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At least 199 records · Page 11Linked to original sources
PubMed1979

Perinatal care and cost effectiveness: changes in health expenditures and birth outcome following the establishment of a nurse-midwife program.

Estimates of infant health status and expenditures for perinatal care are presented for periods of time before and after implementation of a nurse-midwife program in rural Georgia. As the program developed, the infant mortality rate of the four counties served by the program showed a decrease. Similarly, the target population (pregnant women of low to moderate income who had no private physician) experienced decreases in the rate of neonatal mortality, low birthweight, and short gestational age. Estimated expenditures for perinatal care in the four counties decreased as well. These results are examined from the perspective of the National Health Planning and Resources Development Act of 1974 and the utility of using an epidemiologic approach for estimating the output of health services in terms of health status is emphasized.

Cost-Benefit Analysis↗
PubMed1990

Modeling the effect of insurance on health expenditures in the People's Republic of China.

A pilot study was undertaken in two rural counties in Sichuan Province to determine the feasibility of offering health insurance to peasant families. Models of per capital inpatient and outpatient health care expenditures were developed using self-reported utilization from a survey of 880 households, supplemented by cost and utilization data from the providers in the counties. Expenditures at a facility were modeled as a function of level of insurance in three parts: (1) as the product of the probability of any use, (2) the expected number of visits given any use, and (3) the cost per visit at the facility. Output from the model for representative insurance plans is presented.

China↗
PubMed2000

The quest for an accurate accounting of public health expenditures.

This article describes one effort to develop management tools that will help public health administrators and policy makers implement comprehensive public health strategies. It recounts the ongoing development of a methodology through which the Essential Public Health Services can be related to public health budgets, appropriations, and expenditures. Through three pilot projects involving: (1) nine state health agencies, (2) three local health agencies, and (3) all local jurisdictions and the state health agency in one state, a workable methodology for identifying public expenditures for comprehensive public health programming has been identified.

Accounting↗
PubMed1992

Measuring the relationship between income and NHEs (national health expenditures).

This article uses recently published time series data for the Organization for Economic Cooperation and Development countries to estimate income elasticities for health care expenditures. Several different models and alternative specifications are examined to determine the sensitivity and robustness of the estimated relationships. Income is the dominant-determinant of health care spending and longrun income elasticity for health care is significantly greater than unity. This implies that health care is a luxury good, and expenditures will tend to rise with the level of national income. There is little evidence that the degree of public finance reduces the level of health care expenditures.

Data Collection↗
PubMedDate not supplied

New cardiovascular drugs: patterns of use and association with non-drug health expenditures.

The potential role of new drugs in reducing expenditures for non-drug health services has received considerable attention in recent policy debates. We estimate expenditure models to determine whether the use of newer drugs to treat cardiovascular conditions is associated with lower (or higher) non-drug expenditures for these conditions. We fail to substantiate the findings of previous research that newer drugs are associated with reductions in non-drug expenditures. We find, however, that increases in the number of drugs used, or the mix of drugs of different ages, are associated with increased non-drug expenditures and find that the number or mix of drugs used are important confounders in the estimated association between drug age and non-drug expenditures.

Adult↗
PubMedDate not supplied

[Rationalization of health expenditures: the Séguin's plan in 1987].

Sickness insurance is universal and compulsory in France. It is financed mainly by contributions from employers and employees. Consequently its soaring costs may sharply reduce the competitive French products on the world market. Successive French administrations have attempted to curb the growing health costs by increasing co-payment. The program launched in 1987 was innovating since it was aimed at the group of insured people who were previously not submitted to co-payment (persons having presumably grave illness...). The program was a breakthrough in the French system which was built on a mixed concept of insurance and solidarity. The program was undoubtedly a great success. However, lack of an efficient information system, and reaction of the various actors (patients and doctors) who succeeded to adjust themselves to the new regulations, diminished its impact some years after it has been implemented.

France↗
PubMed1982

Allocating health expenditures to treatment and prevention.

Rational evaluation of important health sector issues requires more formal analysis of the optimal allocation of resources to treatment and prevention. The suggested approach imbeds a Markov model of the disease process in a simple budget-constrained nonlinear program. Expenditures are allocated to prevention and treatment of a given disease so as to maximize the expected fraction of time spent in the undiseased state by a group of individuals. Random-parameter simulations of a plausible form of the model produce qualitatively different expansion paths for the optimal spending mix, suggesting the need for a flexible policy stance until the parameters of such models can be estimated.

Health Expenditures↗
PubMed1997

The effect of universal coverage on health expenditures for the uninsured.

OBJECTIVES: Universal coverage will trigger an increase in health-care spending, because the uninsured will use more services after they are insured. The effect of insurance status on expenditures is estimated here from a multivariate statistical model. METHODS: The model is estimated with data from the 1987 National Medical Expenditure Survey, aged to 1994 using population projections from the US Bureau of the Census and expenditure projections from the Health Care Financing Administration. RESULTS: Expenditures for the full-year uninsured increase by approximately $700 per person in 1994 as a result of universal coverage. Nearly half of the increase is because of a substantial increase in the likelihood of hospitalization. CONCLUSIONS: If the uninsured are enrolled in plans similar to those offered by employers currently, personal health-care spending increases by approximately $20 billion in 1994. There are other costs associated with universal coverage that are not included in this figure.

Adolescent↗
PubMed1997

The impact of Parkinson's disease on health status, health expenditures, and productivity. Estimates from the National Medical Expenditure Survey.

Parkinson's disease (PD) is a common disorder that leads to severe disability, despite pharmacological and surgical interventions. As PD progresses, patients and their families experience substantial health and economic burdens. Little research has been conducted into the economic consequences of PD or the impairment of health dimensions, such as social function and mental health, that may accompany the deterioration in economic resources and physical function. In the current study, the US National Medical Expenditure Survey (NMES) was examined as a source of population-based information about health-resource use, medical expenditures and health status. 43 patients with PD were identified, and each was matched with 3 individuals without PD to estimate the costs attributable to PD. Data from the NMES demonstrate the serious health and economic burdens of PD. The patients with PD were clearly shown to have decreased health status, increased health expenditures and lost productivity relative to controls. However, these estimates of the magnitude of disease burden must be used with caution. The small sample size appears to have inadequately represented patients in the earliest and the most advanced stages of PD. There was also considerable variability in case-control groups, resulting in wide confidence intervals for the estimates.

Aged↗