Abstract：
:Despite the growing literature on economic evaluation of health care programmes, little attention has been paid to the theoretical foundations of cost-effectiveness and cost utility analyses and the validity of the decision rules adopted as methods of achieving the stated goals. We show that although applications of the techniques can be used to pursue some managerial objectives in the context of highly constrained environments, such applications are inconsistent with both welfare economic objectives and the interpretations of the findings of these applications. Alternative strategies are identified as potential and practical methods for pursuing welfare economic objectives.
journal_name
J Health Econjournal_title
Journal of health economicsauthors
Birch S,Gafni Adoi
10.1016/0167-6296(92)90004-ksubject
Has Abstractpub_date
1992-10-01 00:00:00pages
279-96issue
3eissn
0167-6296issn
1879-1646pii
0167-6296(92)90004-Kjournal_volume
11pub_type
杂志文章,评审abstract：:Recent analyses suggest that cigarette excise taxes lower prenatal smoking. It is unclear, however, whether the association between taxes and prenatal smoking represents a decline among women of reproductive age or a particular response by pregnant women. We address this question directly with an analysis of quit and ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2003.06.003
更新日期：2003-11-01 00:00:00
abstract：:Numerous studies have examined the effectiveness of alcohol and traffic policies in reducing automobile crashes and fatalities, but only a few have analyzed the impact of state-specific policies on motorcycle safety. Given the growing popularity and inherent safety risks of motorcycle riding, this study provides a com...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2009.05.002
更新日期：2009-07-01 00:00:00
abstract：:This study asks why hospitals provide direct financial support to nursing schools and faculty. This support is striking because nursing education is clearly general, clearly paid by the firm, and information asymmetries appear minimal. Using AHA and survey data, I find hospitals employing a greater share of their MSA'...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2012.09.002
更新日期：2013-01-01 00:00:00
abstract：:Flat capitation (uniform prospective payments) makes enrolling healthy enrollees profitable to health plans. Plans with relatively generous benefits may attract the sick and fail through a premium spiral. We simulate a model of idealized managed competition to explore the effect on market performance of alternatives t...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(97)00029-5
更新日期：1998-06-01 00:00:00
abstract：:In a 1975 paper, Neuhauser and Lewicki analysed a colorectal cancer screening policy approved by the American Cancer Society. Their analysis yielded an incremental cost per case detected in excess of $47 million. This vivid demonstration of the impact of marginal analysis is frequently cited by health economists and i...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(90)90004-m
更新日期：1990-01-01 00:00:00
abstract：:When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), the provider on duty must quickly decide how aggressively the patient should be treated. Using Florida data on all such patients from 1992 to 2014, we decompose practice style into two components: The provider's probability of conduct...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2016.01.013
更新日期：2016-05-01 00:00:00
abstract：:We exploit lottery-determined admission to dental school to estimate the payoffs to the study of dentistry in the Netherlands. Using data from up to 22 years after the lottery, we find that in most years after graduation dentists earn around 50,000 Euros more than they would earn in their next-best profession. The pay...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2018.11.001
更新日期：2019-01-01 00:00:00
abstract：:Late childhood and adolescence is a critical time for social and emotional development. Over the past two decades, this life stage has been hugely affected by the almost universal adoption of the internet as a source of information, communication, and entertainment. We use a large representative sample of over 6300 ch...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2019.102274
更新日期：2020-01-01 00:00:00
abstract：:We conduct an applied welfare economics analysis of cigarette tax avoidance. We develop an extension of the standard formula for the optimal Pigouvian corrective tax to incorporate the possibility that consumers avoid the tax by making purchases in nearby lower tax jurisdictions. To provide a key parameter for our for...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2013.08.005
更新日期：2013-12-01 00:00:00
abstract：:Despite the scarcity of transplantable organs, 45% of livers are rejected by the first surgeon to whom they are offered. I present a model in which a surgeon decides to accept or reject an organ for a patient based on the patient's current health level. Using data on transplanted patients, I show that surgeons' behavi...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(02)00077-2
更新日期：2002-11-01 00:00:00
abstract：:In a recent issue of this Journal, McRae and Tapon (1985) use the Canadian experience with compulsory patent licensing and three provincial drug reimbursement programs to evaluate post-patent barriers to entry in the pharmaceutical industry. In this paper we provide additional evidence on the influence of differing pr...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(87)90031-2
更新日期：1987-03-01 00:00:00
abstract：:This paper empirically investigates the long-run effects of major health improvements on income growth in the United States. To isolate exogenous changes in health, the econometric model uses quasi-experimental variation in cardiovascular disease mortality across states over time. Based on data for the white populatio...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2020.102398
更新日期：2021-01-01 00:00:00
abstract：:This paper performs new tests of the QALY model when health varies over time. Our tests do not involve confounding assumptions and are robust to violations of expected utility. The results support the use of QALYs at the aggregate level, i.e. in economic evaluations of health care. At the individual level, there is le...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2008.05.009
更新日期：2008-09-01 00:00:00
abstract：:Recently, much research has been devoted to the question of how the conventional net national product measure should be augmented so as to cover changes in the stocks of natural resources. This paper investigates the treatment of health (capital) and the risk of 'doomsday' caused by pollution in such welfare measures....
