Health Economics Commons^™

Medicare Drug Price Negotiation Program Draft Guidance, Fred Ledley M.D., Edward Zhou Pharmd, Paula Chaves Da Silva Ph.D.

CISI Publication

This comment focuses on Section 50.1, provisions 1 & 3 of the draft guidance regarding the negotiation of a “maximum fair price” under the Inflation Reduction Act (IRA), research and development (R&D) costs of the primary manufacturer, and prior federal financial support for novel therapeutic discovery and development. Specifically, we argue that a negotiated, “maximum fair price” must consider both public sector (federal) and private sector (manufacturer) investments and provide returns to both commensurate with the scale and risk of their investments. This comment addresses three issues and makes specific recommendations regarding each:

1. In negotiating a “maximum fair price,” both …

Hiv Estimation Using Population-Based Surveys With Non-Response: A Partial Identification Approach, Oyelola A. Adegboye, Tomoki Fujii, Denis H. Y. Leung, Siyu Li

Research Collection School Of Economics

HIV estimation using data from the demographic and health surveys (DHS) is limited by the presence of non-response and test refusals. Conventional adjustments such as imputation require the data to be missing at random. Methods that use instrumental variables allow the possibility that prevalence is different between the respondents and non-respondents, but their performance depends critically on the validity of the instrument. Using Manski's partial identification approach, we form instrumental variable bounds for HIV prevalence from a pool of candidate instruments. Our method does not require all candidate instruments to be valid. We use a simulation study to evaluate and …

Health Insurance And The Rise Of Women: Evidence From The New Cooperative Medical Scheme, Xingyu Bai

Dissertations and Theses Collection (Open Access)

Females are traditionally viewed as the primary providers of informal parental care in China, especially in rural areas. We investigate whether health insurance coverage in rural China, the New Cooperative Medical Scheme (NCMS), can unleash more female labor force participation by reducing the burden of informal parental care. Employing a heterogeneity-robust difference-in-differences estimation, we find that the NCMS has a significant positive impact on female labor supply, primarily in non-farm occupations. In contrast, we observe no significant changes in male labor supply. We explore the mechanism by showing that the NCMS significantly decreases both the provision and demand for parental …

Effect Of Catastrophic Medical Insurance On Healthcare Service Utilization And Quality, Ruiqi Ding

Dissertations and Theses Collection (Open Access)

China implemented catastrophic medical insurance (CMI) program to provide additional reimbursement for individuals requiring extensive healthcare services due to severe illnesses. This study empirically assesses the impact of the CMI program on the healthcare utilization and quality of care for severely ill patients, using medical insurance claim data from 2012 to 2018 in a capital city in China. The analysis yields the following conclusions: First, CMI decreased the medical expenditure of severe patients, but it had no impact on alleviating the financial burden. Second, CMI curbed abuse and saved medical resources, and in the meantime, it increased the use of …

Analisis Penerapan Activity-Based Costing Tindakan Debridemen Bedah Pada Diagnosis Tunggal Di Kamar Operasi Rskd Duren Sawit Tahun 2022, Reynaldi Fattah Zakaria, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

In 2022, RSKD Duren Sawit has officially held operating room services. The demand for more comprehensive operating room services increased rapidly. The temporary operating room rates were set by adapting the rates of other regional hospitals and the Governor of DKI Jakarta's regulations. There is a huge difference in costs between the hospital rates and the INA-CBGs claim rates, especially for surgical debridement performed in the operating room. One of the factors causing the difference is the undetermined cost for debridement based on the unit cost component. Knowing the unit-cost debridement in the operating room according to the cost per …

Dampak Program Bantuan Sosial Sebagai Intervensi Gizi Sensitif Terhadap Status Stunting Pada Balita, Nasa Milta Sahara, Dwini Arianto, Mahar Santoso

Jurnal Ekonomi Kesehatan Indonesia

Stunting is a significant issue for nations, affecting both public health and economic development. It results from a combination of direct and indirect causes. The government addresses stunting through specific nutritional interventions targeting direct causes and sensitive nutritional interventions for indirect causes. Given the strong link between stunting and poverty, social assistance programs (BANSOS) such as the Family Hope Program (PKH) and Rice for the Poor (RASKIN) are crucial in combating stunting by improving socioeconomic conditions. This study analyzes the impact of these social assistance programs on stunting in children under five, using data from the 2007 and 2014 Indonesian …

