Health Economics Commons^™

Community Benefits Spending By Private Tax-Exempt Hospitals In The U.S., Wael Elrayes

Theses & Dissertations

The Internal Revenue Service issued the long awaited regulatory guidelines for the Community Benefits (CB) spending for private tax-exempt hospitals in December 2008, which required these hospitals to report their policies, practices, and spending on CB activities. The Affordable Care Act amended these rules in 2010 by adding a section on Community Health Needs Assessment.

This study evaluates and tracks spending on the total and different CB activities by all private tax-exempt hospitals in seven states after the implementation of the latest IRS and ACA reporting regulations from 2010 - 2013. Moreover, this study investigates which community health indicators are …

The Design Of An Instrument To Assess Clinical Laboratories Efficacy Post Implementation Of The Patient Protection Affordable Care Act, Harry Mcdonald Jr.

Dissertations

The healthcare system in the United States has undergone substantial changes in support of the Patient Protection and Affordable Care Act (PPACA). On March 23, 2010, the implementation of the new healthcare law brought universal healthcare access to all Americans, while attempting to increase quality and decrease medical costs. The new law promotes more of a quality-focused, outcome-based model rather than a pay-for-fee service model; thus, moving the paradigm from infrequent to preemptive healthcare. The PPACA postulates as the only way to achieve cost savings while increasing quality and access. Never before has there been such an extensive change to …

Why Do Women Delay In Seeking Prenatal Care? A Discrete-Time Survival Analysis, Ama Agyeiwaa Abrokwah

Research and Creative Activities Poster Day

Prenatal care during early stages of pregnancy can result in early detection of some pregnancy related complications which can help reduce both maternal and infant mortality (Conway et al., 2006). The cost of service has been identified as an important determinant of the utilization of prenatal care in most developing countries. This paper evaluates how Ghana’s social health insurance program affects the timing of prenatal care utilization using survival analysis techniques. This paper hypothesizes that having insurance will result in early utilization of prenatal care.

Maternal Autonomy And Child Health Care Utilization: Evidence From Bangladesh, Ashiqul Alam

Undergraduate Research Symposium 2017

My research looked into the relationship between maternal autonomy and how child health care is utilized in third world countries. I worked with my professor, Dr. Bibhudutta Panda, to specifically look at Bangladesh as our country of interest. The country itself is smaller than Florida but is ranked number 8 for the most populated country. In Bangladesh the infant mortality rate is 6 times more than the US, at 30.7 per 1000 live births and government expenditure is also low. The main reason behind to pick Bangladesh is also that it is a third world country and also a patriarchal …

Determinants Of Health Expenditures In Oecd Countries, Giang Phi

Honors Projects in Economics

Around the world, governments are coping with spiraling health care spending. This spurs the need for further insight in the determinants of such expenditures. This study investigates the determinants of health care expenditures for a sample of thirty five countries in the Organization for Economic Cooperation and Development (OECD) from 2000 to 2013 in order to understand the impact of different factors on health care spending growth. Besides Gross Domestic Product (GDP), the study accounts for many different driving forces such as demographics, medical progress, health system characteristics, public financing, and other non-medical determinants of health spending such as alcohol …

Fertility And Female Labor Force Participation: The Role Of Legal Access To Contraceptives, Chaney Skadsen

Student Research – Stevenson Center

Around the world there has been a global trend of falling fertility rates and increasing female labor force participation rates, simultaneously. The negative association between the two provides impetus to investigate whether fertility acts as an obstruction to the labor market for women and the possibility of incompatibility between motherhood and employee. I find that fertility only acts as an inhibiter to the labor force for women when instrumented with legal access to sterilization as a form of contraception among the other three forms tested. Therefore, when permanent forms of contraceptives are legal and available it allows for more women …

Foreign Aid Allocation And Impact In Latin America And The Caribbean (Lac): A Cross-Country Analysis Of Foreign Aid Impact On Gdp Per Capita And Life Expectancy, Ancito Etienne

Undergraduate Theses and Capstone Projects

This research paper is an empirical study of the impact of official development assistance and official aid received, [henceforth, to be referred to as “foreign aid”], on life expectancy and GDP per capita in Latin America and the Caribbean. I used a panel dataset of 19 countries dated from 1996 to 2014 to perform two distinctive regressions using the OLS method. In addition, an exploration of the impact of GDP per capita on life expectancy was conducted to determine whether there was a cause and effect phenomenon; that is, testing whether an impact of foreign aid on GDP per capita …

Analisis Upaya Rumah Sakit Dalam Menutupi Kekurangan Biaya Klaim Indonesia Case Base Group (Ina-Cbgs) Yang Dihitung Dengan Metode Activities Base Costing Pada Rumah Sakit Swasta Kelas C Di Kota Medan Tahun 2017, Destanul Aulia, Sri Fajar Ayu Universitas Sumatera Utara

