Health Economics Commons^™

Incentives To Change: Effects Of Performance-Based Financing On Health Workers In Zambia, Gordon C. Shen, Ha Thi Hong Nguyen, Ashis Das, Nkenda Sachingongu, Collins Chansa, Jumana Qamruddin, Jed Friedman

Publications and Research

Background: Performance-based financing (PBF) has been implemented in a number of countries with the aim of transforming health systems and improving maternal and child health. This paper examines the effect of PBF on health workers’ job satisfaction, motivation, and attrition in Zambia. It uses a randomized intervention/control design to evaluate before–after changes for three groups: intervention (PBF) group, control 1 (C1; enhanced financing) group, and control 2 (C2; pure control) group.

Methods: Mixed methods are employed. The quantitative portion comprises of a baseline and an endline survey. The survey and sampling scheme were designed to allow for a rigorous impact …

The Effect Of Health Care Entrepreneurship On Local Health: The Case Of Medexpress In Appalachia, Amir B. Neto, Joshua C. Hall

Economics Faculty Working Papers Series

We test the hypothesis that the opening of an Urgent Care Center (UCC) has positive impacts on the local community. There are several mechanisms through which a UCC can have an impact: lower health care costs, emergency room decongestion, and improved access to medical information. We examine the entry of MedExpress into Appalachian counties between 2001 and 2013. Employing data from Health Resources Files, which provides information for all counties for specific years, we use Propensity Score Matching to create a year 2000 control group for the counties “treated” by MedExpress entry beginning in 2001. We then employ a standard …

Social Health Insurance Coverage And Financial Protection Among Rural-To-Urban Internal Migrants In China: Evidence From A Nationally Representative Cross-Sectional Study, Wen Chen, Qi Zhang, Andre M. N. Renzaho, Fangjing Zhou, Hui Zhang, Li Ling

Community & Environmental Health Faculty Publications

INTRODUCTION: Migrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We assessed social health insurance (SHI) coverage and its financial protection effect among rural-to-urban internal migrants (IMs) in China.

METHODS: Data from the '2014 National Internal Migrant Dynamic Monitoring Survey' were used. We categorised 170 904 rural-to-urban IMs according to their SHI status, namely uninsured by SHI, insured by the rural SHI scheme (new rural cooperative medical scheme (NCMS)) or the urban SHI schemes (urban employee-based basic medical insurance (UEBMI)/urban …

Health Aid In Africa: Placement, Service Utilization, And Benefit, Carrie Dolan

Theses and Dissertations

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its …

Analisis Estimasi Biaya Langsung Medis Penderita Rawat Jalan Diabetes Mellitus Tipe 2 Di Rsud Dr. Abdul Aziz Singkawang Tahun 2013, Mursalin Mursalin, Prastuti Soewondo

Jurnal Ekonomi Kesehatan Indonesia

Diabetes mellitus is an epidemic disease that seriously threatens global health. In addition to the high levels of morbidity and mortality, it also causes many countries around the world to spend a significant amount of money on healthcare. This study aims to calculate the direct medical costs and influencing factors of type 2 diabetes mellitus outpatient care. The study was conducted from January to February 2015 at RSUD dr. Abdul Aziz Singkawang in West Kalimantan. The study design used quantitative analysis with secondary data retrospectively collected from 2013, with a sample size of 200. The results of the multivariate analysis …

Perbandingan Klaim Penyakit Katastropik Peserta Jaminan Kesehatan Nasional Di Provinsi Dki Jakarta Dan Nusa Tenggara Timur, Heniwati Heniwati, Hasbullah Thabrany

Jurnal Ekonomi Kesehatan Indonesia

Several diseases that become catastrophic at the household level include end-stage renal disease, cardiovascular diseases, cancer, thalassemia, and hemophilia. Patients with these diseases benefit significantly from the National Health Insurance (JKN), and these conditions absorb high claim costs from JKN. Special attention is needed to manage these diseases effectively. Disparities in healthcare facilities, specialists, and variations in Case Mix Group (CMG) payment are suspected to be important contributing factors to the variation in JKN fund absorption across provinces. This study uses 2014 claim data from BPJS Kesehatan in Jakarta and East Nusa Tenggara (NTT) provinces to explore the extent of …

Analisis Pembiayaan Kesehatan Daerah Bersumber Publik: Studi Kasus Di Dinas Kesehatan Kabupaten Bogor Tahun 2012, 2013 Dan 2014, Tuti Handayani, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

This study aims to look at the picture of health expenditures in Bogor District Health Office to see the allotment according to the four dimensions of District Health Accounts (DHA) in 2014 to see the trend in 2012 and 2013. This study took data from a secondary data source realization of health spending that was then processed and presented according to the funding source, budget managers, service providers, and programs. The study used a descriptive research design with evaluative approach and was conducted in Bogor District Health Office. Analysis showed that the total health financing in Bogor District Health Department …

