Medical Care Expenditure Indexes: A Comparison of Indexes using MarketScan and Pharmetrics Data

In recent years, healthcare service utilization has undergone several shifts, having potentially important implications for the cost of medical care.

Ethical Aspects of Insurance

The nature and ethical basis for insurance in general will be briefly discussed. Reference will then be made to alternatives to insurance as a means for meeting the cost of medical care. Finally, the ethical aspects of private insurance and social insurance will be analyzed as means for paying for health services

The Effects of Competition on Variation in the Quality and Cost of Medical Care

We estimate the effects of hospital competition on the level of and the variation in quality of care and hospital expenditures for elderly Medicare beneficiaries with heart attack. We compare competition's effects on more-severely ill patients, whom we assume value quality more highly, to the effects on less-severely ill, low-valuation patients. We find that low-valuation patients in less-competitive markets receive more intensive treatment than in more-competitive markets, but have statistically similar health outcomes. In contrast, high-valuation patients in less-competitive markets receive less intensive treatment than in more-competitive markets, and have significantly worse health outcomes. Since this competition-induced increase in variation in expenditures is, on net, expenditure-decreasing and outcome-beneficial, we conclude that it is welfare-enhancing. These findings are inconsistent with conventional models of vertical differentiation, although they can be accommodated by more recent models.

Do Microfinance Programs Help Families Insure Consumption Against Illness?

Families in developing countries face enormous financial risks from major illness both in terms of the cost of medical care and the loss in income associated with reduced labor supply and productivity. We test whether access to microfinancial savings and lending institutions helps Indonesian families smooth consumption after declines in adult health. In general, results support the importance of these institutions in helping families to self-insure consumption against health shocks.

Children with Special Healthcare Needs: The Cost of Medical Care

The purpose of this study was to explore factors that impact children with special healthcare needs’ (CSHCN) health insurance coverage and out-of-pocket medical expenses. The Ecological Model for Health Promotion developed by McLeroy et al. (1988) was the guiding theoretical framework for this study. Using data from the 2020 National Survey of Children’s Health, I conducted descriptive statistics, logistic regressions, and multilevel modeling analyses to determine if health insurance coverage and out-of-pocket expenses for CSHCN differed by individual, family, and community, organization, and policy factors. Results indicated that race, gender, disorder category, insurance type, and family’s federal poverty level were associated with CSHCN’s type of health insurance, insurance coverage, problems paying for medical bills, and out-of-pocket medical expenses. Implications for research and policy, along with limitations for this study, are reported

A Systems Thinking Approach to Redesigning the Patient Experience to Reduce 30 Day Hospital Readmission

INTRODUCTION The cost of medical care is spiraling out of control, and one of the many reasons is lack of preventative care, poor communication to the patient and primary caregiver(s) both in an inpatient and outpatient setting. There are potentially many reasons for this cost escalation, one of the drivers of this cost is 30 day readmission after a hospitalization and this is what was examined in this analysis. The purpose of this paper in particular is to share what has been learned using a systems thinking approach to hospital readmissions and the patient experience. It is critical to understand the problems that occurred in the past. In addition, we will explain the methodology utilized and bring awareness to the iterative process. We will also demonstrate a suggested redesigned model

The rising cost of medical care and its effect on inflation

Medical care, Cost of ; Inflation (Finance)

The cost of universal free access for treating HIV/AIDS in low-income countries: the case of Senegal

Since late 2003 in Senegal, voluntary tests, ARVs and CD4 counts have been provided free of charge by the State within the framework of public health services. Debate now focuses on expanding free access to other components of care (consultations, hospitalizations, complementary exams for opportunistic infections). A preliminary study assessed the supplementary cost needed to fund all care and appraised this measure's impact on the national program. Direct costs for treatment were calculated using two different methods: (1) by calculating total expenditures for a sample of 299 patients over a 22-month period (July 2003 to April 2005) treated by HAART (2 NRTI + 1 PI or NNRTI); and (2) by assessing the theoretical costs necessary to apply the national treatment protocols. Furthermore, national budgetary projections were analyzed to estimate possible margins available to officials. In 2006, the total cost of medical care for someone taking ARVs falls around 412€ per year; 84% of the cost covers the price of ARVs and reagents for CD4 counts. The total annual cost of medical care for a PLWHA who does not need ARV drugs is approximately 40€ per year, with 90% of this amount covering biological exams. Projections concerning changes in the number of PLWHA and treatment needs and analysis of budget estimations for 2007-2011 demonstrate that supplementary costs incurred by complete free access could be easily covered without disrupting the proposed funding plan. Complete free access for medical care for all PLWHA in the country is therefore economically feasible; what remains is to define this decision's integration into the current paying health system without causing disturbances that render the decision ineffective.VIH ; sida ; mdicaments antirétroviraux ; prise en charge médicale ; accès aux soins ; financement de la santé ; gratuité ; payement par les usagers ; Sénégal

Energy, Nutrition, and Exercise: An Effort to Prevent Childhood Obesity in Vermont

Childhood obesity is an epidemic in the United States affecting 17% of all children. In Vermont 12.5% of children are obese. This carries increased risk for many health problems and an increased cost of medical care averaging $19,000 per obese child over a lifetime. This project aims to teach children about healthy food choices and exercise.https://scholarworks.uvm.edu/fmclerk/1162/thumbnail.jp

Bending the cost curve in the United States: the role of comparative effectiveness research

Owing to an increasing focus on the rising cost of medical care in the United States, bending the cost curve has become the central tenet of healthcare reform. The exact definition of this phrase, however, remains elusive. In order to affect change in the cost and quality of healthcare, the importance of comparative effectiveness research must be recognized