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Homelessness has many causes and also is stigmatized in the United States, leading to much misunderstanding of its causes and what policy solutions may ameliorate the problem. The problem is of course getting worse and impacting many communities far removed from the West Coast cities the authors examine in this study. This analysis examines the socioeconomic variables influencing homelessness on the West Coast in recent years. The authors utilize a panel fixed effects model that explicitly includes measures of healthcare access and availability to account for the additional health risks faced by individuals who lack shelter. The authors estimate a spatial error model (SEM) in order to better understand the impacts that systemic shocks, such as the COVID-19 pandemic, have on a variety of factors that directly influence productivity and other measures of welfare such as income inequality, housing supply, healthcare investment, and homelessness.

The authors examine whether or not applicants and recipients of federal disability insurance (DI) inflate their self-assessed health (SAH) problems relative to others. To do this, the authors employ a technique which uses anchoring vignettes. This approach allows them to examine how various cohorts of the population interpret survey questions associated with subjective self-assessments of health. The results of the analysis suggest that DI participants do inflate the severity of a given health problem, but by a small but significant degree. This tendency to exaggerate the severity of disability problems is much more apparent among those with more education (especially those with a college degree). In contrast, racial minorities tend to underestimate severity ratings for a given disability vignette when compared to their white peers.

Circular economy (CE) is receiving increasing worldwide attention as a manner to overcome the challenges linked to current trends of unsustainable energy and resource consumption. This paper aims to fill this gap and analyze the adherence to sustainable, access-based and collaborative consumption practices by exploring the role of CE awareness, specifically in the context of Porto, the second-largest city of Portugal.

The methodology of choice is quantitative, based on partial least square-based structural equation modeling.

The result shows that there is an influence of CE awareness on subsequent sustainable consumption models.

Present research contributes to the theory on CE awareness and sustainable consumption. It proposes a model that could be applied in other countries. As this research is developed within the city of Porto, it may limit generalizations of obtained results.

As CE practices are embodied into national and local policies, this research contributes to understanding local contexts of CE practices dissemination, providing practical suggestions for businesses and policymakers aiming the transition to the CE.

An original approach to measuring the awareness of CE economy is proposed, that is analyzed not only from the familiarity perspective but in six dimensions of its construction: familiarity, importance, perception or interpretation, advantages, social impact and barriers in this process. Further, the conceptual model of the impact that these dimensions have on the adoption of sustainable consumption models (purchase of sustainable products, access-based and collaborative consumption) is proposed.

This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.

This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.

Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.

This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.

Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.

The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.

The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on self-management efforts. These decisions not only impact health outcomes but also shape the demand for care, subsequently influencing care costs. Despite the significance of this interplay, current payment schemes often overlook these dynamics. The research focuses on investigating the implications of a novel behavior-based payment scheme, designed to align incentives and establish a direct connection between patients' decisions and care costs. The primary objective is to comprehensively understand whether and how this innovative payment scheme structure influences key stakeholders, including patients, care providers, insurers and overall social welfare.

In this paper, we propose a game-theoretical model to incorporate the performance of self-management with the demand for healthcare service, compare the patient's effort decision for self-management and provider's price decision for healthcare service under a behavior-based scheme with that under two implemented widely payment schemes, that is, co-payment scheme and co-insurance scheme.

Our findings confirm that the behavior-based scheme incentives patient self-management more than current schemes while reducing their possibility of seeking healthcare service, which indirectly induces the provider to lower the price of the service. The stakeholders' utility under various payment schemes is sensitive to the cost of treatment and the perceived health utility of patients. Especially, patient health awareness is not always benefited provider profit, as it motivates patient self-management while diminishing the demand for care.

We provide a novel framework for characterizing behavior-based payment schemes. Our results confirm the need for modification of the current payment scheme to incentivize patient self-management.

In 2011, Brazil introduced a national pay-for-performance (P4P) scheme called the National Program for Improving Primary Health Care Access and Quality (PMAQ), rolled out over three cycles and reaching more than 5,000 municipalities and 40,000 family health teams (FHTs). There is little evidence on how the PMAQ was implemented locally and whether this variation in implementation affects performance, particularly, in terms of work process indicators. This study compared different cases of municipal-level PMAQ implementation (bonuses paid or not to FHTs) over the last two program cycles to analyze the quality of the work processes, actions and services of FHTs.

This was a cross-sectional analytical study using secondary data from an external evaluation of the Brazilian PMAQ. In total, 27,500 FHTs participated in the evaluation. They were divided into four clusters based on whether or not municipalities paid bonuses to workers during cycles 2 and 3 of the program (2013–2019). Variables regarding work processes, actions and services were classified as “Quality Assurance – QA” or “Continued Quality Improvement – CQI”, and an individual score was assigned based on the average score of each variable.

The four clusters displayed an increase in overall QA and CQI scores between the two program cycles; though this increase was small between the set of primary health care teams that received bonuses and those that did not.

This paper contributes to bridging the gap in the scientific literature for evaluative studies on the relationship between direct payment for performance to health professionals and better quality actions and services in low and middle-income countries.

The objective of this paper is to examine the effect of spending one extra year in high school on early marriage and childbirth.

The study takes advantage of the education reform in 2007 that extended the years of high school education by one to conduct a quasi experiment. The marriage and fertility outcomes of women who completed a four-year senior high school education are compared to those who completed a three-year senior high school education.

The findings from the study indicate that the one-year extension in high school education led to a 4.75 percentage point reduction in the probability of ever marrying by age 27 and a 6.7 percentage point reduction in the probability of ever given birth. The authors demonstrate that the extension of the duration of high school education by one year has a heterogeneous effect, as it reduced the fertility and marriage outcomes of rural girls more than urban girls. The study reveals opportunity costs and confinement effects as possible mechanisms through which the policy affected early marriage and birth.

This study is one of the few studies that examine the impact of the duration of secondary school education on fertility and marriage. For Africa in particular, there is no such study. Thus, this study provides a unique contribution to the literature since available studies on this subject matter can only be found in advanced economies. Unlike other studies in Africa that use a design that provides the combined effect of duration of schooling and school enrolment on fertility and marriage, this design enables the authors to only look at the effect of duration of schooling on fertility and marriage.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-04-2023-0323

There is a renewed interest among economists and policymakers in striking a perfect balance between the market, state, and the community for equitable and sustained development. Inclusive development is the need of the hour and healthcare cooperatives provide the perfect means to deliver that. The cooperatives can and should have an important role to play in this scenario. However, there is an important need to provide an enabling environment for the genesis and growth of Healthcare Cooperatives in India and to learn from the best models and practices across the world. The chapter discusses the effectiveness of healthcare cooperatives.

This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth.

The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership.

Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries.

To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330