Analisis Pengaruh Dimensi Fraud Triangle Dalam Kebijakan Pencegahan Fraud Terhadap Program Jaminan Kesehatan Nasional Di Rsup Nasional Cipto Mangunkusumo, Hasan Sadikin, Wiku Adisasmito

Jurnal Ekonomi Kesehatan Indonesia

The National Health Insurance (JKN) held by the Social Security Agency (BPJS) Health started to be implemented from 1 Indonesia’s Health Insurance Program in January 2014. The implementation of a national insurance program found the risk. The risk of occurrence of fraud in Indonesia is very high but it is still difficult to identify its risk. This is supported by the lack of awareness of all parties, including patients, providers and insurance companies although such actions exists. Health fraud is a serious threat to the entire world, which led to financial abuse of scarce resources and the negative impact on …

Malnutrition In Eastern Indonesia: Does Food Access Matter?, Arina Nur Fauziyah

Jurnal Ekonomi Kesehatan Indonesia

Meningkatnya prevalensi kekurangan gizi dan kelebihan berat badan di Indonesia Timur menimbulkan dugaan bahwa keterbatasan akses pangan, baik dari sisi akses ke pasar maupun akses secara ekonomi berpengaruh terhadap beban ganda malnutrisi. Studi ini bertujuan untuk menganalisis pengaruh akses pangan terhadap kekurangan gizi pada balita dan kelebihan berat badan individu dewasa serta kemungkinan terjadinya beban ganda malnutrisi dalam satu rumah tangga di Indonesia Timur. Dengan menggunakan data IFLS East tahun 2012 dan metode estimasi probit serta probit with sample selection, hasil studi menemukan bahwa keterbatasan akses pangan secara ekonomi, dari sisi pendapatan dan harga pangan pokok tidak hanya meningkatkan kemungkinan …

A Study Of The Relationship Between Job Related Stress And Temporomandibular Disorders In Accountants Working In Jakarta, Cindy Maura Saputra, Laura Susanti Himawan, Ira Tanti

Journal of Dentistry Indonesia

Stress is a known risk factor for Temporomandibular Disorders (TMD), however there are few studies of TMD in people who work in high stress jobs. Accounting is a profession known for its high levels of stress and expectation. Objective: The aim of this study is to investigate the relationship between the intensity and frequency of job related stress and the occurrence of TMD in accountants in Jakarta. Methods: A cross-sectional study, with ethics approval from the Ethical Committee of the Faculty of Dentistry, University Indonesia, was performed on 116 accountants aged 21 to 50, living in Jakarta. Subjects were asked …

Burden Of Disease Associated With Lower Levels Of Income Among Us Adults Aged 65 And Older, Erica I. Lubetkin, Haomia Jia

Publications and Research

Background: Persons aged 65 years and older represent a heterogeneous group whose prevalence in the USA is expected to markedly increase. Few investigations have examined the total burden of disease attributable to lower levels of income in a single number that accounts for morbidity and mortality.

Methods: We ascertained respondents’ health-related quality of life (HRQOL) scores and mortality status from the 2003 to 2004, 2005 to 2006, 2007 to 2008 and 2009 to 2010 cohorts of the National Health and Nutrition Examination Survey (NHANES) with mortality follow-up through 31 December 2011. A mapping algorithm based on respondents’ age and answers …

Decreasing Cost Associated Medication Nonadherence, Shawn E. Raymond

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Shawn E. Raymond

Medication cost is a major contributor for patient medication nonadherence. Take in the fact that a large population lives in poverty, many cannot afford to pay the retail prices associated with purchasing their medications. By incorporating wholesale medications into a charitable health clinic, the reduced cost of medications for treatment of both acute and chronic illnesses could be passed on to those in need thereby decreasing cost associated medication nonadherence. Nurse Practitioners in the state of Kansas are not afforded the privilege to purchase, repackage and distribute or resell wholesale …

Goods-Time Elasticity Of Substitution In Health Production, Juan Du, Takeshi Yagihashi

Economics Faculty Publications

We examine how inputs for health production, in particular, medical care and health-enhancing time, are combined to improve health. The estimated elasticity of substitution from a constant elasticity of substitution production function is significantly less than one for the working-age population, rejecting the unit elasticity of substitution used in previous studies.

Give A Man A Fish: A Narrative Approach To A Case Study Of Soup Kitchens In The Wentworth Community, Evelyn Shen

Independent Study Project (ISP) Collection

This study uses a narrative approach to explore the role of soup kitchens in the predominantly Coloured and English-speaking Wentworth community. Many of the community’s churches1 and non-profit organizations host soup kitchens regularly, rotating so that there is a meal available each day of the week.

