Abstract:
:Moral hazard in public insurance for long-term care may be counteracted by strategies influencing supply or demand. Demand-side strategies may target the patient or the insurer. Various demand-side strategies and how they are implemented in four European countries (Germany, Belgium, Switzerland and the Netherlands) are described, highlighting the pros and cons of each strategy. Patient-oriented strategies to counteract moral hazard are used in all four countries but their impact on efficiency is unclear and crucially depends on their design. Strategies targeted at insurers are much less popular: Belgium and Switzerland have introduced elements of managed competition for some types of long-term care, as has the Netherlands in 2015. As only some elements of managed competition have been introduced, it is unclear whether it improves efficiency. Its effect will depend on the feasibility of setting appropriate financial incentives for insurers using risk equalization and the willingness of governments to provide insurers with instruments to manage long-term care.
journal_name
J Health Serv Res Policyjournal_title
Journal of health services research & policyauthors
Bakx P,Chernichovsky D,Paolucci F,Schokkaert E,Trottmann M,Wasem J,Schut Fdoi
10.1177/1355819615575080subject
Has Abstractpub_date
2015-07-01 00:00:00pages
170-6issue
3eissn
1355-8196issn
1758-1060pii
1355819615575080journal_volume
20pub_type
杂志文章abstract:BACKGROUND:Access to cardiac treatments has been documented to vary with patients' age. It is unknown whether these variations reflect patients' treatment preferences. We aimed to investigate patients' preferences for cardiology treatments and develop a Patients' Preferences Questionnaire. METHODS:Semi-structured inte...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008012
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVES:To assess whether it is feasible to elicit patients' preferences for treatments and then to proceed with randomisation which may allocate those with preferences to their less preferred treatment; and to describe which prognostic variables were associated with such preferences within the context of a randomis...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969600100403
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVES:To understand the challenges and opportunities associated with the introduction of assistant practitioner (AP) roles supporting the work of ward-based registered nurses (RNs) in National Health Service (NHS) acute hospital trusts in England. METHODS:Three case studies of NHS acute hospital trusts. This pape...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2011.010106
更新日期:2011-04-01 00:00:00
abstract::We review the foundations of resource allocation rules based on cost-effectiveness information. Comprehensive approaches, where a total budget is allocated in one go, require estimation of the costs and effects of all available health care programmes, which is unlikely to be practical. A common alternative is to asses...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/1355819042250177
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness and cost of obtaining consent for review of medical records within the passively observed non-intervention arm of a cluster randomized controlled trial, 'Comparison Arm for ProtecT'. METHODS:Two hundred and thirty men, who had been notified to the trial by cancer registries as h...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008085
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:The National Service Framework (NSF) for Coronary Heart Disease--published by the English Department of Health in 2000--sets out how those within the health service should seek to prevent and treat coronary heart disease and care for people with the disease. Its prescriptions are partly based on what is know...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581906776318956
更新日期:2006-04-01 00:00:00
abstract::'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical app...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819616660581
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:Successful partnership working has theoretically been linked to improvements in service delivery and is dependent on the strength of the partnership, trust, communication, professional roles and resource sharing. Empirical evidence to confirm the relationships between these factors and improved service provi...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819612473584
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Improvements in health service provision need not be costly and indeed may save money. Administration of radio iodine ((131)I) to patients with thyrotoxicosis in the UK is often delayed because few endocrinologists have appropriate Administration of Radioactive Substances Advisory Committee (ARSAC) certifica...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907782101534
更新日期:2007-10-01 00:00:00
abstract::There has been much speculation about whether the National Institute for Health and Clinical Excellence (NICE) has, or ought to have, a 'threshold' figure for the cost of an additional quality-adjusted life-year above which a technology will not be recommended for use. We argue that it is not constitutionally appropri...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907779497567
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To evaluate how UK maternity unit protocols conformed to national recommendations for preventing early-onset neonatal Group B Streptococcal (GBS) disease. METHODS:In December 2005, all UK obstetric maternity units were contacted and asked to provide a copy of their protocol on preventing GBS disease. Informa...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2007.007144
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:Effective use of staff is a major aim in all health-care systems both to maximize their impact and to minimize costs. In England, a few general practitioners (GPs) have been recruiting physician assistants (PAs) to work in their practices, independent of any pilot schemes. Our objective was to study the motiv...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.010061
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:To test the effects of adding text messages to weekly email communications on recipients' total physical activity (leisure-time; workplace; domestic and garden; and active transportation) in employees of universities and colleges in the UK. METHODS:A randomised trial with two study groups (email only or ema...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,随机对照试验
doi:10.1177/1355819613478001
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:The National Health Insurance (NHI) system in Taiwan launched a trial capitation provider payment programme in 2011, with the capitation formula based on patients' average NHI expenditure in the previous year. This study seeks to examine the concentration and persistence of health care expenditure among the ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819615577711
