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1 – 10 of over 4000Beatriz González López-Valcárcel and Laura Vallejo-Torres
This paper aims to provide an estimation of the costs of the coronavirus (COVID-19) pandemic with a special focus on Spain. Costs include macroeconomic costs of foregone gross…
Abstract
Purpose
This paper aims to provide an estimation of the costs of the coronavirus (COVID-19) pandemic with a special focus on Spain. Costs include macroeconomic costs of foregone gross domestic product (GDP) attributable to the pandemic and the direct and indirect costs of prevention, treatment and lost productivity. This study also analyzes the cost-effectiveness of the test-tracking-quarantine (TTQ) strategy in Spain.
Design/methodology/approach
The macroeconomic costs of foregone GDP attributable to the pandemic are estimated for different countries and areas by comparing the present GDP forecasts for 2020 and 2021 with counterfactuals estimated before the COVID-19 crisis aftermath. The total cost of the COVID-19 for Spain in 2020 was obtained using the cost of illness approach with a bottom-up process. A cost-effectiveness analysis of the TTQ strategy in Spain is based on the estimation of the total costs of TTQ and the health gains and avoided health-care costs associated with the TTQ strategy. A sensitivity analysis explores the consequences of uncertainty in key parameters.
Findings
The GDP cost of the COVID-19 is by far larger than all the other components of the cost. The global cost of the Covid-19 crisis in 2020–2021 is estimated at 14% of 2019 GDP (around 12,206 mm$). In the specific case of Spain, it amounts to 24% of the 2019 GDP; which is 397.3 m €. Spain is and will be by far the European country most economically affected by the pandemic. In Spain 2020, the GDP cost accounts for 94.7% of the total cost of the COVID-19 and health-care direct costs are only 2.14%. TTQ is a dominant strategy in Spain. For each euro spent on it, 7 euros will be recovered only in terms of saved health-care resources.
Research limitations/implications
Given the large degree of uncertainty and the fast-evolving nature of the epidemic, a number of assumptions are required to arrive at the estimates provided in this study. The results were found to be robust to the assumptions applied.
Practical implications
TTQ is a key strategy for the contention of the epidemy and it is justified from the economic perspective.
Originality/value
This is the first estimation of the cost of the COVID-19 and the cost-effectiveness of the TTQ strategy for Spain.
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Ricardo Kaufmann and Norma Pontet-Ubal
The estimation of the burden of a disease is one of the tasks with the longest tradition in health economics, which allows us to know the volume of resources that a country…
Abstract
The estimation of the burden of a disease is one of the tasks with the longest tradition in health economics, which allows us to know the volume of resources that a country allocates to a specific health problem, and to compare countries and diseases. Although the fundamental objective of health systems is not to reduce the cost of the disease, but to improve the health of the population, the studies of burden of disease establish the economic seriousness of the problem, orienting the priorities of action.
Government-funded medical expenditure in Uruguay for the last ten years has tripled in US dollars. The increase in the prevalence of overweight and obesity has contributed to this growth. According to the World Health Organization, Uruguay has the highest growing trend in the prevalence of both overweight and obesity in South America. We have previously estimated that economic burden linked to obesity will be more than US$500 million by 2020, a figure close to 1% of the country’s GDP.
In this study, we tried to generate a measure of value to ascertain the cost of inaction in the fight against obesity and its consequences linked to several non-communicable diseases. The cost of inaction is not defined as the cost of not doing, but as the cost of not implementing the right policies (in this case health prevention policies) at the right time.
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Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the…
Abstract
Purpose
Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.
Design/methodology/approach
Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.
Findings
The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.
Originality/value
There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.
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Fiorella Pia Salvatore, Simone Fanelli, Chiara Carolina Donelli and Michele Milone
This study aims to analyze the value-based health-care model in defining a strategy to guide the evolution of health-care organizations toward a value-oriented model. To improve…
Abstract
Purpose
This study aims to analyze the value-based health-care model in defining a strategy to guide the evolution of health-care organizations toward a value-oriented model. To improve the quality of care by ensuring economic sustainability, it is necessary to redefine the concept of competition in healthcare and align it with the concept of maximizing value for patients.
