The Physician-Patient Relationship Revisited - the Patient's View

The importance of the physician-patient relationship for the health care market is beyond controversy. Most theoretical work is done in a principal-agent framework, dealing with moral hazard problems. Recent work emphasizes a two-sided asymmetric information relationship between physician and patient (double moral hazard). In contrast to most work looking only at the physician's perspectives, our paper concentrates on the patient's view. Estimation results using panel data support the hypotheses that physician consultation and health-relevant behavior are not stochastically independent. This means that health care demand is determined by the patient and not only by the physician. In the recursive bivariate probit model, the patient’s health-relevant behavior has a significant positive influence on the probability of a physician visit. This should be taken into account in the discussion that primary care physicians should function as gatekeepers.physician-patient relationship, health behavior, bivariate probit

Short-run dynamics and long-run effects of demographic change on public debt and the budget

The German population is aging. Since fewer children are born and simultaneously life expectancy rises, demographic changes will lead to a double aging process. The paper analyzes the effects of demographic changes on national debt and the public budget by applying a cointegration analysis to global budget variables. Our procedure which covers the period between 1950 and 1990 completes prevailing projections, emphasizing that low vital rates are not the basic problem but the long-run trend of decreasing fertility and mortality rates. The estimation results of several error- correction models show that in the long-run an increase in the old age dependency ratio, and a decrease in the reproduction rate will lead to higher public expenditures. As regards public revenue, the results are ambivalent. The change in the age structure results in higher tax revenue, whereas the decline of population has the opposite effect. Furthermore, we find empirical evidence that aging increases the debt ratio. This development counters current efforts to reduce the public debt share of production potential and the tax load ratio. As a consequence, more action is needed to improve Germanys competiveness as a business location. Compared to these long-run effects, the short-run dynamics is only of minor importance. Significant parameter estimates can be found mainly in the model for the social security contribution rate. --

Health Relevant Behavior and its Impact on the Physician-Patient Relationship

The importance of the physician-patient relationship for the health care market is beyond controversy. Recent work emphasizes a two-sided asymmetric information relationship between physician and patient. In contrast to most work looking only at the physician's perspective, our paper concentrates on the patient's view. Estimation results support the hypotheses that physician consultation and health relevant behavior are not stochastically independent. In the recursive bivariate probit model, patient’s health relevant behavior has a significant influence on the probability of a physician visit. This means that health care demand and not only the contact decision is determined by both, patient and physician.physician-patient relationship, health behavior, bivariate probit panel

Investigating in-medium properties of the ω\omega meson via the ω→π0γ\omega\rightarrow\pi^0\gamma decay

We investigate the feasibility of studying in-medium properties of the $\omega$ meson in photoproduction experiments via the decay $\omega\rightarrow\pi^0\gamma$. We use the GiBUU transport model to compare different methods of obtaining in-medium information, such as the invariant mass spectrum, transparency ratio, excitation function and momentum spectrum. We show that the final-state interaction of the pion poses a major obstacle for the interpretation of the invariant mass spectrum. The other three observables turn out to be fairly independent of final-state interactions and thus can give access to the $\omega$'s in-medium properties.Comment: 8 pages, 6 figure

Health, health care, and the environment: econometric evidence from German micro data

The paper develops and applies a Grossman-style health production model set up in discrete time to explain the impact of environmental pollution on the demand for both health and health care. In order to introduce the environment, our analysis takes changes in environmental conditions to influence the rate at which an individual's stock of health depreciates. While the theoretical part of our paper also contains a discussion of the full model, we restrict our analysis to a submodel which is known as the pure investment model. lbis is because the other submodel, the pure consumption model, implies a rather implausible case of satiation with respect to the individual's preferences. Our empirical findings' are based on data taken from the German Socio-economic Panel (SOEP). The stock of health capital and environmental pollution are treated as latent variables and estimated using a LINCS model. The quality of the environment turns out to be an important determinant of health capital. From the point of view of health economics, improvements in environmental conditions can be interpreted as preventive measures. In terms of prevention, public policies designed to protect the environment also yield significant health effects. As regards health care demand the influence is not dearcut, i.e. one cannot necessarily expect a reduction in resource use. --

