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The objective of this chapter is to introduce the reader to Spatial Health Econometrics (SHE). In both micro and macro health economics there are phenomena that are characterised by a strong spatial dimension, from hospitals engaging in local competitions in the delivery of health care services, to the regional concentration of health risk factors and needs. SHE allows health economists to incorporate these spatial effects using simple econometric models that take into account these spillover effects. This improves our understanding of issues such as hospital quality, efficiency and productivity and the sustainability of health expenditure of regional and national health care systems, to mention a few.
With the spread of the coronavirus disease across over 100 countries and its status upgraded to that of a pandemic on 11 March 2020 (World Health Organization), increased…
With the spread of the coronavirus disease across over 100 countries and its status upgraded to that of a pandemic on 11 March 2020 (World Health Organization), increased attention is being placed on the policy measures that may be required to effectively curb the rate of contagion within and across countries. Currently, several governments, such as China, Italy, Spain, Japan and the Republic of Korea, have implemented emergency measures informed by the principle of social distancing to limit the spread of coronavirus (World Health Organization). Ever since the virus was first identified in Wuhan City in December 2019, this succession of uncoordinated policy responses offers a set of natural experiments that should be analysed to understand the successes and failures of containment at the societal level. In this analysis, we focus on the case of Italy, the hardest hit country in Europe (Dong, Du, & Gardner, 2020; World Health Organization). The objective of this short note is to provide an even-handed analysis of the actions taken by the Italian government to cope with the transmission of the virus and to highlight lessons in emergency management that can be learnt for other countries currently facing the onset of the Covid-19 epidemic.
This chapter reviews graphical modeling techniques for estimating large covariance matrices and their inverse. The chapter provides a selective survey of different models…
This chapter reviews graphical modeling techniques for estimating large covariance matrices and their inverse. The chapter provides a selective survey of different models and estimators proposed by the graphical modeling literature and offers some practical examples where these methods could be applied in the area of health economics.
The search for more effective policies, choice of optimal implementation strategies for achieving defined policy targets (e.g., cost-containment, improved access, and…
The search for more effective policies, choice of optimal implementation strategies for achieving defined policy targets (e.g., cost-containment, improved access, and quality healthcare outcomes), and selection among the metrics relevant for assessing health system policy change performance simultaneously pose continuing healthcare sector challenges for many countries of the world. Meanwhile, research on the core drivers of healthcare costs across the health systems of the many countries continues to gain increased momentum as these countries learn among themselves. Consequently, cross-country comparison studies largely focus their interests on the relationship among health expenditures (HCE), GDP, aging demographics, and technology. Using more recent 1980–2014 annual data panel on 34 OECD countries and the panel ARDL (Autoregressive Distributed Lag) framework, this study investigates the long- and short-run relationships among aggregate healthcare expenditure, income (GDP per capita or per capita GDP_HCE), age dependency ratio, and “international co-operation patents” (for capturing the technology effects). Results from the panel ARDL approach and Granger causality tests suggest a long-run relationship among healthcare expenditure and the three major determinants. Findings from the Westerlund test with bootstrapping further corroborate the existence of a long-run relationship among healthcare expenditure and the three core determinants. Interestingly, GDP less health expenditure (GDP_HCE) is the only short-run driver of HCE. The income elasticity estimates, falling in the 1.16–1.46 range, suggest that the behavior of aggregate healthcare in the 34 OECD countries tends toward those for luxury goods. Finally, through cross-country technology spillover effects, these OECD countries benefit significantly from international investments through technology cooperations resulting in jointly owned patents.
Purpose: In this chapter, we examine the National Health Service (NHS) and Adult Social Care (ASC) in England, focussing on policies that have been introduced since 2000…
Purpose: In this chapter, we examine the National Health Service (NHS) and Adult Social Care (ASC) in England, focussing on policies that have been introduced since 2000 and considering the challenges that providers face in their quest to provide a high standard and affordable health service in the near future.
Methodology/Approach: We discuss recent policy developments and published analysis covering innovations within major aspects of health care (primary, secondary and tertiary) and ASC, before considering future challenges faced by providers in England, highlighted by a 2017 UK Parliament Select Committee.
Findings: The NHS and ASC system have experienced tightening budgets and serious financial pressure, with historically low real-terms growth in health funding from central government and local authorities. Policymakers have tried to overcome these challenges with several policy innovations, but many still remain. With large-scale investment and reform, there is potential for the health and social care system to evolve into a modern service capable of dealing with the needs of an ageing population. However, if these challenges are not met, then it is set to continue struggling with a lack of appropriate facilities, an overstretched staff and a system not entirely appropriate for its patients.
As all countries in the world, Polish health care system has to challenge four fundamental transformations: demographic, technological, epidemiological and cultural. Each…
As all countries in the world, Polish health care system has to challenge four fundamental transformations: demographic, technological, epidemiological and cultural. Each of them generates serious threats for the sustainability of the system. The Polish society is ageing even faster than other in the European Union. For the sustainability of the system, the ageing of the population is a double challenge: on the expenditure side and on the financing side.
The Polish health care system is characterised by three negative features: under-financing of health care, misguided organisation of the health sector and health care entities and a dramatic shortage of health care professionals. The share of GDP devoted to health has remained constant over the last years at the level of 6.3%–6.7%. Poland has one of the lowest rates of practicing doctors and nurses in the EU countries. Lack of attractiveness of the medical professions caused by consistently low wages has created a huge generation gap.
Looking from the perspective of cost-effectiveness, we must to state, that the system, with its small financial outlays, provides a relatively high level of health for the population. However, it does not mean that better results could not be achieved. The majority of the public hospitals run in the form of independent public health care units that are highly inefficient and indebted. All attempts to restructure the sector and to solve the problem of arrears of the public hospitals failed so far.
To face the challenges, Poland must change its health policy. An increase in the sector's financing is needed, bearing in mind that increasing outlays alone is certainly not enough to solve all problems and secure sustainability. Deep structural and organisational changes are necessary. Unfortunately, politicians avoid making difficult but necessary decisions, e.g., drastic restructuring of the hospital sector, preferring above all to increase public spending on health.
We study the sustainability of the Austrian healthcare system. In the first part of the chapter, we provide background on the state of the Austrian healthcare sector. In…
We study the sustainability of the Austrian healthcare system. In the first part of the chapter, we provide background on the state of the Austrian healthcare sector. In the second part, we review major healthcare interventions that recently took place in Austria, discussing their effectiveness and implications for sustainability. In the third part, we address five public health challenges that are particularly interesting in the Austrian context: ageing, risky health behaviours, healthcare access in rural areas, refugees and infectious disease epidemics.