112,017 research outputs found
New Technologies and Costs in Healthcare
No full textNew sanitation and health technology applied to treatments, procedures, and devices is constantly revolutionizing epidemiological patterns. Since the early 1900s it has been responsible for significant improvements in population health by turning once-deadly diseases into curable or preventable conditions, by expanding the existing cures to more patients and diseases, and by simplifying procedures for both medical and organizational practices. Notwithstanding the benefits of technological progress for the population health, the innovation process is also an important driver of health expenditure growth across all countries. The technological progress generates additional financial burden and expands the volume of services provided, which constitutes a concern from an economic point of view. Moreover, the evolution of technology costs and their impact on healthcare spending is difficult to predict due to the revolutionary nature of many innovations and their adoption. In this respect, the challenge for policymakers is to discourage overadoption of ineffective, unnecessary, and inappropriate technologies. This task has been long carried out through regulation, which according to standard economic theory is the only response to market failures and socially undesirable outcomes of healthcare markets left on their own. The potential welfare loss of a market failure must be confronted with the costs of regulatory activities. While health technology evolution delivers important value for patients and societies, it will continue to pose important challenges for already overextended public finances
Criterio di ripartizione e simulazione a medio e lungo termine della spesa sanitaria in Italia: una proposta operativa
No full textI crescenti vincoli che la finanza pubblica ha imposto ai finanziamenti per i servizi sanitari hanno spinto studiosi e policy maker ad interessarsi sempre più sia del problema della sostenibilità finanziaria del sistema nel lungo periodo sia dello sviluppo di sempre più efficienti criteri di allocazione delle risorse al fine di soddisfare meglio i bisogni di salute della popolazione. Obiettivo del presente lavoro è quello di stimare un modello econometrico in grado di affrontare in modo congiunto questi due problemi. L’analisi empirica è condotta utilizzando dati di spesa sanitaria a livello di Asl provenienti dai conti economici Asl/Ao del Ministero della salute. I risultati ottenuti mettono in evidenza due aspetti rilevanti: i) il criterio di ripartizione proposto riesce ad approssimare la distribuzione dei reali bisogni sanitari della popolazione italiana meglio di quanto fino ad oggi proposto dal Ministero della salute utilizzando le sole variabili di età e sesso; ii) le previsioni di spesa al 2050 sono più basse di quelle proposte dalla Ragioneria Generale dello Stato, dall’Ocse e dall’Ue.The recent constraints introduced by public finance on healthcare financing have triggered among researchers and policy makers a large interest in the long-run financial sustainability of the healthcare systems and in the development of better allocation fund criteria in order to satisfy patient healthcare needs. The objective of this study is to implement and estimate an econometric model which embraces this twofold issue. The empirical analysis is conducted by using healthcare expenditure balance sheets recorded by Local health authorities (Asl) and collected by the Italian Ministry of health. The analysis highlights two main aspects: i) our capitation rates can approximate the healthcare needs of the Italian population far more precisely than the algorithm currently used by the Ministry of health; ii) our long-run simulations predict lower healthcare expenditure levels in 2050 than those proposed by the State general accounting department (RGS), the Oecd or the Eu
Invecchiamento e politiche sanitarie: le sfide per un sistema sostenibile
No full textThis article discusses the challenges of today’s health care systems in the international setting, with a closer look on the Italian situation. It offers a wide set of arguments explaining the mech- anisms, which guided the health care systems evolution in the last decades. It presents the challenging aspects related to demographic aging and rising life expectancy rates, where the next fifty years will see a remarkable increase in the prevalence of the elderly, with contemporaneous low fertility rates. Moreover, it discusses the recent situation related to the burden of chronic disease, showing how the gains in life expectancy entail a decrease in the proportion of disability free lived years, due to an anticipation in the offset of pathologies. Finally, the article discusses the need for prevention action, proposes a set of policies and the areas of their application rele- vant from the point of view of this discussion
Body Weight, Eating Patterns, and Physical Activity: The Role of Education
