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

Institutional communication revisited: Preferences, opportunity structures and scientific expertise in policy networks

Information exchange in policy networks is usually attributed to preference similarity, influence reputation, social trust and institutional actor roles. We suggest that political opportunity structures and transaction costs play another crucial role and estimate a rich statistical network model on tie formation in the German toxic chemicals policy domain. The results indicate that the effect of preference similarity is absorbed by other determinants while opportunity structures indeed have to be taken into account. We also find that different types of information exchange operate in complementary, but not necessarily congruent, ways.

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

Coping with creeping catastrophes: national political systems and the challenge of slow-moving policy problems

No abstract available

Relationalism in Political Theory and Research: The Challenge of Networked Politics and Policy-Making

Political theory and research approaches are in most cases not explicit in all respects, but are usually shaped by implicit background theories and scientific worldviews, e.g. presuppositions and paradigms. Examples are idealism, materialism or institutionalism. A fairly new perspective in this regard is relationalism. This way of thinking, in its ontological orientation, conceives the world only in terms of relations. Research programmes with a relationalist orientation put this idea into practice with methods of social network analysis which are more and more used also in political science. Several variants of this new -ism and type of network thinking are presented in this paper in a critical perspective. Relationalism is ultimately seen as fruitful perspective, but is seen as limited in its explanatory power, though. It should therefore always be combined with other approaches and perspectives.Teoria polityczna i badania w tej dziedzinie nie są zwykle pod każdym względem jednoznaczne, ale podlegają wpływom ukrytych teorii wyjściowych i światopoglądów naukowych, obejmujących na przykład założenia i paradygmaty. Przykładami są idealizm, materializm czy instytucjonalizm. Stosunkowo nowe podejście stanowi w tym względzie relacjonalizm. W ramach tej orientacji ontologicznej świat pojmowany jest wyłącznie w kategoriach relacji. Programy badawcze utrzymane w duchu relacjonizmu realizują tę ideę w praktyce za pomocą metod analizy sieci społecznych, które w coraz większym stopniu wchodzą w użycie także w naukach politycznych. Niniejszy artykuł prezentuje krytyczny ogląd kilku odmian tego nowego “izmu” i rodzajów myślenia sieciowego. Relacjonalizm jest ostatecznie postrzegany jako perspektywa pożyteczna, ale o ograniczonej mocy eksplanacyjnej. Dlatego powinien być zawsze stosowany w połączeniu z innymi podejściami i perspektywami

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

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