Determinan Belanja Kesehatan Rumah Tangga Di Pulau Jawa Menggunakan Geographically Weighted Regression, Yaulanda Fadhila, Nucke Widowati Kusumo Projo

Jurnal Ekonomi Kesehatan Indonesia

The success of a country’s health development is marked by achieving fair access to healthcare and protecting the population from financial risks of health. Household spending on healthcare, or out-of-pocket (OOP) expenses, in Indonesia, remains far above the ideal limit set by the WHO. There is a noticeable disparity in OOP health expenditures across provinces in Indonesia. The five provinces with the highest per capita OOP expenses are on Java island. This high per capita OOP spending on Java indicates potential issues with access to healthcare services and financial protection in this region. This study aims to identify factors influencing …

Analisis Klaim Rawat Inap Rsud Kebayoran Baru November 2022 – April 2023: Pendekatan Sistem, May Rabiulyati, Atik Nurwahyuni, Pujiyanto Pujiyanto

Jurnal Ekonomi Kesehatan Indonesia

Hospitals receive payments through claim submissions with complete documents to the Social Security Administering Agency (BPJS) Health. However, not all inpatient claims have been submitted to BPJS Health, and there are still 16.97% pending inpatient claims. In claims that are not approved, claims can be resubmitted, but time constraints for the claim process have resulted in 2.64% of inpatient cases in 2022 not resubmitted. Qualitative research through in-depth interviews with 15 respondents aims to analyze the management of inpatient claims for BPJS Kesehatan Kebayoran Baru Hospital from November 2022 to April 2023. The study results showed that not all printed …

Analisis Pembiayaan Berdasarkan Lama Rawat Pasien Bpjs Diabetes Melitus Tipe Ii Komplikasi Sirkulasi Perifer Di Rsu Pku Muhammadiyah Bantul, Firman Firman, Kartika Lestari

Jurnal Ekonomi Kesehatan Indonesia

Length of stay (LOS) can increase hospital rates and become a cost issue for patients, potentially resulting in a discrepancy between hospital rates and INA-CBGs rates at the hospital. This study aims to determine the difference between the actual costs and BPJS claim costs for diabetic patients based on the length of stay and class level. The research method is observational with a descriptive approach. The data collection technique used retrospective medical record data from 50 patients. The results showed that the largest average difference between hospital costs and BPJS claim costs was for patients with a length of stay …

Assessing The Impact Of Tuberculosis On Economic Growth In Asean Countries: A Conceptual Framework And Panel Data Analysis, Agus Fitriangga, Alex Alex

Jurnal Ekonomi Kesehatan Indonesia

Tuberculosis (TB) remains a major global health issue, particularly in Southeast Asia, where its impact extends beyond public health to affect economic performance. This study evaluates the economic implications of TB incidence on gross domestic product (GDP) growth across eight ASEAN countries from 2000 to 2020. We employed a panel data regression approach, utilizing Common Effect Model (CEM), Fixed Effects Model (FEM), and Random Effects Model (REM) to analyze the relationship between TB incidence and economic growth. The dataset included annual GDP figures, TB incidence rates, foreign direct investment (FDI), labor force size, and trade openness, sourced from international databases. …

Weight Misperceptions And Health Management Via Information Nudges, Lanjie Wang, Xuan Zhang, Seonghoon Kim, Kanghyock Koh

Research Collection School Of Economics

Being overweight or obese is a serious public health problem. Misperception of one's own weight status and inertia are major obstacles to weight control. To overcome these two problems, we conduct a randomized controlled trial in which participants are presented with the correct weight category based on their body mass index to remove any weight misperception, and then given six biweekly reminders about healthy diet and physical activity via SMS/email. We find that our intervention reduces individuals’ weight misperception and encourages healthier dietary choices. However, it has little impact on their physical activity. We further show that people who were …

Unveiling The Impact Of Jkn: Easing Financial Burdens For Pregnant Women In Indonesia, Januar Sulaeman, Riatu Mariatul Qibthiyyah