Qualitative data was gathered through volunteering with the soup kitchens as a participant observer and having conversations and open-ended interviews with soup kitchen guests and hosts. Institutional context was provided by interviews with the Convener of the War Room and the Ward Councillor, and representatives of three non-profits in the community. In order to …

Economic Costs And Benefits Of A Community-Based Lymphedema Management Program For Lymphatic Filariasis In Odisha State, India, Eileen Stillwaggon, Larry Sawers, Jonathan Rout, David Addiss, Leanne Fox

Economics Faculty Publications

Lymphatic filariasis afflicts 68 million people in 73 countries, including 17 million persons living with chronic lymphedema. The Global Program to Eliminate Lymphatic Filariasis aims to stop new infections and to provide care for persons already affected, but morbidity management programs have been initiated in only 24 endemic countries. We examine the economic costs and benefits of alleviating chronic lymphedema and its effects through a simple limb-care program. For Khurda District, Odisha State, India, we estimated lifetime medical costs and earnings losses due to chronic lymphedema and acute dermatolymphangioadenitis (ADLA) with and without a community-based limb-care program. The program would …

Three Essays On Informal Payments In The Health Care Sector In Russia, Alexandra Polovinka

Dissertations

Health care is one of the most corrupt sectors in Russia. In 2015 twenty percent of patients paid a bribe for the health care services once or twice, and thirteen percent more than twice (Russian Public Opinion Research Center, 2015). Using data on adults from over 5,000 households in Russia, this three-essay study analyzes out-of-pocket formal (official) and informal (unofficial, bribes) payments for the health care.

In the first essay, I study whether there is a difference in the amount of unofficial pay-ments across five types of health care services (ambulance, inpatient, outpatient, dental, and medical checkups) and two types …

The Financial Dialogue In The Development Of Medical Treatment Plans, Christopher D. Busack, Ms3, Bethany Fox, Ms3

The Medicine Forum

As patients face increasingly high out-of-pocket costs and difficulties navigating the healthcare system, failing to discuss available treatment options in financial terms can lead to grave consequences for patients. Medical bills are responsible for the majority of bankruptcies in the United States. Given the severe financial implications of medical bills, it is imperative that patients become more involved in discussions of their treatment plans and become aware of the costs of their decisions up front. Counseling about costs ensures that physicians avoid placing a debilitating financial burden on patients and maintain adherence to the ethical principle of non-maleficence. Various studies …

Evaluasi Pengadaan Obat Publik Pada Jkn Berdasarkan Data E-Catalogue Tahun 2014-2015, Ary Dwiaji, Prih Sarnianto, Hasbullah Thabrany

Jurnal Ekonomi Kesehatan Indonesia

Since National Health Insurance (JKN) has been implemented, drug procurement in public health care facilities use e-Purchasing via e-Catalogue. Based on the RKO and HPS, drafting e-Catalogue have gone through a tender process and price negotiations. The process chain will effect the type (molecules) and the amount of drug through the e-Catalogue as well as the number and volume of demand by public health care facilities (e-Order).

Biaya Dan Outcome Hemodialisis Di Rumah Sakit Kelas B Dan C, Firda Tania, Hasbullah Thabrany

Jurnal Ekonomi Kesehatan Indonesia

Chronic Kidney Disease (CKD) is a condition that is increasing in incidence in Indonesia, consuming a lot of National Health Insurance (JKN) public funds. In the JKN program, hemodialysis (HD) for treating CKD is guaranteed but requires a balance between costs and outcomes. Since 2014, BPJS has covered almost all HD costs in Indonesia with different Casemix Base Group (CBG) rates according to hospital class.

Application Of Decision Analytic Model In Health Economic Evaluation: Smoking Cessation Cases, Septiara Putri

Jurnal Ekonomi Kesehatan Indonesia

Health economic evaluation that encompasses decision analytic model is a beneficial approach for assisting decision maker to choose the best health intervention for patients. Decision analytic model has been increasingly applied in health economic evaluation. This mathematical approach is mostly used for conducting cost-effectiveness of healthcare interventions. Decision tree and Markov model has been widely applied in the past 20 years. Decision tree is the simplest form of decision model that drawn by the series of branches and clear pathways. Meanwhile, Markov model is one of the powerful approaches that employ stochastic process in health economic evaluation. This paper describes …

Terapi Sistemik Defisit Jkn: Bahan Refleksi Bagi Semua Pihak, Budi Hidayat

Jurnal Ekonomi Kesehatan Indonesia

The deficit deserves to be considered a chronic JKN disease. Indications of the deficit are revealed from the claims ratio figures. In 2014 and 2015, the claims ratio was consistently above 100%. This figure results from dividing claim costs (or participant health costs) by contribution income. Thus, the claims ratio describes the absorption of contribution funds for health costs only. However, contribution income must also be allocated for operational expenses and reserves. The JKN deficit will continue to grow if systemic therapy is nil. For 2016, the author's estimation results by referring to the assumed contribution amounts by Presidential Regulation …

