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Discussion of health care costs has expanded beyond the technical domains of accountancy and entered the realms of public discourse. Analyses this discourse through an examination of all the stories published in The New York Times between 1 April 1992 and 1 May 1993 which contained the phrase “health care costs”. Describes the current discourse and examines how antagonostic social interests strive to inscribe the concept of health care cost with conflicting meanings and ideological accents.

The purpose of this paper is to enhance the knowledge about the use of online communication between patients and health-care professionals in public health care. The study explores digital divide gaps and the impacts of online communication on the overall costs of health care.

This study focuses on online health care in Denmark. The authors rely on population data from 3,500 e-visits (e-mail consultations) between patients and general practitioners (GPs) from 2009 to 2015. Additionally, they include survey data on the use of the internet to search for health-related information.

The analysis of the Danish data reveals a rapid uptake in the use of the internet to search for health-related information and a three-fold increase in e-visits from 2009 to 2015. The results show that the digital divide gaps exist also in the online health-care communication. Further, the study findings suggest that enforced supply of online communication between GPs and patients does not alleviate the costs. Rather, the number of visits to GPs has not been decreased significantly and health-care costs showing a marginal increase.

Further data should be collected and analyzed to explore the impacts of other institutional factors and population cohort on the digital divide and healthcare costs. Also, it is difficult to estimate whether the increased use of online health care in the long run lead to lowering overall health-care costs. While the internal validity of the study is high due to the use of population data, the external validity is lower as the study results are based on the data collected in Denmark only.

The study offers important input for practice. First, leaders in government might reconsider how they can control the health-care costs when opening online channels for communication between patients and doctors. Second, concerns about digital divide issues remains, but the study suggests that the uptake of e-visits does not widen the socio-economic, gender or age gaps. For health policy concern, this is encouraging news to lead to an increasing push of online communication.

The dynamics of online health-care communication may lead to mixed results and unexpected impacts on overall health-care costs.

The paper offers new insights in the impacts of mandatory supply of digital services. The Danish push-strategy has led to an enforced supply of e-visits and a rapid growing use of the online health care without widening digital divide but at the risk of potential increasing the overall costs.

Health care spending in the U.S. continues to outpace inflation and wage growth, which is likely to keep the burden of rising health care costs in the spotlight. As health care costs increase, health insurers face the challenges of providing quality health care at a reasonable cost. Some health care providers and insurers use economic measures such as return on investment to assess the effectiveness of health care. How does one measure the value of health? What are some of the advantages and disadvantages of using economic measures to evaluate health care?

This paper looks health care costs and who pays for them. What portion of health care costs is borne by employers? What portion by employees? Who does or should pay for health care of people who are uninsured? What is the role of insurance? If people do not have health care insurance, does it matter whether the reason they are uninsured is because they cannot afford it or because they choose not to be insured?

Selvam (2002) belives that the number one ethical dilemma in the U.S. is how to address the almost 40 million Americans who lack health care coverage. With rising hospital costs, even the hardest-working and most prudent persons are at risk. Many workers do not have health insurance and even if they are covered, they may not get what they need. What are some of the ethical issues facing patients, health care providers and insurers? What role should government have in assuring that all people receive quality health care?

Since the mid‐1980s the major players in US health care have argued that costs and benefits should underlie the allocation of health care resources. Looks at 30 cost benefit studies taken from the medical literature and examines five of them in depth, using the “depth hermeneutical” approach advocated by Thompson (1990). Concludes that cost benefit studies are about not only the co‐ordination of interests but also the obscuring and exclusion of other interests.

The purpose of this paper is to explore the whole system cost of the care pathway for older people (aged 65-years old and over) admitted to hospitals as a result of falls in Torbay, a community of 131,000 in the southwest of England with a high proportion of older residents, over a two-year period.

The paper analysed patient-level linked acute hospital, community care and local authority-funded social care data to track patients’ care costs – for those patients admitted to an acute hospital due to their fall – in the 12 months before and after their fall.

On average, the cost of hospital, community and social care services for each admitted for a fall were almost four times as much in the 12 months after admission, than the cost of the admission itself. Over the 12 months that followed admission for falls, costs were 70 per cent higher than in the 12 months before the fall. The most dramatic increase was in community health care costs (160 per cent), compared to a 37 per cent increase in social care costs and a 35 per cent increase in acute hospital care costs. For patients who had a minor fall and those who survived 12 months after the fall, the costs of care home services increased significantly; for patients with hip fracture, the costs of community care services increased significantly; for patients who did not survive 12 months after the fall, the cost of acute inpatient and community health visits increased significantly.

This is the only study that has assessed the costs across the acute hospital, community care and social care pathway for this group of patients, in an English population. This will help commissioners and providers understand and develop better-integrated responses to frail elderly patients needs.