Economics and Finance in Indonesia

Indonesia’s maternal mortality rate is the second highest in the ASEAN, partly due to financial barriers preventing adequate care during pregnancy and childbirth. The National Health Insurance (JKN) scheme, which is the embodiment of universal health coverage (UHC), was designed by the Indonesian government to reduce the financial risk of its participants. However, its impact on out-of-pocket health spending for pregnant women is under-researched. Using propensity score matching (PSM) and 2019 SUSENAS data, this study found that JKN membership significantly reduced out-of-pocket health spending for pregnant women—especially in eastern Indonesia, where poverty and healthcare access represent critical issues.

Essays In Applied Microeconomics, Ege Aksu

Dissertations, Theses, and Capstone Projects

This dissertation consists of two chapters that investigate the effect of public health policies on health outcomes.

The first chapter evaluates the impact of the extensive health care reforms enacted between 2003–2013 under the Health Transformation Program (HTP) in Turkey on maternal and infant health outcomes for the poor. By focusing on a specific insurance program (Green Card) expansion that was a part of HTP, I explore changes in infant survival, fertility, and children’s vaccination status. Before 2004, all public health insurance beneficiaries (the control group) were covered for outpatient services, including prenatal and postnatal doctor visits, gestational diabetes screenings, …

A Cost-Effectiveness Analysis Of Telehealth Vs. Office-Based Delivery Of Buprenorphine At The Addiction And Substance Abuse Program (Asap) Clinic - University Of New Mexico Hospital: A Societal Perspective, Rana Alkhafaji

Pharmaceutical Sciences ETDs

This study evaluates the cost-effectiveness of office-based versus telehealth delivery of buprenorphine treatment for opioid use disorder (OUD). A retrospective chart review of 135 patients at the University of New Mexico Hospital's Addiction and Substance Abuse Program compared retention rates and costs between the two settings. Retention was defined as continuous treatment for at least six months. No statistically significant difference in retention rates was found, with 51% for office-based and 42% for telehealth. However, office-based treatment had higher total costs, with an incremental cost-effectiveness ratio of $3,750 per 1% increase in retention. The findings suggest telehealth is a cost-effective …

Contents Of Vol. 31, No.1, April 2024, Yuniardini Septorini Wimardhani

Journal of Dentistry Indonesia

This is the Cover and the Contents of the Vol. 31 No. 1 2024

The Impact Of Refractive Error Correction On Harvest Productivity In The Guatemalan Coffee Sector, Bryce C. Everett

Master's Theses

Providing refractive error correction has the potential to bolster productivity within developing countries. Current literature is in agreement that interventions targeting those with uncorrected visual impairment can realize benefits in various sectors, with particular regard to agriculture. The design of this experiment attempts to derive the intent-to-treat (ITT) effect stemming from the provision of glasses to coffee harvesters in Guatemala. Methodology incorporates two distinct approaches: an ANCOVA model with basic controls and a fixed effects model with a control for farm-specific harvest trends. With daily harvest weight observations serving as a proxy for productivity, and a sample of 321 participants …

Dose Higher Socioeconomic Status Associate With Better Mental Health Outcomes Among Primary Caregivers In Rural China?, Wenwen Zhang

Master's Theses

This study explores the intricate relationship between socioeconomic status (SES) and the mental health outcomes of primary caregivers in rural China, focusing on the Early Childhood Development (ECD) context in Ya'an. Anchored in a major intervention project launched in 2023, the study critically examines the hypothesis that higher socioeconomic status correlates with lower levels of negative emotions among caregivers.

Utilizing cross-sectional data, the research investigates how educational attainment and household income influence caregivers' mental health, measured through the DASS-21 score in three dimensions: stress, anxiety, and depression. The findings reveal that higher household income and educational levels are significantly associated …

Does Higher Socioeconomic Status Associate With Better Mental Health Outcomes Among Primary Caregivers In Rural China?, Wenwen Zhang

Master's Theses

This study explores the intricate relationship between socioeconomic status (SES) and the mental health outcomes of primary caregivers in rural China, focusing on the Early Childhood Development (ECD) context in Ya'an. Anchored in a major intervention project launched in 2023, the study critically examines the hypothesis that higher socioeconomic status correlates with lower levels of negative emotions among caregivers.