Design/methodology/approach
Performance measurement is a crucial aspect of the analysis of health-care organizations. Porter developed an effective analytical technique and presented the measurement of health-care outcomes based on health conditions, the efficiency of health-care organizations and the type of service provided.
Findings
Clinical outcomes and data on the costs of care of each patient are essential to evaluate improvement in treatment value over time. Engaging in the evaluation of what happens to patients in their course of care enables the expansion of the measurement of outcomes because it measures all the health services related to it.
Originality/value
Building a health-care system based on the value and continuous improvement of care and services provided is a goal shared by many countries and international organizations. Today, the analysis of outcomes is important for making informed decisions, directing and planning clinical and organizational changes by improving the quality of care and services.
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Koki Hirata, Kunichika Matsumoto, Ryo Onishi and Tomonori Hasegawa
The purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.
Abstract
Purpose
The purpose of this article is to clarify the social burden of Japan’s three major diseases including Long-term Care (LTC) burden.
Design/methodology/approach
A modification of the Cost of Illness (COI)—the Comprehensive-COI (C-COI) was utilized to estimate three major diseases: cancer, heart disease, and cerebrovascular diseases (CVD). The C-COI consists of five parts: medical direct cost, morbidity cost, mortality cost, formal LTC cost and informal LTC cost. The latter was calculated by two approaches: opportunity cost approach (OC) and replacement approach (RA), which assumed that informal caregivers were substituted by paid caregivers.
Findings
The C-COI of cancer, heart disease and CVD in 2017 amounted to 10.5 trillion JPY, 5.2 trillion JPY, and 6.7 trillion JPY, respectively (110 JPY= 1 US$). The mortality cost was preponderant for cancer (61 percent) and heart disease (47.9 percent); while the informal LTC cost was preponderant for CVD (27.5 percent). The informal LTC cost of the CVD in OC amounted to 1.8 trillion JPY; while the RA amounted to 3.0 trillion JPY.
Social implications
The LTC burden accounted for a significant proportion of the social burden of chronic diseases. The informal care was maintained by unsustainable structures such as the elderly providing care for the elderly. This result can affect health policy decisions.
Originality/value
The C-COI is more appropriate for estimating the social burden of chronic diseases including the LTC burden and can be calculated using governmental statistics.
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This paper aims to explore avenue where suppliers and manufacturers are aligned with health-care providers to improve supply chain visibility. Supply chain finance is explored to…
Abstract
Purpose
This paper aims to explore avenue where suppliers and manufacturers are aligned with health-care providers to improve supply chain visibility. Supply chain finance is explored to link suppliers/manufacturers with health-care providers.
Design/methodology/approach
Existing literature on supply chain visibility in health care forms a basis to achieve the study purpose. Alignment calls also for financial health where supply chain partners’ working capital is readily available to execute joint supply chain plan.
Findings
There is a disjoint in supply chain alliance between suppliers/manufacturers and providers where providers are unable to trace the origin of supplies. Quality care suffers and cost of care rises as providers search for supplies on an emergency basis. This paper provides a framework where solution can be formulated.
Research limitations/implications
Suppliers/manufactures form a direct strategic alliance with providers where product visibility enables health-care providers with a better patient management with lower cost of supplies. Inventory management and logistics cost will be lowered as better planning/forecasting is in place. This paper does not call for testing any hypothesis. Perhaps, next move along this line will be to investigate financial health of supply chain partners based on supplier relationship management practices.
Originality/value
This paper proposes health-care supply chain as an alternative solution to achieve the following twin purposes: controlling the cost while improving quality of care through supply chain finance. As far as we know, this study is the first attempt to achieve the goals.
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Antti Rautiainen, Toni Mättö, Kari Sippola and Jukka O. Pellinen
This article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.
Abstract
Purpose
This article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.
Design/methodology/approach
In contrast to the majority of earlier studies focusing on special health care, the study was conducted in a Finnish basic health care organization. The empirical data include 36 interviews, accounting reports, budgets, newspaper articles and meeting notes collected 2013–2018.