Management accounting, inter alia, gives information on how resources are allocated within organisations. If managers wish to change patterns of resource allocation, accounting knowledge is pivotal to any change processes. In health care organisations resources follow decisions made by clinicians, hence to have an impact on resource allocations managers must influence them. Direct managerial control over clinicians is not possible or desirable in health care organisations. This article suggests that incentives are an alternative to control in health care and investigates the impact of financial incentives within hospitals, utilising a naturally occurring experimental situation that has arisen between the UK and Canada.

Consumer‐driven health care (CDHC) has been proposed to reduce the USA health care costs through greater free market economic exposure. The purpose of this paper is to review the USA health care system, insurance plans, and CDHC plan elements and assumptions regarding patients, service providers, and insurers, in order to identify research and social marketing needs of CDHC.

The paper is an assessment of literature from academic and practitioner communities.

Social marketing programs can contribute to preparing consumers and practitioners for CDHC. However, the degree to which CDHC can reduce health care costs is uncertain. More research is needed comparing CDHC plans with traditional plans and comparing CDHC enrollees with enrollees in other types of plans to determine the true benefits and costs of CDHC and to identify consumers' information needs. Research is needed into how to gather and provide understandable health care provider quality and cost‐effectiveness information, and into how current insurers can help consumers make effective CDHC decisions. Research is needed as to how CDHC is perceived by consumers, providers, and insurers, and the use of CDHC reimbursement accounts and their effect on behavior and costs. Research is also needed into which decisions can be made by consumers without specialized professional knowledge. Provider research is needed into outcome risk adjustments, how practitioners view CDHC, how willing practitioners are to participate in a more open‐free market, and how CDHC may affect professional practices.

Insights gained from this paper can contribute to social marketing program designs needed for practitioner and consumer acceptance and effective use of CDHC.

Amid increasing interest in how government regulation and market competition affect the cost and financial sustainability in health care sector, it remains unclear whether health care providers behave similarly to their counterparts in other industries. The goal of this chapter is to study the degree to which health care providers manipulate accruals in periods of financial difficulties caused, in part, by the rising costs of labor.

We collected the financial information of health care providers in 43 countries from 1984 to 2013 and conducted a pooled cross-sectional study with country and year fixed-effects.

The empirical evidence shows that health care providers with higher wage costs are more likely to smooth their earnings in order to maintain financial sustainability.

The finding of this study not only informs regulators that earnings management is pervasive in health care organizations around the world, but also contributes to the studies of financial book-tax reporting alignment, given the existing empirical evidence linking earnings management to corporate tax avoidance in this very sector.

The aim of this research is to develop a model to forecast short-term health cost changes. The motivation for producing such a model is to provide local decision makers with a tool to predict short-term health-care costs in their localities. In order to achieve this objective, we collected data on total health-care expenditures and demographic data for California counties from 2000 to 2007. We then used various statistical methods to better understand the data and developed a regression model. Each year's prediction model was then used to forecast the following year's total health-care expenditure. The model developed adequately predicted health-care costs for the years on which the model was developed (2000–2006), and adequately forecast health-care costs for the holdout year, 2007. The average adjusted R2 value was 0.57, with an average mean absolute deviation score of 34. The best predictors of total health-care expenditures were county population, the number of county health-care facilities, and county per capita personal income. The practical implications of the model are that it will provide public and private decision makers with a useful tool for forecasting short-term demand for health-care services, enabling better planning for health-care manpower, facility planning, and financial planning needs. The contribution of this paper contrasts with the earlier work in that it supports short-term operational, not strategic, planning needs. The paper's limitation is that it relies on data from one state. It should be tested in other, dissimilar, areas of the United States.

In all industries, competition among businesses has long been encouraged as a mechanism to increase value for patients. In other words, competition ensures the provision of better products and services to satisfy the needs of customers This paper aims to develop a model that can be used to empirically investigate a number of complex issues and relationships associated with competition in the health care industry.

A literature review was conducted. A total of 50 items of literature related to the subject were reviewed.. Various perspectives of competition, the nature of service quality, health system costs, and patient satisfaction in health care are examined

A model of the relationship among these variables is developed. The model depicts patient satisfaction as an outcome measure directly dependent on competition. Quality of care and health care systems costs, while also directly dependent on the strategic mission and goals, are considered as determinants of customer satisfaction as well. The model is discussed in the light of propositions for empirical research.

Empirical studies based on the model proposed in this paper should help identify areas with significant impact on patient satisfaction while maintaining high quality of service at lower costs in a competitive environment.

The authors develop a research model which included propositions to examine the complex issues of competition in the health care industry.