Jurnal Ekonomi Kesehatan Indonesia

Indonesia has developed the National Social Insurance System with the establishment of the National Health Insurance program and organized by BPJS Kesehatan. One of payment way of health services for the hospital in the era of JKN is Indonesian Case Base Group (INA-CBG’s), that is the payment of claims from BPJS to hospital on a package of services based on the packet of disease diagnosis and procedure.This study aims to analyze efforts by hospitals to cover the cost deficiency of INA CBG’s claims in Privat Hospital in Medan. This research type is descriptive with qualitative and quantitative. Qualitative is done …

Cost Recovery Rate Tarif Rumah Sakit Dan Tarif Ina-Cbg’S Berdasarkan Clinical Pathway Pada Penyakit Arteri Koroner Di Rs Pemerintah A Di Palembang Tahun 2015, Mardiah Mardiah, Ronnie Rivany

Jurnal Ekonomi Kesehatan Indonesia

The difference of cost negative in the case of Coronary Artery Disease (CAD) with Percutaneous Coronary Intervention (PCI), indicate health financing gap between of hospital rates and INA-CBG’s rates. This study aimed to see the difference between the cost recovery rate (CRR) of hospital rates and INA-CBG’s rates for CAD with PCI at A Hospital. The results showed that the cost of treatment based on clinical pathways at the severity level I had a higher CRR Hospital rates compared to INA-CBG’s CRR, whereas at the severity level II, Hospital CRR rate was lower than INA-CBG’s CRR for the utility of …

Analisis Minimalisasi Biaya Obat Antihipertensi Antara Kombinasi Ramipril-Spironolakton Dengan Valsartan Pada Pasien Gagal Jantung Kongestif Di Rumah Sakit Pemerintah Xy Di Jakarta Tahun 2014, Cyntiya Rahmawati, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

Hypertension is one of risk factors for congestive heart failure as the top 10 most prevalent diseases in XY Public Hospital in 2014. It has a large number of total cost and cost deviation between hospital and JKN rate. This study aimed to choose an alternative that is more cost-effective to treat congestive heart failure at XY Hospital in 2014. This was a quantitative research using retrospective cross-sectional analysis. The study compared the average value of total cost of two alternative treatments, ramipril-spironolactone with valsartan by using Hospital’s perspective. Direct medical cost components were cost of drugs, cost of physicians’ …

Medicaid Managed Care And The Health Care Utilization Of Foster Children, Makayla Palmer, James Marton, Aaron Yelowitz, Jeffery Talbert

Molasky Family Department of Economics and Real Estate Faculty Research

A recent trend in state Medicaid programs is the transition of vulnerable populations into Medicaid managed care (MMC) who were initially carved out of such coverage, such as foster children or those with disabilities. The purpose of this article is to evaluate the impact of the transition of foster children from fee-for-service Medicaid coverage to MMC coverage on outpatient health care utilization. There is very little empirical evidence on the impact of managed care on the health care utilization of foster children because of the recent timing of these transitions as well as challenges associated with finding data sets large …

Overpopulation And The Impact On The Environment, Doris Baus

Dissertations, Theses, and Capstone Projects

In this research paper, the main focus is on the issue of overpopulation and its impact on the environment. The growing size of the global population is not an issue that appeared within the past couple of decades, but its origins come from the prehistoric time and extend to the very present day. Throughout the history, acknowledged scientists introduced the concept of “overpopulation” and predicted the future consequences if the world follows the same behavioral pattern. According to predictions, scientists invented the birth control pill and set population control through eugenics. Despite that, population continued to increase and fight with …

Production Of Energy And Environmental Protection As A Prerequisite For Sustainable Development, Diana Baus

Dissertations, Theses, and Capstone Projects

This paper explains why renewable energy is a prerequisite for sustainable development. The development of renewable energy sources is important because renewable energy sources have a very important role in reducing emissions of carbon dioxide (CO₂) into the atmosphere, eradicate poverty and increase the employment rate. In the first section the paper introduces renewable energy sources. The focus is on the function of solar energy, wind power, biomass, geothermal energy, and hydroelectric energy and their implementation globally. The second part of the paper elaborates on the economic, political, and social aspects for the development of renewable energy sources. …

Medicaid, Family Spending, And The Financial Implications Of Crowd-Out, Marcus Dillender

Upjohn Institute Working Papers

A primary purpose of health insurance is to protect families from medical expenditure risk. Despite this goal and despite the fact that research has found that Medicaid can crowd out private coverage, little is known about the effect of Medicaid on families' spending patterns. This paper implements a simulated instrumental variables strategy with data from the Consumer Expenditure Survey to estimate the effect of an additional family member becoming eligible from Medicaid on family-level health insurance coverage and spending. The results indicate that an additional family member becoming eligible for Medicaid increases the number of people in the family with …