Findings
The use of accounting techniques in this case did not offer professionals sufficient support under conditions of conflict. The authors suggest that this perceived lack of support intensified the negative emotions toward accounting techniques. These negative emotions aggregated into incompatible professional-level institutional logics, which contributed to the lack of hybridization between such logics. The authors highlight the importance of the cognitive microfoundations, that is, the individual-level interpretations and emotional responses, in the analysis of conflicting institutional logics.
Practical implications
Managerial attention needs to be directed to accounting practices perceived as frustrating or threatening, a perception that can prevent the use of accounting techniques in the creation of professional hybrids. The Finnish basic health care context involves inconsistent political decision-making, multiple tasks, three institutional logics and individual interpretations and emotions in various decision-making situations.
Originality/value
This study develops microfoundational accounting research by illustrating how individual-level cognitive microfoundations such as dissatisfaction with budgeting, aggregate into professional-level institutional logics, and in our case, prevent professional hybridization in a basic health care setting characterized by conflict and three separate institutional logics.
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Timo Pohjosenperä and Hanna Komulainen
This paper aims to explore the dynamics of value co-creation in the context of health care logistics by focusing on the change in the value creation spheres of a logistics service…
Abstract
Purpose
This paper aims to explore the dynamics of value co-creation in the context of health care logistics by focusing on the change in the value creation spheres of a logistics service provider and its customer organization.
Design/methodology/approach
The development of value co-creation between the two organizations was researched through a qualitative case study that focuses on a situation wherein the hospital’s central warehouse was moved to a more distant location. Data consist of the interviews and focus group discussions of both nursing staff and logistics managers before and after the change. The empirical results are reflected to service and value co-creation literature as well as to existing knowledge about health care logistics.
Findings
The new situation compelled the counterparts to plan more structured logistics service procedures, as there was no longer any possibility for nursing staff to pick up urgently needed items from the central warehouse. This strengthened the role of the joint value creation sphere and made it more visible during the change.
Research limitations/implications
The study contributes to the evolving research on health care logistics and connects it to timely service value discussion. This paper proposes that as the physical distance of service facilities increases, the joint co-creation sphere, interestingly, gets widened during the change.
Practical implications
Managerially, the study provides implications for how to develop health-care material logistics to provide more value for both the logistics service providers and their customers.
Social implications
Understanding value co-creation in health care logistics services supports care organizations in developing their processes toward better care for the patients. Thus, health care logistics research facilitates societies and health-care systems to reach their goals in terms of better service and lower costs.
Originality/value
This study presents an up-to-date example of value co-creation in the scarcely researched context of health care logistics.
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Samuli Tikkanen, Pekka Räsänen, Timo Sinervo, Ilmo Keskimäki, Merja Sahlström, Tiina Pesonen and Hanna Tiirinki
Health care integration is crucial in improving service equality and patient outcomes. However, measuring integration between the health and social care sectors remains…
Abstract
Purpose
Health care integration is crucial in improving service equality and patient outcomes. However, measuring integration between the health and social care sectors remains challenging. This article aims to review existing systematic models to identify alternative health and social care integration measurement tools. The review focuses on models that involve systematic planning and long-term cooperation across different organizational sectors.
Design/methodology/approach
The study examines various dimensions and elements of integration, including process, outcome and structural measures. It compares different tools used to measure social and health care integration, such as the Rainbow model, Balanced Scorecard (BSC) Scorecard, PRISMA, SCIROCCO, integRATE, health-data simulation (HSIM) and the model developed by Åhgren and Axelsson. The analysis includes both empirical studies and theoretical frameworks.
Findings
The findings highlight the importance of standardized measurement methods to assess the impact of integration initiatives on patient outcomes, healthcare costs and the quality of care.
Originality/value
The review contributes to the ongoing discourse on social and health care integration, particularly in the Nordic context. The results can inform social and healthcare providers, policymakers and researchers in evaluating and improving integration initiatives.
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