Abstract:
:This paper discusses some of the economic issues which underpin the rationale for investment in information and communications technologies (ICTs). Information imperfections lead to significant transaction costs (search, negotiating and monitoring) which in turn confer a negative externality on parties involved in exchange. This divergence in private and social costs leads to a degree of resource misallocation (efficiency loss) which, uncorrected, results in a sub-optimal outcome. Traditional solutions to this problem are to rely upon direct government action to reduce the costs of transacting between market agents, or to employ tax/subsidy measures and other legislative action to achieve the desired market outcome. Three key policy questions are raised in the context of the NHS purchaser/provider relationship. Firstly, what is the optimum level of transaction costs; secondly, can ICTs assist in lowering the level of transaction costs to the optimum level; thirdly, who should bear the investment cost in reducing the level of transaction costs? The issue of property rights in different information systems is discussed and raises interesting policy questions about how much investment should be undertaken centrally rather than devolved to a more local level. In some ways this economic framework offers a post hoc justification of why different ICT systems have been introduced at various levels of the NHS. Essentially this reduces to the problem of externalities: providing good information confers a positive externality: not providing relevant, timely and accurate information confers a negative externality, by increasing further the level of transaction costs. The crucial role which ICT systems can play lies in attempting to reduce the level of transaction costs and driving the market towards what Dahlman has described as the transaction-cost-constrained equilibrium.
journal_name
Health Econjournal_title
Health economicsauthors
Ferguson B,Keen Jdoi
10.1002/(SICI)1099-1050(199601)5:1<25::AID-HEC181>subject
Has Abstractpub_date
1996-01-01 00:00:00pages
25-36issue
1eissn
1057-9230issn
1099-1050pii
10.1002/(SICI)1099-1050(199601)5:1<25::AID-HEC181>journal_volume
5pub_type
杂志文章相关文献
HEALTH ECONOMICS文献大全abstract::Obese children tend to perform worse academically than normal-weight children. If poor cognitive achievement is truly a consequence of childhood obesity, this relationship has significant policy implications. Therefore, an important question is to what extent can this correlation be explained by other factors that joi...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3211
更新日期:2015-09-01 00:00:00
abstract::This paper estimates treatment effects of managed care plans on the utilization of health care services using data from two contemporaneous, nationally representative household surveys from the USA. The paper exploits recent advances in simulation-based econometrics to take the endogeneity of enrollment into managed c...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1096
更新日期:2006-07-01 00:00:00
abstract::The introduction of the New Cooperative Medical Scheme (NCMS) in rural China has been the most rapid and dramatic extension of health insurance coverage in the developing world in this millennium. The literature to date has mainly used the uneven rollout of NCMS across counties as a way of identifying its effects on a...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.2965
更新日期:2014-08-01 00:00:00
abstract::Multiple parties influence the choice of facility for hospital-based inpatient and outpatient services. The patient is the central figure, but their choice of facility is guided by their physician and influenced by hospital characteristics. This study estimated changes in referral patterns for inpatient admissions and...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3160
更新日期:2016-04-01 00:00:00
abstract::Using a random sample of more than 4000 veterans, we test the effects of combat exposure on mental health. We focus on two cohorts of veterans: those who served in Vietnam (1964-1975) and the Gulf War (1990-1991). Combat exposure differed between these groups in intensity, duration and elapsed time since exposure. We ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1594
更新日期:2011-04-01 00:00:00
abstract::Though risk adjustment is necessary in order to make equitable comparisons of resource utilization in the treatment of acute myocardial infarction patients, there is little in the literature that can be practically applied without access to clinical records or specialized registries. The aim of this study is to show t...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1177
更新日期:2007-04-01 00:00:00
abstract::The relationship between health care expenditure and health outcomes has been the subject of recent academic inquiry in order to inform cost-effectiveness thresholds for health technology assessment agencies. Previous studies in public health systems have relied upon data aggregated at the national or regional level; ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3503
更新日期:2017-12-01 00:00:00
abstract::Epidemiological studies indicate that minority populations in the US - including African Americans, Native Americans and Mexican Americans - are particularly at risk for diabetes and that their complications are more frequent and severe. Using microdata from a 1994-1999 population based study of middle aged and older ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.676
更新日期:2002-07-01 00:00:00
abstract::Using longitudinal data from the Canadian National Population Health Survey (NPHS), we study the relationship between health and employment among older Canadians. We focus on two issues: (1) the possible problems with self-reported health, including endogeneity and measurement error, and (2) the relative importance of...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1051
更新日期:2005-10-01 00:00:00
abstract::The origin of the obesity epidemic in developing countries is still poorly understood. It has been prominently argued that economic development provides a natural interpretation of the growth in obesity. This paper tests the main aggregated predictions of the theoretical framework to analyze obesity. Average body weig...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.2968
更新日期:2014-07-01 00:00:00
abstract::Government projections of future health care expenditures--a great concern given the aging baby-boom generation--are based on econometric regressions that control explicitly for age but do not control for end-of-life expenditures. Because expenditures increase dramatically on average at the end of life, predictions of...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.831
更新日期:2004-04-01 00:00:00
abstract::We aim to establish whether it is ever appropriate to conduct cost-minimisation analysis (CMA) rather than cost-effectiveness analysis.We perform a literature review to examine how the use of CMA has changed since Briggs & O'Brien announced its death in 2001. Examples of simulated and trial data are presented: firstly...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1812
更新日期:2013-01-01 00:00:00