Utilizing cross-sectional data, the research investigates how educational attainment and household income influence caregivers' mental health, measured through the DASS-21 score in three dimensions: stress, anxiety, and depression. The findings reveal that higher household income and educational levels are significantly associated …

Le Coût Des Lésions Psychologiques Liées Au Travail Au Québec, Martin Lebeau, Jaunathan Bilodeau, Marc-Antoine Busque

Portraits statistiques

Cette étude présente une analyse statistique des coûts des lésions psychologiques liées au travail au Québec. Les coûts financiers et humains engendrés par les lésions psychologiques acceptées à la Commission des normes, de l'équité, de la santé et de la sécurité du travail (CNESST), survenues entre 2014 et 2019, ont été évalués à 1,01 milliard de dollars. Cela correspond à un coût annuel moyen de 169 millions de dollars et un coût moyen par lésion de 121 590 $. En dollars constants, les coûts annuels de ces lésions ont augmenté de 195 % sur les six années à l’étude.

Les …

Assessing The Economic Consequences Of Sewage Overflows On California Housing Values, Nathalie M. Nyanga

Master's Projects and Capstones

Sewage overflows (SSOs) represent a critical environmental challenge in California, and the impact of SSOs on housing prices is a vital issue. The study aims to determine how the frequency of sewage overflow events affects housing price fluctuations and conduct an event study. Employing linear, lasso, ridge, and random forest regression analyses, the study predicts the severity of overflow. Notably, lasso regression emerges as the most effective model for predicting housing prices in the event of an SSO occurrence. Additionally, the event study analysis provides insights into the factors influencing housing prices.

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Beer, Bourbon, And Bertrand: An Experimental Economics Analysis, Noah Cameron Dixon

Honors Thesis

The purpose of this paper is to determine the effect that binge drinking has on economic performance in a standard Bertrand-style game. Results indicate that binge drinking, when paired with poor protective behavioral strategies, increases cooperative pricing in a Bertrand-style game, with this result persisting across various contextual frameworks. In the aggregate, this study contributes to the literature by being the first of its kind to evaluate the effect of observational binge-drinking meta scores on performance in a Bertrand-style game. To measure economic performance in the market, participants play the 2/3 average game and a standard Bertrand game with zero …

The Effects Of Pre-Abortion Restrictions On Women's Well-Being, Reesa Sooklall

Theses and Dissertations

Eleven states require women seeking abortions to undergo mandated ultrasounds prior to the procedure while twenty-four states require women to wait either 24, 48 or 72 hours between receiving state mandated counseling and the procedure. I examine the effects of abortion restrictions on health behaviors and health care of women. I apply staggered difference-in-differences to the Behavioral Risk Factor Surveillance System data to estimate the causal effects of the two-trip mandatory waiting period (MWP) law and mandatory ultrasounds (MUS) law on women’s mental health, use of alcohol and tobacco, and whether women are obtaining routine mammograms and pap smears. The …

Overcoming Disparities In The Treatment Of Alzheimer’S Disease, Christian Gamboa, Tribhuvan Lanka, Elaine Flowers, Nayarith Lopez

Rowan-Virtua Research Day

Background: Deaths due to Alzheimer’s have been increasing at an exponential rate for the last 24 years, with an astounding 145% increase between the years 2000-2024. Early detection is key to slowing down the rate of decline. Unfortunately, Latino and African American individuals delay seeking care, which predisposes them to worse outcomes. To date, socioeconomic limitations are the main factors leading to delayed care in Latino and African American communities. A service project was developed with the aim of addressing limitations that result in delays to seeking care within Latino and African American communities.