A Comparative Budget Requirements For Tb Program Based On Minimum Standard Of Services (Spm) And Budget Realization: An Exit Strategy Before Termination Of Gf Atm, Ery Setiawan, Purwa K. Sucahya, Hasbullah Thabrany

Jurnal Ekonomi Kesehatan Indonesia

It has become a common issue that the Global Fund (GF) as one of the largest international donors to AIDS, Tuberculosis, and Malaria Program will immediately stop the funding. Data shows that in 2009 GF ATM support reached 88,8% while APBN funding just cover 11,2% of the total budget needed. However, APBN budget for ATM programs was significantly increased in 2012 which covered almost 30% of the total budget. Eventhough the increasing trend of ATM budget seemed at the central government level, how ever the local governments will hold the key to the sustainability of the post- termination GF ATM …

People’S Support On Sin Tax To Finance Uhc In Indonesia, 2016, Hasbullah Thabrany, Zahrina Laborahima

Jurnal Ekonomi Kesehatan Indonesia

Indonesia has the highest prevalence of smokers with 67% of adult males were smokers. Smoking prevalence among all adults increased sharply from 27% in 1995 to 36.3% in 2013. High consumption of cigarettes has been correlated with low price and excise of cigarettes. Experiences from other countries showed that one of the most effective way to reduce cigarette consumption is by increasing cigarette price and excise. Burden of tobacco related diseases has increased. The health burden will increase claims of JKN or Universal Health Coverage which currently has claim ratio of 115% and the quality of care remain low. The …

The Economics Of Lotto, Ian Walker, Robert E. Pryce, Rhys Wheeler, Nick Powdathvee

International Conference on Gambling & Risk Taking

No abstract provided.

Variation In Restaurant Sanitary Scores In New York City, Kyle Gregory

Theses and Dissertations

The purpose of this study was to determine whether restaurants that are homogenous in nature would exhibit substantially different hygiene scores based on the underlying consumer learning behaviors present in the neighborhoods in which the restaurants are located.

Public Health Spending And Its Contributions To The Total Spend On Health, Glen P. Mays

Health Management and Policy Presentations

This presentation provides an overview of recent research on governmental public health expenditures and their interaction with medical spending, carried out through the Robert Wood Johnson Foundation supported initiatives on Public Health Services and Systems Research (PHSSR) and the new Systems for Action research program. This work illustrates the value of tracking resource use across multiple sectors that influence health and well-being in American communities. As such, this work can inform the ongoing dialogue about methodologies for summarizing total health spending for the U.S. and for state and local areas.

Hospital-Skilled Nursing Facility Referral Linkage Reduces Readmission Rates Among Medicare Patients Receiving Major Surgery, Andrew J. Schoenfeld, Xuan Zhang, David C. Grabowski, Vincent Mor, Joel S. Weissman, Momotazur Rahman

Research Collection School Of Economics

BACKGROUND:In the health reform era, rehospitalization after discharge may result in financial penalties to hospitals. The effect of increased hospital-skilled nursing facility (SNF) linkage on readmission reduction after surgery has not been explored.METHODS:To determine whether enhanced hospital-SNF linkage, as measured by the proportion of surgical patients referred from a hospital to a particular SNF, would result in reduced 30-day readmission rates for surgical patients, we used national Medicare data (2011-2012) and evaluated patients who underwent 1 of 5 operative procedures (coronary artery bypass grafting [CABG], hip fracture repair, total hip arthroplasty, colectomy, or lumbar spine surgery). Initial evaluation was performed …

Measuring Progress To Comprehensive Public Health Systems, National Preparedness, And A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

This update describes recent progress on two national health measurement initiatives: The National Health Security Preparedness Index and the National Longitudinal Survey of Public Health Systems. These longitudinal data sources offer valuable perspectives on how health security practices and public health delivery systems are changing across the U.S.

Understanding The Value Of Multi-Sector Partnerships To Improve Population Health, Glen P. Mays

Health Management and Policy Presentations

We review recent research concerning multi-sectoral partnerships aimed at improving health status on a population-wide basis, with a particular focus on implementation strategies and on health and economic impact. While still preliminary and emerging, research indicates that large health benefits are possible through collective actions that engage the medical, public health, and social sectors. Mechanisms for aligning incentives, dividing responsibilities equitably, and measuring progress regularly appear critical to success.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays, Rick Ingram

Health Management and Policy Presentations

We review methods for measuring the structure of public health delivery systems using data from the National Longitudinal Survey of Public Health Systems. A growing body of research using these measures demonstrates how multiple sectors contribute to core public health functions, and how these functions influence community health status over time. We end with a summary of how the Comprehensive Public Health System measure will be used in monitoring the impact of the 21st Century Public Health System initiative.