巴西私营医疗保险部门的价格制定。

IF 1.5 4区 经济学 Q3 BUSINESS, FINANCE International Journal of Health Economics and Management Pub Date : 2024-03-01 Epub Date: 2023-09-10 DOI:10.1007/s10754-023-09361-0
Mônica Viegas Andrade, Carolina Marinho, Letícia Nunes, Flavia Colares
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引用次数: 0

摘要

巴西的私人医疗保险市场规模仅次于美国,位居世界第二,这使其成为宝贵的现实证据来源。本文记录了巴西医生住院报销费用的变化情况,并探讨了这些费用与医疗机构和医疗保险公司市场份额之间的关系。我们采用了固定效应面板回归法,并利用了一个前所未有的数据库,该数据库包含了 2016 年医疗保险公司支付住院费用的全国行政记录。我们发现,ICU 程序的报销与医疗机构的市场份额之间存在正相关关系。相反,我们观察到与保险公司的市场份额呈负相关。此外,我们还记录了巴西各州之间和州内手术价格的巨大差异,并观察到巴西竞争更激烈的市场往往拥有更高的人口和 GDP 水平。总之,我们的研究加深了我们对发展中国家医生报销费用定价动态的理解。从本研究中获得的见解可以帮助政策制定者制定适当的法规,以确保医疗保健服务的适当获取。
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Price setting in the Brazilian private health insurance sector.

Brazil's private health insurance market is the second largest in the world, behind only the United States, making it a valuable source of real-world evidence. This paper documents how physicians' inpatient reimbursement fees vary in the country and explores the relationship between these fees and the market share of health providers and health insurance companies. We implement a fixed-effects panel regression and take advantage of an unprecedented database that contains national administrative records of inpatient procedures paid by health insurance companies in 2016. We find a positive correlation between reimbursement for ICU procedures and provider market share. Conversely, we observe a negative correlation with insurers' market share. Additionally, we document substantial variation in procedure prices, both across and within Brazilian states, and observe that more competitive markets in Brazil tend to have higher population and GDP levels. Overall, our research enhances our understanding of the price setting dynamics of physician reimbursement fees in the context of a developing country. The insights gained from this study can assist policymakers in formulating appropriate regulations to ensure appropriate access to healthcare services.

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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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