58 research outputs found
Market structure and hospital–insurer bargaining in the Netherlands
In 2005, competition was introduced in part of the hospital market in the Netherlands. Using a unique dataset of transactions and list prices between hospitals and insurers in the years 2005 and 2006, we estimate the influence of buyer and seller concentration on the negotiated prices. First, we use a traditional structure–conduct–performance model (SCP-model) along the lines of Melnick et al. (J Health Econ 11(3): 217–233, 1992) to estimate the effects of buyer and seller concentration on price–cost margins. Second, we model the interaction between hospitals and insurers in the context of a generalized bargaining model similar to Brooks et al. (J Health Econ 16: 417–434, 1997). In the SCP-model, we find that the market shares of hospitals (insurers) have a significantly positive (negative) impact on the hospital price–cost margin. In the bargaining model, we find a significant negative effect of insurer concentration, but no significant effect of hospital concentration. In both models, we find a significant impact of idiosyncratic effects on the market outcomes. This is consistent with the fact that the Dutch hospital sector is not yet in a long-run equilibrium
Changes in the total leukocyte and platelet counts in Papuan and non Papuan adults from northeast Papua infected with acute Plasmodium vivax or uncomplicated Plasmodium falciparum malaria
<p>Abstract</p> <p>Background</p> <p>There are limited data on the evolution of the leukocyte and platelet counts in malaria patients.</p> <p>Methods</p> <p>In a clinical trial of chloroquine vs. chloroquine plus doxycycline vs. doxycycline alone against <it>Plasmodium vivax </it>(n = 64) or <it>Plasmodium falciparum </it>(n = 98) malaria, the total white cell (WCC) and platelet (PLT) counts were measured on Days 0, 3, 7 and 28 in 57 indigenous Papuans with life long malaria exposure and 105 non Papuan immigrants from other parts of Indonesia with limited malaria exposure.</p> <p>Results</p> <p>The mean Day 0 WCC (n = 152) was 6.492 (range 2.1–13.4) × 10<sup>9</sup>/L and was significantly lower in the Papuans compared to the non Papuans: 5.77 × 10<sup>9</sup>/L vs. 6.86 × 10<sup>9</sup>/L, difference = -1.09 [(95% CI -0.42 to -1.79 × 10<sup>9</sup>/L), P = 0.0018]. 14 (9.2%) and 9 (5.9%) patients had leukopaenia (<4.0 × 10<sup>9</sup>/L) and leukocytosis (>10.0 × 10<sup>9</sup>/L), respectively. By Day 28, the mean WCC increased significantly (P = 0.0003) from 6.37 to 7.47 × 10<sup>9</sup>/L (73 paired values) and was similar between the two groups. Ethnicity was the only WCC explanatory factor and only on Day 0.</p> <p>The mean Day 0 platelet count (n = 151) was 113.0 (range 8.0–313.0) × 10<sup>9</sup>/L and rose significantly to 186.308 × 10<sup>9</sup>/L by Day 28 (P < 0.0001). There was a corresponding fall in patient proportions with thrombocytopaenia (<150 × 10<sup>9</sup>/L): 119/151 (78.81%) vs. 16/73 (21.92%, P < 0.00001). Papuan and non Papuan mean platelet counts were similar at all time points. Only malaria species on Day 0 was a significant platelet count explanatory factor. The mean D0 platelet counts were significantly lower (P = 0.025) in vivax (102.022 × 10<sup>9</sup>/L) vs. falciparum (122.125 × 10<sup>9</sup>/L) patients.</p> <p>Conclusion</p> <p>Changes in leukocytes and platelets were consistent with other malaria studies. The Papuan non Papuan difference in the mean Day 0 WCC was small but might be related to the difference in malaria exposure.</p
Reduce fluctuations in capacity to improve the accessibility of radiotherapy treatment cost-effectively
A methodology to estimate the potential to move inpatient to one day surgery
BACKGROUND: The proportion of surgery performed as a day case varies greatly between countries. Low rates suggest a large growth potential in many countries. Measuring the potential development of one day surgery should be grounded on a comprehensive list of eligible procedures, based on a priori criteria, independent of local practices. We propose an algorithmic method, using only routinely available hospital data to identify surgical hospitalizations that could have been performed as one day treatment. METHODS: Moving inpatient surgery to one day surgery was considered feasible if at least one surgical intervention was eligible for one day surgery and if none of the following criteria were present: intervention or affection requiring an inpatient stay, patient transferred or died, and length of stay greater than four days. The eligibility of a procedure to be treated as a day case was mainly established on three a priori criteria: surgical access (endoscopic or not), the invasiveness of the procedure and the size of the operated organ. Few overrides of these criteria occurred when procedures were associated with risk of immediate complications, slow physiological recovery or pain treatment requiring hospital infrastructure. The algorithm was applied to a random sample of one million inpatient US stays and more than 600 thousand Swiss inpatient stays, in the year 2002. RESULTS: The validity of our method was demonstrated by the few discrepancies between the a priori criteria based list of eligible procedures, and a state list used for reimbursement purposes, the low proportion of hospitalizations eligible for one day care found in the US sample (4.9 versus 19.4% in the Swiss sample), and the distribution of the elective procedures found eligible in Swiss hospitals, well supported by the literature. There were large variations of the proportion of candidates for one day surgery among elective surgical hospitalizations between Swiss hospitals (3 to 45.3%). CONCLUSION: The proposed approach allows the monitoring of the proportion of inpatient stay candidates for one day surgery. It could be used for infrastructure planning, resources negotiation and the surveillance of appropriate resource utilization
Evidence on market structure of the deregulated US airline industry
Airline deregulation in the USA was a rejection of inefficient regulation and inspired by the perspective of both potential and actual competition in the industry. Using multivariate regression and efficiency frontier techniques, the emergent structure of unregulated airline markets is assessed. Our findings, based on panel data for major US airlines during the period 1984-1991, indicate that (1) as a result of successful efforts by airlines to reduce the scope for competition, aviation technology now exhibits increasing rather than constant returns to network size as predicted by cost studies prior to deregulation; (2) deregulation failed to produce evidence of efficiency convergence among carriers as would be expected under sufficiently competitive conditions.
BT's pricing and profitability A method of assessment
SIGLEAvailable from British Library Document Supply Centre- DSC:3597.9715(UCS-DE-DPS--92-05) / BLDSC - British Library Document Supply CentreGBUnited Kingdo
The interpretation of coefficients in multiplicative-logarithmic functions
SIGLEAvailable from British Library Document Supply Centre- DSC:3597.9715(UCS-DE-DP--90-09) / BLDSC - British Library Document Supply CentreGBUnited Kingdo
Industrial structure in US telecommunications Some empirical evidence
SIGLEAvailable from British Library Document Supply Centre- DSC:3597.9715(UCS-DE-DP--90-05) / BLDSC - British Library Document Supply CentreGBUnited Kingdo
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