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Article

Neil Small and Russell Mannion

Mainstream health economics labours under a misleading understanding of the nature of the topic area and suffers from a concomitant poverty of thinking about theory and…

Abstract

Purpose

Mainstream health economics labours under a misleading understanding of the nature of the topic area and suffers from a concomitant poverty of thinking about theory and method. The purpose here is to explore this critical position and argue that health economics should aspire to being more than a technical discipline. It can, and should, engage with transformative discourse.

Design/methodology/approach

It is argued that the hermeneutic sciences, emphasising interpretation not instrumentality or domination, offer a route into the change to which one seeks to contribute. The article specifically focuses on the way Habermas provides insights in his approach to knowledge, reason and political economy. How he emphasises complexity and interaction within cultural milieu is explored and primacy is given to preserving the life‐world against the encroachments of a narrow rationalization.

Findings

The argument for a critical re‐imagining of health economics is presented in three stages. First, the antecedents, current assumptions and critical voices from contemporary economics and health economics are reviewed. Second, the way in which health is best understood via engaging with the complexity of both the subject itself and the society and culture within which it is embedded is explored. Third, the contribution that hermeneutics, and Habermas's critical theory, could make to a new health economics is examined.

Originality/value

The paper offers a radical alternative to health economics. It explores the shortcomings of current thinking and argues an optimistic position. Progress via reason is possible if one reframes both in the direction of communication and in the appreciation of reflexivity and communality. This is a position that resonates with many who challenge prevailing paradigms, in economics and elsewhere.

Details

Journal of Health Organization and Management, vol. 19 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

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Abstract

Details

Human Capital and Health Behavior
Type: Book
ISBN: 978-1-78635-466-2

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Article

R.G. Brooks

Health economics is now a well‐established topic within the discipline of economics. A 5,500‐item bibliography covering material up to 1982 is available (Blades et al

Abstract

Health economics is now a well‐established topic within the discipline of economics. A 5,500‐item bibliography covering material up to 1982 is available (Blades et al, 1986). Health economists write on such diverse matters as (to select at random) demand for acute care in hospitals, the costs of illness, the economics of alcoholism, cost‐benefit analysis in magnetic resonance imaging, and the pros and cons of any number of ways of financing the delivery of health services. Here in the UK the Health Economists' Study Group boasts around 150 members. Meanwhile, hardly a day goes by without the newspapers containing items concerning topics which could form the basis for health economists' involvement in analysis, evaluation and, in some cases, policy advice. The jargon of economics and evaluation is becoming familiar to a wider audience: thus articles on cost‐effectiveness and cost‐benefit analysis appear regularly in medical journals and the quality‐adjusted life‐year (QALY) has featured on TV. Thus a review of some of the recently published books in this area would appear appropriate at this juncture.

Details

Journal of Economic Studies, vol. 14 no. 5
Type: Research Article
ISSN: 0144-3585

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Article

Yavuz Yasar

The purpose of this paper is to propose an alternative, interdisciplinary teaching of health, health care and medical care based on three pillars: social economics, the…

Abstract

Purpose

The purpose of this paper is to propose an alternative, interdisciplinary teaching of health, health care and medical care based on three pillars: social economics, the social determinants of health (SDH) and ethics. Based on these three pillars, the global financial crisis is presented as the moment of manifestation of the SDH at individual and aggregate levels that require a critical analysis from a broader perspective that is possible with social economics and ethics.

Design/methodology/approach

The author designed a writing-intensive course based on four modules about definition of health, health care, medical care and determinants of health; political economy of financing and organization of medical care; policies including reform proposals; and medical ethics and moral philosophies that reflect back on the previous topics, respectively.

Findings

The course attracts students from different disciplines who found it realistic and comprehensive so that it can be related easily to other disciplines owing to its interdisciplinary design. It also helps students to improve their writing skills.

Research limitations/implications

The course is taught only in US context and is still open to further development.

Practical implications

The theoretical pillars of the course can be adopted and experimented with in different contexts (e.g. wars, plagues, immigration, etc.) and inform the participants about the subject matters from a broader perspective.

Originality/value

This paper provides a successful and novel teaching experience of health and medical care by putting social economics, SDH and ethics together.

Details

International Journal of Social Economics, vol. 46 no. 8
Type: Research Article
ISSN: 0306-8293

Keywords

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Article

Nicholas Wells

Statistics for the economics of health care encompasses three enormous subject areas in their own right. In order to make my task more manageable, I have decided not to…

Abstract

Statistics for the economics of health care encompasses three enormous subject areas in their own right. In order to make my task more manageable, I have decided not to say very much directly about statistics, as Dr. Alderson of the Office of Population Censuses and Surveys, and Dr John Fry, leading authorities on mortality and morbidity statistics — which are of course essential data in studying many health issues, have given papers at this seminar. Instead, I shall concentrate on the remaining two, economics and health care and in so doing divide my paper into two parts. The first will look at the evolution of health economics and then I shall turn my attention specifically to the work of my own organisation, the Office of Health Economics (OHE).