Strategi Pemasaran Pelayanan Continuous Ambulatory Peritoneal Dialysis Di Klinik Khusus Ginjal X Batam Tahun 2016, Bertha Toha, Vetty Y Ulianty Permanasari

Jurnal Ekonomi Kesehatan Indonesia

Currently only 53% of patients with end-stage renal disease that can access dialysis and mostly get Hemodialysis (HD), whereas the cost to Continous Ambulatory Peritoneal Dialysis (CAPD) cheaper than HD (Ministry of Health, 2016). Services of CAPD in Clinic for Kidney Disease X. Batam began since 2010, but the number of CAPD patients only 3% of the end stage renal disease patients there. The purpose of this study to analyze the Marketing Strategy of Continuous Ambulatory Peritoneal Dialysis Services at the Clinic for Kidney Disease X Batam Year 2016. The design of the study is an analytic descriptive with quantitative …

Analisis Minimisasi Biaya Amlodipin Generik Dan Bermerk Pada Pengobatan Hipertensi Di Rs X Pekanbaru Tahun 2015, Hanny Merliana, Amal Chalik Sjaaf

Jurnal Ekonomi Kesehatan Indonesia

Hypertension in a big challenge in Indonesia, proven by its prevalence that reached 25% in 2013 and conditions that mostly found in primary health care. In addition, hypertension management is considered to be suboptimal despite the availability of effective drugs. Amlodipine is one of anti-hypertensive that is commonly prescribed by X Hospital, Pekan Baru. Therefore, it is important to do cost minimization analysis to compare both generic and branded Amlodipine as an implementation of cost and quality control. This retrospective study involved early and medium stage of hypertensive patients that have at least a month period of treatment from January …

Analisis Biaya Akibat Sakit Serta Kualitas Hidup Pasien Diabetes Mellitus Tipe 2 Dengan Penyakit Jantung, Lusiani Septika Sari

Jurnal Ekonomi Kesehatan Indonesia

Indonesia is the fourth most deaths due diabetes mellitus and heart disease among south Asia countries. Cost of illness from diabetes mellitus with heart disease is the highest cost if it is compared with combination of diabetes mellitus with other chronic disease. This study with 110 patients as samples is aiming to describing the cost of illness and quality of life of patients with type 2 diabetes mellitus with heart disease in X public hospital. With cross sectional research design, primary data is collected with survey technique that uses structured questionnaire and secondary data is obtained through medical record document …

Analisis Implementasi Kebijakan Rujuk Balik Diabetes Melitus Di Puskesmas X Kota Tangerang Selatan, Aries Hamzah, Wahyu Sulistiadi

Jurnal Ekonomi Kesehatan Indonesia

The Increasing of Prevalence of Diabetes Mellitus will increase health expenditure in Universal Health Coverage (JKN). The role of health primary care as the front side in health services on back referral for Diabetes disease becomes very important. The purpose of this study was to determine the effectiveness of policy implementation in Diabetes Mellitus back referral behind PHC X 2014. This study used a qualitative approach to the study design content analysis and triangulation methods. Primary data obtained by in-depth interviews, focus groups, and observations in the field. Secondary data were obtained from policy documents and literature. The results showed …

Cost Effectiveness Analysis Between Hemodialysis And Peritoneal Dialysis, Elsa Novelia, Ryan Rachmad Nugraha, Hasbullah Thabrany

Jurnal Ekonomi Kesehatan Indonesia

The number of patients with End Stage Renal Disease (ESRD) in Indonesia is growing. Increasing prevalence of hypertension and diabetes mellitus contributes to higher prevalence of ESRD. The majority of patients (94%) with ESRD are undertaking hemodialysis (HD) at public and private hospitals. However, continuous ambulatory Peritoneal Dialysis (PD) has been prescribed to small portion of patients with ESRD. The aim of this study was to examine the cost effectiveness between HD and PD on ESRD patients. This study compared 78 HD patients at Hospital X in Bogor and 10 PD patients at Hospital Y in Jakarta. Patient’s quality of …

Biaya Satuan Dan Pemulihan Biaya (Cost Recovery Rate) Layanan Pasien Acute Coronary Syndrome Dengan Rawat Inap Di Rumah Sakit X Tahun 2015, Anna Aurelia, Eka Pujiyanti

Jurnal Ekonomi Kesehatan Indonesia

X Hospital is a Class C Hospital in South Jakarta, which experiencing a substantial increased number of patients since the BPJS has implemented the referral system. Acute Coronary Syndrome (ACS) patient is a patient with a medical emergency require intensive treatment in the ICU. The purpose of this study was to analyze the cost for hospitalized ACS patients at X Hospital in 2015 using activity based costing. The study revealed that the unit cost of hospitalized ACS patients at X Hospital in 2015 was Rp 6.083.444,-. The Cost Recovery Rate for patients with fee-for-service was 227.98% and for BPJS patient …

Race, Age, And Neighborhood Socioeconomic Status In Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry, Sheryl L. Coley, Tracy R. Nichols

Journal of Health Disparities Research and Practice

Introduction: Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers.