abstract::The impact of market concentration has been little studied in markets for ambulatory care in the developing world, where the retail sector often accounts for a high proportion of treatments. This study begins to address this gap through an analysis of the consumer market for malaria treatment in rural areas of three d...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1473
更新日期:2009-06-01 00:00:00
abstract::In a large number of situations, activities in health care have to be measured in terms of outcome and cost. However, the cases where outcome is fully captured by a single measure are rather few, so that one uses some index for outcome, computed by weighing together several outcome measures using subjective and somewh...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.900
更新日期:2004-12-01 00:00:00
abstract::The goal of this paper is to measure the marginal change in facility-level costs of medical care for children under five due to an increase in service quality achieved through the integrated management of childhood illness (IMCI) strategy. Since the beneficial effects of IMCI training on child health outcomes are due ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1231
更新日期:2008-01-01 00:00:00
abstract::Non-compliance with medication therapy remains an unsolved and expensive problem for healthcare systems around the world, yet we know little about the factors that affect a patient's decision to follow treatment recommendations. In particular, there is little evidence on the extent to which doctors can influence patie...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3357
更新日期:2017-06-01 00:00:00
abstract::High costs and deficits in the care of patients with chronic diseases have triggered numerous programs to improve the quality and efficiency of treatment of chronic diseases. Decision makers need to estimate the impact of a disease management program (DMP) on long-term costs and cost-effectiveness in order to decide w...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1503
更新日期:2010-06-01 00:00:00
abstract::Laws mandating that individuals wear a seat belt have the presumed goal of reducing motor vehicle accident fatalities, but the prevailing view is that they may reduce the number of organs available. I provide a conceptual model identifying mechanisms whereby the law could either increase or decrease organ donation. Ex...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.4140
更新日期:2020-08-03 00:00:00
abstract::This paper estimates the impact of the implementation of the Affordable Care Act (ACA) in 2014 on the decision to be self-employed. Using data from the Current Population Survey, we employ two identification strategies. Utilizing prereform variation in state nongroup health insurance market regulations, we find that t...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3500
更新日期:2017-12-01 00:00:00
abstract::Accurate future projections of population health are imperative to plan for the future healthcare needs of a rapidly aging population. Multistate-transition microsimulation models, such as the U.S. Future Elderly Model, address this need but require high-quality panel data for calibration. We develop an alternative me...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3986
更新日期:2020-07-14 00:00:00
abstract::According to the justification hypothesis, non-employed individuals may over-report their level of work limitation, leading to biased census/survey estimates of the prevalence of severe disabilities and the associated labor force participation rate. For researchers studying policies which impact the disabled or elderl...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3020
更新日期:2015-03-01 00:00:00
abstract::How donor organs are allocated for transplant can affect their scarcity. In 2008, Israel's Parliament passed an Organ Transplantation Law granting priority on organ donor waiting lists to individuals who had previously registered as organ donors. Beginning in November 2010, public awareness campaigns advertised the pr...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3328
更新日期:2017-04-01 00:00:00
abstract::This paper provides new empirical evidence on the employment and earning effects of the recent Medicaid expansion. Unlike most existing studies that use a conventional state and year fixed effects approach, our main identification strategy is based on the comparison of employment and wages in contiguous county-pairs i...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3976
更新日期:2020-03-01 00:00:00
abstract::This paper explores and critically discusses some of the methodological limitations of using the number-needed-to-treat (NNT) in economic evaluation. We argue that NNT may be a straightforward measure of benefit when the effect of an intervention is immediate, but that serious problems arise when the effect is delay r...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.797
更新日期:2004-01-01 00:00:00
abstract::Successive UK governments have pursued a policy of community care for people with learning disabilities which, in the past ten years, has led to a marked change in the nature of residential provision. Research evidence on the costs and quality of alternative forms of community provision is inconclusive and contradicto...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.4730020308
更新日期:1993-10-01 00:00:00
abstract::This paper directly compares the relative sensitivity of time-trade-off (TTO) and willingness-to-pay (WTP) values obtained for various levels of change in health status. This was achieved by administering a TTO and WTP survey to a population of 50 subjects, assessing their valuation of various degrees of change in hea...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.604
更新日期:2001-09-01 00:00:00
abstract::Many states in the US have passed laws mandating insurance companies to provide or offer some form of mental health benefits. These laws presumably lower the price of obtaining mental health services for many adults, and as a result, might improve health outcomes. This paper analyzes the effectiveness of mental health...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1023
更新日期:2006-01-01 00:00:00
abstract::Using the difference-in-difference-in-differences method, we examine the effect of the National Health Insurance (NHI) on mortality, self-assessed health, and functional limitations of the elderly and seek to determine whether the effect is spread equally across health classes. We find that the NHI only has an effect ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1815
更新日期:2013-01-01 00:00:00
abstract::We assess the impact on teenage childbearing as well as student knowledge, attitudes, and behavior of a typical HIV/AIDS teacher training program in the Cameroon. Applying a regression discontinuity design identification strategy based on the key administrative criterion that determined program deployment, we find tha...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1643
更新日期:2010-09-01 00:00:00
abstract::Since 2017, many US cities have implemented taxes on sugar-sweetened beverages to decrease consumption of sugary beverages and raise revenue. We analyze household receipt data to examine the impact of taxes on households' beverage purchases in the four largest US cities with such taxes: Philadelphia, PA; San Francisco...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.4141
更新日期:2020-10-01 00:00:00