Details

Aslib Proceedings, vol. 38 no. 5
Type: Research Article
ISSN: 0001-253X

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Article

Marta Pascual-Saez, David Cantarero-Prieto and Daniela Castañeda

The correlation between health care expenditure, gross domestic product (GDP) and population over 65 years (understood as share of the elderly) is a key question for health

Abstract

Purpose

The correlation between health care expenditure, gross domestic product (GDP) and population over 65 years (understood as share of the elderly) is a key question for health economics and demographic impact. The purpose of this paper is to study the role of ageing society to curb rising health care expenditures along the Spanish regions over the period 2002-2013, identifying their geographic differences and explain them based on GDP differences.

Design/methodology/approach

Cointegration technique is used in order to test if there is a statistically significant connection between variables.

Findings

They are similar to some obtained when using unit root test. In particular, the authors find how the elderly positively affects health care expenditure per capita.

Practical implications

The findings suggest that any cooperation policies should aim at improving the access of people to health care services based on public health care expenditures.

Originality/value

To the best of the knowledge this is one of the first studies which suggest different results by Spanish regions due to mature decentralized system in recent years.

Details

International Journal of Social Economics, vol. 44 no. 10
Type: Research Article
ISSN: 0306-8293

Keywords

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Book part

Badi H. Baltagi, Francesco Moscone and Rita Santos

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…

Abstract

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.

Details

Health Econometrics
Type: Book
ISBN: 978-1-78714-541-2

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Article

Mervi Vähätalo and Tomi Juhani Kallio

The purpose of this paper is to analyse the way in which the factors influencing a transformation towards or away from modularity, according to general modular systems…

Abstract

Purpose

The purpose of this paper is to analyse the way in which the factors influencing a transformation towards or away from modularity, according to general modular systems theory, appear in the context of health services, and the extent to which the special characteristics of health services might support or prevent its application.

Design/methodology/approach

The arguments constructed in the study are based on the theme of modularity, reflected against the special characteristics of health services identified in the context of health economics.

Findings

The results include 11 proposition pairs that direct health services both towards and away from modularity.

Research limitations/implications

Health services are highly heterogeneous in nature and the authors illustrate this with a wide range of examples from elderly care as the authors discuss the application of modularity in this context. Nevertheless, the authors recognise that modularity might suit some health services better than others. The findings provide potentially important information to health service managers and providers, enabling them to understand how modularity would benefit health service provision and where contradictions are to be expected.

Originality/value

This study contributes to the discourse on service modularity in general, and complements the literature on modularity with reference to both public and private health services.

Details

International Journal of Operations & Production Management, vol. 35 no. 6
Type: Research Article
ISSN: 0144-3577

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Article

Sherman T. Folland

Need has persisted as a central concept in health policy debate. Despite confusion over its meaning and derivation it seems to summarise a belief by many policy makers…

Abstract

Need has persisted as a central concept in health policy debate. Despite confusion over its meaning and derivation it seems to summarise a belief by many policy makers that the concerns of health policy go beyond the merely economic. Economists, on their side, frequently stop at the borders of economics, leaving the concept of need to others, preferring where possible the concepts of demand and supply. This state of affairs increases the risk that the relationship of health care need to economic theory will not be well understood by policy makers, and that economists will misunderstand why their policy advice, when given, is so frequently ignored.

Details

International Journal of Social Economics, vol. 13 no. 1/2
Type: Research Article
ISSN: 0306-8293

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Article

Leonard G. Schifrin

Michael F. Drummond, in a recent paper in this Journal, has pointed out the usefulness and even necessity of physicians in clinical practice understanding certain key…

Abstract

Michael F. Drummond, in a recent paper in this Journal, has pointed out the usefulness and even necessity of physicians in clinical practice understanding certain key concepts of economics that apply to the provision of medical care. While the clinical practice of medicine and economic theory may appear to be quite unrelated, in fact they share a basic purpose: that of maximising the benefit society as a whole receives from the limited productive capability at hand. Viewed in this way, choices in the provision of medical care are but a subset of all choices that society must make in allocating this limited capability among many competing uses. ‘Economising’ thus is applicable to each component of economic activity, including the provision of medical care. ‘Scarcity’ and ‘opportunity cost’, as defined by Drummond, are the anchors of the bridge joining medical care and economics, and represent the fundamental concepts in the teaching of economic ways of thinking to those who determine the allocation of resources between medical care and other sectors of production, and within medical care. This paper builds on Drummond's ‘teaching approaches’ — his suggestions about where, when, what, and how to proceed until the infusion of this sort of economics education into the medical curriculum — with observations derived from 16 years' experience in teaching health care economics, in many settings, in the United States. It offers them, with due qualification for the differences between the US and UK medical care delivery and financing systems, in the hope that they may prove useful in expanding the teaching of economic concepts to future clinical practitioners and managers in both countries.

Details

Journal of Management in Medicine, vol. 4 no. 3
Type: Research Article
ISSN: 0268-9235

Keywords

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