expense of others. It has to be repeated that the empirical analysis was limited to statements from the interest groups in the pre-legislative stage of the whole process. From this point the most promising procedure would appear to be the step-by-step analysis of the statements of the groups during the legislative process as well. This would give the researcher a chance to evaluate whether or not the theoretical hypotheses can be confirmed, whether or not our simple theoretical model is an appropriate way to understand the behavior of the affected groups and what was finally responsible for the outcome of the legislation. Therefore this paper should be seen as a first attempt to apply the framework of public choice theory to the field of health care financing and to demonstrate that much more research is needed.","PeriodicalId":79866,"journal":{"name":"Developments in health economics and public policy","volume":"1 ","pages":"267-85"},"PeriodicalIF":0.0,"publicationDate":"1992-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21024241","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}

引用次数: 6

首页上一页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Developments in health economics and public policy

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