Health Economics Commons^™

Drug Policy: The Effect Of Medical Marijuana On Opioid Consumption During The Us Opioid Epidemic, Jonathon David Knudson

Graduate Student Theses, Dissertations, & Professional Papers

The introduction and subsequent over-prescribing of extended-release opioids in the United States resulted in a large rise in both addiction and overdose. Recognition and regulation of these new drugs as addictive did little to control the supply of opioids to Americans while Prescription Drug Monitoring Programs and Abuse Deterrent reformulations had limited effect to control the problem. Simultaneously, states like Michigan and Rhode Island legalized medical marijuana through voter referenda opening the door for a new approach to pain management. Recent research has found medical marijuana has proven an effective treatment for conditions such as chronic pain and PTSD and …

Childhood Snap Receipt As A Protective Factor Against Adult Obesity: Examining The Interaction Of Snap Participation And Neighborhood Disadvantage, Thomas Vartanian, Linda Houser

The Journal of Sociology & Social Welfare

Using the Panel Study of Income Dynamics (PSID) with family fixed-effects (FE) models, we explore how neighborhood conditions and time receiving SNAP benefits during childhood interact to relate to time spent obese in adulthood. Results suggest that, for those growing up in less advantaged neighborhoods, SNAP receipt between the ages of 9–13 and 14–18 was associated with subsequently shorter periods of time obese in adulthood. Conversely, for those growing up in more advantaged neighborhoods, SNAP receipt during these same late childhood/ adolescent time periods was associated with relatively high proportions of time in adulthood spent obese. SNAP participation during early …

Technical And Scale Efficiency Of Public Hospitals In Papua New Guinea, James Noah

Chulalongkorn University Theses and Dissertations (Chula ETD)

The objective of the study was to estimate the relative technical efficiency of public hospitals in PNG and estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient using Data Envelopment Analysis for 20 hospitals in PNG using the data for 2017. The study is further extended using the Tobit regression analysis to investigate the institutional and contextual factors on hospital efficiencies. The results of the output-oriented DEA BCC Model indicated that the average constant returns to scale technical efficiency score was 79%; the average variable returns to scale …

Determinants Of Health Promotion Service Consumption In Thailand, Pimpa Vitidladda

Chulalongkorn University Theses and Dissertations (Chula ETD)

Despite being preventable, noncommunicable diseases (NCDs) rank among leading causes of death in Thailand. Four main groups of NCDs involve cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. These chronic diseases worsen economic burden and the quality of life. To ease the burden, health promotion service is one of the tools that can directly cope with risk factors of NCDs. Therefore, increasing health promotion service consumption potentially leads to risk reduction of an individual to develop NCDs. Hence, this research aims to identify the factors influencing health promotion service consumption in Thailand along with marginal effects of each factors. The …

Orthodontic Camouflage Treatment Of A High-Angle Severe Skeletal Class Ii Discrepancy, Deryana Marshadhianti, Miesje Karmiati Purwanegara

Journal of Dentistry Indonesia

Proper orthodontic treatment in adult patients with severe skeletal Class II discrepancy can be challenging. Recently, miniscrew implants have been used as a strategy to treat skeletal Class II patients. Objective: This report illustrates a skeletal Class II malocclusion management combining straight wire technique and miniscrew implant anchorage. Case report: The patient was a 21-years- old Indonesian female with Class II skeletal discrepancy, a retrognathic mandible, a high mandibular plane angle, and a mouth breathing habit due to a history of allergic rhinitis. Anchorage control is important in the sagittal and vertical directions. Miniscrew implants were placed in the …

Antimicrobial Efficacy Of Myrmecodia Pendens Extract And Fraction Combination Against Enterococcus Faecalis Atcc 29212, Faisal Kuswandani, Mieke H. Satari, Ani M. Maskoen

Journal of Dentistry Indonesia

Enterococcus faecalis can withstand harsh environmental conditions in the root canal and cause a secondary infection. Myrmecodia pendens is an herbal medicine rich in polyphenol compounds that have antibacterial, antioxidant, and anticancer properties. Objectives: To analyze the effects of M. pendens fraction combination on the sensitivity of E. faecalis. Methods: The minimum inhibitory concentration (MIC) was determined using a serial microdilution method, and the minimum bactericidal concentration (MBC) was determined by adding the test sample to sterile Mueler Hinton agar medium. Results: The MIC of combination 1 (hexane-ethyl acetate, HE) was 0.049 mg/mL, whereas those of combinations 2 (hexane-water, HA) …

Persistent Endodontics Pathogens Biofilm Inhibited By Lactobacillus Reuteri Indonesian Strain, Armelia Sari Widyarman, Njoo Kiky Elysia Lazaroni