更新日期:2015-07-01 00:00:00
abstract::Patients are increasingly using the internet to access information on health care and services, as well as writing reviews of their own experiences. With patient choice increasing in many health systems, payers, purchasers and providers are attempting to take control of this trend by designing and managing their own p...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.010010
更新日期:2011-04-01 00:00:00
abstract::People with serious and persistent mental illness require a range of community services typically provided by different specialized agencies. At the clinical level, assertive team case management is the strategy commonly used to achieve integration of services across specialized sectors. The USA also has used various ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969700200206
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:To demonstrate the benefits of applying meta ethnography to the synthesis of qualitative research, by means of a worked example. METHODS:Four papers about lay meanings of medicines were arbitrarily chosen. Noblit and Hare's seven-step process for conducting a meta ethnography was employed: getting started; ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581902320432732
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:To examine the influence of the English National Health Service (NHS) South and West (S&W) region Development and Evaluation Committee (DEC) technology appraisal reports on purchasing and clinical decisions in the S&W and elsewhere in the NHS, and to estimate the cost of the DEC process. METHODS:Two postal ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960300800106
更新日期:2003-01-01 00:00:00
abstract::The rationales used in chiropractic are largely in keeping with current evidence-based guidance. When listening to debates for and against the scientific basis of chiropractic, it is important to be aware of the selective use of evidence on both sides and of the limitations of logical positivistic arguments when it co...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.009025
更新日期:2009-07-01 00:00:00
abstract::Continuity of care is concerned with the quality of care over time. There are two important perspectives on this. Traditionally, continuity of care is idealized in the patient's experience of a 'continuous caring relationship' with an identified health care professional. For providers in vertically integrated systems ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581906778476490
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:Randomized controlled trials are important for evaluating health care interventions, but recruitment can be difficult. Studies of potential participants' perspectives on trial participation are accumulating, but their collective contribution is not obvious. In 2007, we conducted a meta-ethnographic synthesis...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/1355819613483126
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of a risk factor checklist and training video for general practitioners in reducing inter-practice variation and improving the appropriateness of referrals (assessed by their positive predictive value or PPV) of patients with suspected otitis media with effusion (OME or 'glue ear') to ...
journal_title:Journal of health services research & policy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1258/1355819011927387
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVES:To compare the cost-effectiveness of four third molar guideline implementation strategies. METHODS:Fifty-one dental practices in Scotland were randomized to one of four implementation strategies. The effectiveness of the strategies was measured by general dental practitioners' compliance with the guideline....
journal_title:Journal of health services research & policy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1258/1355819054339031
更新日期:2005-07-01 00:00:00
abstract::It has previously been suggested that the English Department of Health seems, wittingly or not, to have drawn on the experiences of Stalinist Russia in devising policies for the National Health Service. The development of general practitioner fundholding during the 1990s could be compared to the Soviet support for the...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960000500311
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:Our aim was to evaluate whether the involvement of health care managers in research projects improves the quality and relevance of research, and whether collaboration builds capacity in the managerial community. METHODS:The NIHR Service Delivery and Organization Management Fellowship programme supports the d...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2011.011099
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Automated pharmacy data have been used to develop a measure of chronic disease status in the general population. The objectives of this project were to refine and apply a model of chronic disease identification using Italian automated pharmacy data; to describe how this model may identify patt...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581905774414259
更新日期:2005-10-01 00:00:00
abstract::This article raises the concern that biobanks are failing to realize the expected research and health service outcomes. Rather than biobanking, we have been engaging in 'biohoarding', where building a quantifiable collection of tissue samples is the primary basis of the bio-resource. The root cause of 'biohoarding' is...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819615599014
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:The nine NIHR CLAHRCs are collaborations between universities and local NHS organizations that seek to improve patient outcomes through the conduct and application of applied health research. The theoretical and practical context within which the CLAHRCs were set up was characterized by a considerable degree...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819613499903
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:Increasingly health care performance data are being disseminated in the form of 'league tables' of health care providers, with the implication that such publication helps purchasers select the better providers, and spurs providers into improvements. This paper examines progress to date. METHODS:Three stages...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/135581969800300111
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To explore the tensions across the primary-secondary interface when referral from primary care is to a team and to inform service developments in other specialties. METHODS:A nested qualitative study within a randomized controlled trial of primary care and Community Mental Health Teams (CMHTs) in Croydon and...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1258/jhsrp.2007.006053
更新日期:2008-01-01 00:00:00