Methods: Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial …

Beyond The Legalization Of Marijuana: Economics Of Marijuana As A Drug And Herbal Supplement, Ryan T. Freer

Electronic Theses and Dissertations

Normative studies misunderstand a crucial aspect of cannabis legalization: they have not critically analyzed how the pharmaceutical industry might react when synthetic cannabinoid compounds could be incorporated into new products. I argue that when marijuana is federally legal, there will be two independent market developments in: i) the cannabis market, which includes botanic cannabis and herbal supplements sold in retail nutrition stores; and ii) the FDA-approved ethical drug market. How does the drug industry's monopolistic pricing structure lend itself to strategic pricing for these new synthetic cannabinoids? How much competition can we expect between dispensaries and nutrition shops selling herbal …

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 …

Happiness Index Methodology, Laura Musikanski, Scott Cloutier, Erica Bejarano, Davi Briggs, Julia Colbert, Gracie Strasser, Steven Russell

Journal of Sustainable Social Impact

The Happiness Index is a comprehensive survey instrument that assesses happiness, well-being, and aspects of sustainability and resilience. The Happiness Alliance developed the Happiness Index to provide a survey instrument to community organizers, researchers, and others seeking to use a subjective well-being index and data. It is the only instrument of its kind freely available worldwide and translated into over ten languages. This instrument can be used to measure satisfaction with life and the conditions of life. It can also be used to define income inequality, trust in government, sense of community and other aspects of well-being within specific demographics …

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 …

The Role Of Behavior In The Effectiveness Of Indoor Air Pollution Interventions: Results From The Artis Study, Madison J. Cole

Graduate Student Theses, Dissertations, & Professional Papers

Using panel data from a randomized placebo-controlled trial of a wood stove changeout and air filter interventions, this study addresses the role of behavior in the efficacy of air quality interventions. The effectiveness of an intervention in improving air quality depends on how households respond to and use them. Two important responses are whether the target population complies with the requirements of the intervention and whether users adjust other behaviors that can affect air quality.

This paper’s results are consistent with prior studies in finding that in the absence of interventions, a number of behaviors can affect indoor air pollution, …

Determinants Of The Utilization Of Maternal Health Services In Myanmar, Myat Thu San

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study explored determinants of the utilization of three types of maternal health services in Myanmar: antenatal care (ANC), institutional delivery, and postnatal care (PNC), testing in particular the predisposing factors, enabling factors and perceived need factors. This study used a secondary dataset drawn from the Myanmar Demographic and Health Survey 2015-16 (MDHS). In this nationally representative survey, the number of households that were originally involved was 12,500, among which 12,885 women and 4,737 men were interviewed. The final sample used for analyses in this study consisted of over 3,800 women who had delivered at least one child within 5 …

The Ethical And Economic Concerns Of Physician Assisted Suicide, Wade M. Smith

Augustana Center for the Study of Ethics Essay Contest

No abstract provided.

Partnering With The Private Sector To Strengthen Provision Of Contraception, Karen Hardee, David Wofford, Nandita Thatte

Reproductive Health

Family planning is most successful when clients have a variety of methods to choose from and a variety of service delivery sites from which to obtain them. The private sector plays a critical role in family planning and can contribute to a total market approach to providing contraceptives. Among private sector service options, social marketing, social franchising, and pharmacies and drug shops most readily contribute to sustainable markets for contraceptive services. Corporate sector workplace programs also show promise for reaching millions of women. This evidence brief outlines a number of policy and program considerations for countries as they move toward …

The Relationship Between Income And Food Intake In China, Xinfang Li

Chulalongkorn University Theses and Dissertations (Chula ETD)

This study investigated the effect of food intake, which is considered a form of health investment, on income in China, accounting also for socioeconomic factors. It used the 2011 wave of the China Health and Nutrition survey, including 42,870 observations in the analysis. Six dependent variables, each representing a different measure of income, were explored. The main explanatory variables included a 3-day total food consumption (grams), a 3-day average intake of energy (kilocalories), a 3-day average intake of carbohydrate (grams), a 3-day average intake of protein (grams) and a 3-day average intake of fat (grams). Personal, household, and area characteristics …