No full textIn this article, we empirically study the role of education attainment on individual body mass index (BMI), eating patterns, and physical activity. We allow for endogeneity of schooling choices for females and males in a mean and quantile instrumental variables framework. We find that completion of lower secondary education has a significant positive impact on reduction of individual BMI, containment of calorie consumption, and promotion of physical activity. Interestingly, these effects are heterogeneous across genders and distributions. In particular, for BMI and calorie expenditure, the effect of education is significant for females and is more pronounced for women with high body mass and low physical activity. On the other hand, the effect of education on eating patterns is significant mainly for males, being more beneficial for men with elevated calorie consumption. We also show that education attainment is likely to foster productive and allocative efficiency of individuals in the context of BMI formation. Given that the literature suggests that education fosters development of cognition, self-control, and a variety of skills and abilities, in our context it is thus likely to promote lifetime preferences and means of individuals, which in turn enable them to achieve better health outcomes. Education also provides exposure to physical education and to school subjects enhancing individual deliberative skills, which are important factors shaping calorie expenditure and intake. Finally, we show that in the presence of strong socioeconomic inequalities in BMI, education is likely to have a pronounced impact on healthy BMI for the disadvantaged groups, represented in our framework by females
Who is responsible for your health: You, your doctor or new technologies?
No full textThe aim of the paper is to disentangle the roles
that patients, physicians and technology can have on
patient health outcomes. The analysis focuses on patients
suffering from hypercholesterolemia. Using a large and
detailed dataset of patients collected by the Italian College
of General Practitioners (SIMG) over the period
2001–2006, we observe the existence of heterogeneity in
the time needed to reach an optimal level of health stock.
We firstly explore whether patients recovering faster
exhibit lower hospitalization rates. Secondly, we study the
determinants of the speed of recovery to a good health
status. Results suggest that a 10 % increase in the speed of
recovery reduces hospitalization rates by 1 % in the general
sample and by 1.25 % in patients in primary prevention.
Furthermore, we show that recovering to a good
health status is a multifaceted phenomenon, with technology
explaining from 54 to 68 % of the total effect
The impact of cost-sharing schemes on drug compliance in Italy: evidence based on quantile regression
No full textObjectives In this article we investigate the causal effect
of cost-sharing schemes on compliance with statins in a
quantile regression framework.
Methods We use the health search CSD-LPD data, a
longitudinal observational dataset containing computerbased
patient records collected by Italian general practitioners.
We exploit a series of natural experiments referring
to several introductions of co-payment schemes in some of
the Italian regions between 2000 and 2009. We adopt an
extended difference-in-differences approach to provide
quantile estimates of the impact of co-payments on
compliance.
Results We find that (i) introduction of co-payments hurts
residents of regions with worse quality and provision of
health care; (ii) within these regions, co-payments were
particularly harmful for high compliers; (iii) gender, clinical
history and geographic residence are important
determinants of compliance among poor compliers; (iv)
compliance decreases with the potency and dosage of
statins, particularly for poor compliers.
Conclusions In the presence of inefficient health-care
provision, co-payments are harmful for drug compliance,
and this is especially true for patients who are originally
good compliers
Uncertainty about children's survival and fertility: a test using indian microdata
No full textIn this paper we present a non altruistic model of demand for children in the presence of uncertainty about children’s survival. Children are seen as assets, as they provide help during old age. If certain conditions are met, both the financial market and the family network are used to transfer resources to old age. Theoretical predictions relating to the change in the mean and variance of the survival rate are derived. The empirical analysis is based on data from the Human Development of India (HDI) survey. Different models for count data variables, such as Poisson and hurdle models have been employed in the empirical analysis. The results highlight the importance of the uncertainty about children’s survival in determining parental choices. This shows that realized or expected children’s death is not the only link between fertility decision and children’s mortality. The policy implications of such findings are briefly discussed
- …