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(94)00037-5
更新日期：1995-05-01 00:00:00
abstract：:Most government employees have access to retiree health coverage, which provides them with group health coverage even if they retire before Medicare eligibility. We study the impact of retiree health coverage on the labor supply of public sector workers between the ages of 55 and 64. We find that retiree health covera...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2014.03.013
更新日期：2014-12-01 00:00:00
abstract：:In clinical terms, a screening compliance rate of 100% may be deemed optimal in that the number of abnormalities detected is thereby maximized. This paper explores optimum compliance rates from the cost-effectiveness point of view by modelling the individual's decision to participate in the screening programme. Using ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(91)90004-7
更新日期：1991-07-01 00:00:00
abstract：:Do urban hospital closures affect health care access or health outcomes? We study closures in Los Angeles County between 1997 and 2003, through their effect on distance to the nearest hospital. We find that increased distance to the closest hospital increases deaths from heart attacks and unintentional injuries. This ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2005.10.006
更新日期：2006-07-01 00:00:00
abstract：:This paper analyzes the impact of trans fat bans on cardiovascular disease (CVD) mortality rates. Several New York State jurisdictions have restricted the use of ingredients containing artificial trans fat in food service establishments. The resulting within-county variation over time and the differential timing of th...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2015.09.005
更新日期：2016-01-01 00:00:00
abstract：:A new method is proposed to assess and improve the performance of risk equalization models in competitive markets for individual health insurance, where compensation is intended for variation in observed expenditures due to so-called S(ubsidy)-type risk factors but not for variation due to other, so-called N(on-subsid...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2010.02.001
更新日期：2010-05-01 00:00:00
abstract：:We performed an empirical elicitation of the equity-efficiency trade-off in cost-utility analysis using the rank-dependent quality-adjusted life-year (QALY) model, a model that includes as special cases many of the social welfare functions that have been proposed in the literature. Our elicitation method corrects for ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2004.10.001
更新日期：2005-07-01 00:00:00
abstract：:The purpose of this paper is to examine the effects of alcohol regulation on physical child abuse. Given the positive relationship between alcohol consumption and violence, and the negative relationship between consumption and price, the principal hypothesis to be tested is that an increase in the price of alcohol wil...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(99)00025-9
更新日期：2000-03-01 00:00:00
abstract：:While there has been an important increase in methodological and empirical studies on health inequality, not much has been written on the theoretical foundation of health inequality measurement. We discuss several reasons why the classic welfare approach, which is the foundation of income inequality analysis, fails to...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(01)00138-2
更新日期：2002-05-01 00:00:00
abstract：:EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. It comprises a survey instrument describing health states across five domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2017.06.013
更新日期：2017-09-01 00:00:00
abstract：:Medical decision analyses typically focus on one disease, that is, on one source of risk. In many medical decisions multiple sources of risk co-exist, however. This paper analyzes the effect of such comorbidities on treatment decisions. The effect of comorbidities on treatment decisions depends primarily on the way in...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/S0167-6296(03)00045-6
更新日期：2003-09-01 00:00:00
abstract：:In this paper we investigate the causal effect of years of schooling on health and health-related behavior in West Germany. We apply an instrumental variables approach using as natural experiments several changes in compulsory schooling laws between 1949 and 1969. These law changes generate exogenous variation in year...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2011.01.004
更新日期：2011-03-01 00:00:00
abstract：:We experimentally evaluated the effects of in-kind team incentives on health worker performance in El Salvador, with 38 out of 75 community health teams randomly assigned to performance incentives over a 12-month period. All teams received monitoring, performance feedback and recognition for their achievements allowin...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2019.102267
更新日期：2020-03-01 00:00:00
abstract：:Measuring the lifetime costs and benefits of medical technologies is essential in evaluating technological change and determining the productivity of medical care. Using data on Medicare beneficiaries with a heart attack in the late 1980s and 17 years of follow up data, I evaluate the long-term costs and benefits of r...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2007.09.003
更新日期：2007-12-01 00:00:00
abstract：:The conventional theory of optimal coinsurance rates for health insurance with moral hazard indicates that coinsurance should vary with the price responsiveness or price-elasticity of demand for different medical services. An alternative theory called "value-based cost sharing" indicates that coinsurance should be low...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2008.07.003
更新日期：2008-12-01 00:00:00
abstract：:This paper studies the design of long term care (LTC) insurance contracts in the presence of ex post moral hazard. While this problem bears some similarity with the study of health insurance (Blomqvist, 1997) the significance of informal LTC affects the problem in several crucial ways. It introduces the potential crow...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2016.08.008
更新日期：2016-12-01 00:00:00
abstract：:Although the effect of time to death (TTD) on health care expenditures (HCE) has been investigated using individual level data, the most profound implications of TTD have been for the forecasting of macro-level HCE. Here we estimate the TTD model using macro-level data from the Netherlands consisting of mortality rate...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2012.08.003
更新日期：2012-12-01 00:00:00