Journal of Dentistry Indonesia

Lactobacillus reuteri is known as probiotics that effective to improve oral health. Objective: To analyze the effect of L. reuteri Indonesian strain, towards Enterococcus faecalis and Candida albicans biofilm growth. Methods: This study was conducted using biofilm assay. Each E. faecalis ATCC-29212 and C. albicans ATCC-10231 were cultured in Brain Heart Infusion Broth, distributed into 96 well-microplate and incubated for 24h, 37°C, anaerobic condition for E. faecalis and aerobic condition for C. albicans. L. reuteri LC382415 (Indonesian strain) was cultured in deMann Rogosa Shar pe Broth and diluted into different concentrations (10⁸,10⁶, and 10^{4 …}

Kinerja Rumah Sakit Swasta Dengan Pembayaran Ina Cbgs Di Era Jaminan Kesehatan Nasional: Casemix, Casemix Index, Hospital Base Rate, Atik Nurwahyuni, Ery Setiawan

Jurnal Ekonomi Kesehatan Indonesia

Private hospitals must monitor their performance using indicators commonly used in DRG payment systems: casemix, casemix index and hospital base rate. This study aims to analyze the performance of private hospitals including casemix, casemix index and hospital base rate. This cross sectional study was conducted with a sample of 7 hospitals selected purposively representing private hospital type B, C, and D in 6 provinces. Casemix and CMI RS are strongly influenced by the hospital capacity, which the hospitals class B have higher casemix and CMI than class C and D hospitals. There is a phenomenon, CMI in class C hospitals …

Kajian Literatur Sistematis: Skema Pengendalian Biaya Dalam Asuransi Kesehatan Nasional Di Beberapa Negara, Eka Pujiyanti, Ery Setiawan, Euis Ratna Sari, Indah Pratiwi Suwandi

Jurnal Ekonomi Kesehatan Indonesia

Cost-containment is one of several strategies to ensure the financial sustainability of the National Health Insurance scheme. Several cost-containment models were commonly globally, such as cost-sharing, capping, and others. This review aims to determine the costs and impacts of implemented policy schemes as cost-containment instruments in various countries. We performed a systematic review from several primary databases (Proquest, Pubmed, and Cochrane Library) with the primary intervention are the cost-sharing methods. The results of our review focused on the cost containment scheme from the government perspective, in which the context of social insurance can be a modification of payment systems, cost-sharing, …

Analisis Biaya Satuan (Unit Cost) Dengan Metode Activity Based Costing (Abc) Di Poliklinik Jantung Rsu Dr. H. Koesnadi Bondowoso, Sumiati Sumiati, Eri Witcahyo, Andrei Ramani

Jurnal Ekonomi Kesehatan Indonesia

Determination of rate calculated based on unit cost, based on Bondowoso Regent Regulation Number 62 of 2017, RSU dr. H. Koesnadi Bondowoso unit cost calculates using the Double Distribution method. Double Distribution (DD) method is not appropriate to be applied because it does not reflect activity, method based on activity, precise and accurate so that it can provide the right information is Activity Based Costing (ABC) method. RSU Dr. H. Koesnadi Bondowoso has not made unit cost calculation using Activity Based Costing (ABC) method, especially for outpatient installation. The purpose of this research is unit cost analysis with Activity Based …

Kemampuan Dan Kemauan Pasien Umum Rawat Inap Dalam Membayar Pelayanan Kesehatan Rawat Inap Di Rumah Sakit Umum Kaliwates Kabupaten Jember, Yanuar Anafia, Eri Witcahyo

Jurnal Ekonomi Kesehatan Indonesia

testRational rates were determined by calculating unit costs into account characteristics of product as information related ability and willingness to pay. Ability and willingness were calculated for quality control and cost at the hospital. Community satisfaction index in Kaliwates General hospital released number of customer satisfaction that hasn’t met the standard was rate of inpatient services. Results of preliminary study on general inpatients were 70% having an estimated rate of less than rate set by the hospital, 20% said rates were less affordable and 10% couldn’t estimate rates, then this study was calculate ability and willingness to pay for inpatient …

Analysis Of Risk For Class Shifting And Determinants Of Bpjs Kesehatan Membership Using Generalized Ordered Logit-Unconstrained Partial Proportional Odds Model, Siskarossa Ika Oktora, Ika Yuni Wulansari, Geri Yesa Ermawan

Jurnal Ekonomi Kesehatan Indonesia

The main source of funding of BPJS Kesehatan comes from the different premium class in which the participant registered. The medical benefits among classes are equivalent, except inpatient facilities. But when the improvement health degree is not linear with the incurred costs, problem would arise. This study aims to analyze class shifting and determinants of BPJS Kesehatan membership. Around 1.53 percent of participants access higher classes, while 5.62 percent access lower classes. Class III participants with inpatient status severity level 2 and 3, reaching 41% and 43%, respectively. In addition, 60% of non-PBI participants are Class II premium participants; most …