Risk Adjustment Systems in Health Insurance Markets in the US, Germany, Netherlands and Switzerland

Gesetzliche Krankenversicherung, Versicherungstechnisches Risiko, Vereinigte Staaten, Deutschland, Niederlande, Schweiz, Public health insurance, Actuarial risk, United States, Germany, Netherlands, Switzerland

Sila-Riechstoffe und Riechstoffisostere. - XII : Geruchsvergleiche homologer Organoelementverbindungen der vierten Hauptgruppe (C, Si, Ge, Sn)

Homologous compounds of the linalool type R(CH3)2El-OH (with R = C6H5CH2 and C6H5CH2CH2) as well as their derivatives R(CH3)2El-OCH3 and [R(CH3)2El]2O show, in dependence of El = C, Si, Ge and Sn partly similar, but sometimes very different characteristics of odor. Unexpected are high qualities of fragrance with El = Ge, whereas derivatives with El = Sn remain scentless, obviously owing to polymerization. Noteworthy are the strong differences of odor in the system C6H5CH2El(CH3)3 from C via Si and Ge up to Sn, standing fully contrary to the postulation of Amoore whereupon smell qualities are only controlled by size and shape of molecules. C6H5CH2Sn(CH3)2OH (A1Sn) crystallizes as poly-µ-hydroxo-benzyldimethyltin with an one dimensional SnOSnO chain (SnO 2.17(9) and 2.29(9) A°) in the monoclinic space group C2 (a = 12.696(4), b = 4.181(2), c = 10.626(3) A° and ß = 106.8(3)°)

Das Gesundheitswesen an der Schwelle zum Jahr 2000

Seit dem Krankenversicherungs-Kostendämpfungsgesetz von 1977 wurden 46 größere Gesetze mit über 6.800 Einzelregelungen erlassen mit dem Ziel, die Ausgabensteigerungen im Gesundheitswesen zu begrenzen und den Beitragssatz zu stabilisieren. Die gesetzlichen Eingriffe konnten den Ausgabentrend aber jeweils nur für kurze Zeit bremsen. Die bestehende Beitrags-Leistungs-Spirale konnte bisher nicht durchbrochen werden. Steigende Leistungen implizieren steigende Beitragssätze, die ihrerseits steigende Ansprüche der Versicherten an das System auslösen. Mit Blick auf die Gesundheitsversorgung und Krankenversicherung im Jahr 2000 geht es im Kern darum, die Finanzierung des Gesundheitswesens lohnkostenneutral zu gestalten, individuelles Handeln und finanzielle Verantwortung stärker in Einklang zu bringen und die Ausrichtung der Gesundheitsversorgung hin zu mehr Ergebnisorientierung zu fördern. --

I feel good! Gender differences and reporting heterogeneity in self-assessed health

For empirical analysis and policy-oriented recommendation, the precise measurement of individual health or well-being is essential. The problem with variables based on questionnaires such as self-assessed health is that the answer may depend on individual reporting behaviour. Moreover, if individual‟s health perception varies with certain attitudes of the respondent reporting heterogenei-ty may lead to index or cut-point shifts of the health distribution, causing estimation problems. We analyse the reporting behaviour of individuals on their self-assessed health status, a five-point categorical variable. We explore observed heterogeneity in categorical variables and include unob-served individual heterogeneity using German panel data. Estimation results show different im-pacts of socioeconomic and health related variables on the five subscales of self-assessed health. Moreover, the answering behaviour varies between female and male respondents, pointing to gen-der specific perception and assessment of diseases. Reporting behaviour on self-assessed health questions in surveys is problematic due to a possible heterogeneity. Hence, in case of reporting heterogeneity, using self-assessed measures in empirical studies may be misleading or at least ambiguous.reporting heterogeneity, generalized ordered probit, self-assessed health