Methods: A systematic review of available …

Exploring Hypertension Prevalence Among Ill-Housed Individuals In Urban Environments, Lia Summer Goldberg, Sameer Shah, Nikhila Archakam, Murod Khikmatov, Kesha Choksi, Anddee White

Rowan-Virtua Research Day

This study explores the interrelations of hypertension, homelessness, and access to healthcare in urban ill-housed populations. It was found that conditions such as heart disease and diabetes significantly exacerbate hypertension, which remains highly prevalent due to the population's limited access to consistent medical care. Homelessness further complicates the management of hypertension due to unstable living conditions, making adherence to treatment and follow-up with healthcare providers challenging. Additionally, factors like higher rates of substance abuse and malnutrition among homeless populations contribute to worsening hypertension, which, if untreated, can lead to severe health crises including heart attacks and strokes.

The research underscores …

Pros, Cons, And The Barriers To Implementing A Universal Healthcare System In The United States, Arpun Shah

Rowan-Virtua Research Day

Background: The United States has the most expensive healthcare system in the world. Despite that, it also has worse health outcomes than that of several other countries. The United States is also the only wealthy/developed country without universal healthcare. Universal healthcare, also known as a single-payer healthcare system, refers to the concept that the government finances and governs healthcare for most, if not all residents of the country. The United States currently has a multi-payer system, which means that healthcare is financed through various sources such as the public and private sectors. Purpose: The purpose of this is …

Addressing The Black Maternal Mortality Rate, Kennedy Sanders, Venkateswar Venkataraman, Kate Whelihan

Rowan-Virtua Research Day

Introduction: As of 2021, the Black maternal mortality rate in the United States was 69.9 deaths per 100,000 live births as compared to the national average of 32.9 and the White American average of 26.61. It has been demonstrated that this discrepancy is not fully explained by socioeconomic status. Doulas are professionals who provide support and guidance throughout pregnancy, birth, and early parenthood. Encouraging the use of doulas may be an effective approach to improve the birth experience for Black mothers. Methods: A literature review was performed using PubMed and the following search strings: maternal mortality rate (+race, +race +ethnicity, …

Sunscreen Cost And Its Effect On Skin Cancer In Low-Income Communities: A Systemic Review, John Sauer

Rowan-Virtua Research Day

This research examines the pivotal connection between sunscreen affordability and its impact on skin cancer prevalence, especially in low-income communities. Despite universal dermatological recommendations for daily sunscreen use, stringent criteria contribute to elevated prices, averaging around $10 for a 6 oz unit. This financial strain is compounded for families adhering to recommended application rates, leading to significant economic burdens. Outdoor laborers, less likely to follow guidelines, face heightened risks. Government programs' excluding sunscreen costs further exacerbate challenges for low-income communities, contributing to increased skin cancer incidence. This review aims to establish a correlation between sunscreen cost and skin cancer rates, …

Better Understanding The Risks And Costs Of Motherhood In The Post-Roe United States, Mackayla Wall

Honors Theses

This paper reviews the literature on the risks and costs of motherhood. The paper compares and analyzes various studies conducted between 1990 and 2023 relating to family planning, pregnancy, and maternal health in America. Changes in healthcare legislation and policies, as well as access to contraception and abortion, have all had an impact on the economic costs of pregnancy and motherhood. These changes emphasize the importance of better understanding the economic costs of pregnancy and motherhood in all its stages— from timing pregnancy to recovering from pregnancy and birth and experiencing childrearing costs. When analyzing previous studies, I discovered that …

Expanding The Access To Kidney Transplantation: Strategies For Kidney Transplant Programs, Angie Nishio Lucar, Ankita Patel, Shikha Mehta, Anju Yadav, Mona Doshi, Megan Urbanski, Beatrice Concepcion, Neeraj Singh, M. Lee Sanders, Arpita Basu, Jessica Harding, Ana Rossi, Oluwafisayo Adebiyi, Milagros Samaniego-Picota, Kenneth Woodside, Ronald Parsons

Department of Medicine Faculty Papers

Kidney transplantation is the most successful kidney replacement therapy available, resulting in improved recipient survival and societal cost savings. Yet, nearly 70 years after the first successful kidney transplant, there are still numerous barriers and untapped opportunities that constrain the access to transplant. The literature describing these barriers is extensive, but the practices and processes to solve them are less clear. Solutions must be multidisciplinary and be the product of strong partnerships among patients, their networks, health care providers, and transplant programs. Transparency in the referral, evaluation, and listing process as well as organ selection are paramount to build such …