Employment Outcomes Of The Clarksdale Hope Vi Program, Ramona Stone

Public Health Sciences Faculty Publications

The HOPE VI initiative aimed to reshape neighborhoods in terms of their resident socioeconomic characteristics, business activity, levels of community collaboration, and economic growth. The goal of this research was to examine the relationship between education and employment while controlling for the type of housing received at relocation. This paper is part of a larger quasi-experimental research evaluation. Data sources included administrative records, baseline and follow-up surveys. The survey data was collected from the main adult in the family during face-to-face interviews two years apart. The questionnaire collected information about residents’ demographics, socioeconomic, health, housing, and satisfaction with the support …

An Analysis Of The Economic Barriers To Oral Healthcare Access In Omaha, Nebraska, Elias Witte

Theses/Capstones/Creative Projects

Existing research regarding the analysis of the distribution of oral healthcare practitioners has been conducted across large metropolitan areas within the United States in order to determine the magnitude of healthcare resource deficits. Such research has demonstrated significant deficits in access to oral healthcare predominantly in lower-income urban areas. Consequently, patients in these socioeconomically disadvantaged areas have less access to routine oral care, which impacts their overall health and well-being. While there is an abundance of studies examining this issue in other localities across the country, there is a lack of information regarding the distribution of oral healthcare practitioners in …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Center For Integration Of Science And Industry - Response To Ostp Bioeconomy Rfi, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

RESPONSE TO: AGENCY: Office of Science and Technology Policy (OSTP). ACTION: Notice of request for information (RFI) for Bioeconomy Federal Register /Vol. 84, No. 175 /Tuesday, September 10, 2019 /Notices, page 47561 Transmitted electronically to [email protected]

What specific actions could the U.S. Government take to reinforce a values-based ecosystem that will guide the transformation and expansion of the U.S. Bioeconomy, in both the shortand long-term?

This response addresses specific actions the U.S. Government could take to ensure sustainable funding for the basic research that provides the foundation for the U.S. Bioeconomy. Empirical evidence demonstrates that a mature body of basic …

Treatment Patterns And Economic Burden Of Sickle-Cell Disease Patients Prescribed Hydroxyurea: A Retrospective Claims-Based Study, Nirmish Shah, Menaka Bhor, Lin Xie, Rashid Halloway, Steve Arcona, Jincy Paulose, Huseyin Yuce

Publications and Research

Background: This study aimed to evaluate sickle-cell disease (SCD) treatment patterns and economic burden among patients prescribed hydroxyurea (HU) in the US, through claims data.

Methods: SCD patients with pharmacy claims for HU were selected from the Medicaid Analytic Extracts (MAX) from January 1, 2009 - December 31, 2013. The first HU prescription during the identification period was defined as the index date and patients were required to have had continuous medical and pharmacy benefits for ≥6 months baseline and 12 months follow-up periods. Patient demographics, clinical characteristics, treatment patterns, health care utilization, and costs were examined, and variables were …

The Formation Of Physician Patient Sharing Networks In Medicare: Exploring The Effect Of Hospital Affiliation, Sebastian Linde

Open Access Publishing Support Funded Articles

This study explores the forces that drive the formation of physician patient sharing networks. In particular, I examine the degree to which hospital affiliation drives physicians' sharing of Medicare patients. Using a revealed preference framework where observed network links are taken to be pairwise stable, I estimate the physicians' pair‐specific values using a tetrad maximum score estimator that is robust to the presence of unobserved physician specific characteristics. I also control for a number of potentially confounding patient sharing channels, such as (a) common physician group or hospital system affiliation, (b) physician homophily, (c) knowledge complementarity, (d) patient side considerations …

Improving End Stage Renal Disease Quality Incentive Payment Total Performance Scores, Shelly Guyer, Gina Gregg, Bradley Warady

Posters

The End Stage Rena Disease (ESRD) Quality Incentive Program (QIP) promotes high quality, transparent, cost-efficient care in outpatient dialysis facilities by establishing performance standards that are linked to payment.

The development of a subject matter expert and the sharing of ESRD QIP knowledge resulted in buy-in from dialysis staff and physicians leading to a higher total performance score and the avoidance of payment reduction.

The Effects Of Opioids On Kentucky's Workforce, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

From the executive summary:

Opioid abuse represents a significant and growing public health issue for both the nation and Kentucky. In 2016, opioids contributed to more than 62,000 deaths nationally and 1,406 deaths in Kentucky. National studies have placed the societal costs of opioid abuse at $55.7 billion in 2007 and $78.5 billion in 2013 (Birbaum et al. (2011) and Florence et al. (2016)). These costs included increased health care expenditures, higher criminal justice costs, and lost earnings due to reduced employment and premature deaths. The While House Council of Economic Advisors (2017) estimated the societal costs of opioid abuse …