Demand-side strategies to deal with moral hazard in public insurance for long-term care.


: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.


Bakx P,Chernichovsky D,Paolucci F,Schokkaert E,Trottmann M,Wasem J,Schut F




Has Abstract


2015-07-01 00:00:00














  • General practitioners' uptake of clinical practice guidelines: a qualitative study.

    abstract:OBJECTIVE:To explain recent rapid audited change in the uptake of locally implemented, evidence-based clinical guidelines for asthma and angina in primary care. METHODS:A case study of primary care in two matched, adjacent districts in Northern England, focusing on a stratified random sample of 49 general practitioner...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Harrison S,Dowswell G,Wright J,Russell I

    更新日期:2003-07-01 00:00:00

  • Effect of physicians' gender on communication and consultation length: a systematic review and meta-analysis.

    abstract:OBJECTIVE:Physician gender may be a source of differences in communication between physicians and their patients, which may in turn contribute to patient satisfaction and other outcomes. Our aim was to review systematically research on gender differences in the length, style and content of communication with patients. ...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章,meta分析,评审


    authors: Jefferson L,Bloor K,Birks Y,Hewitt C,Bland M

    更新日期:2013-10-01 00:00:00

  • What evidence is there that a physiotherapy service in the emergency department improves health outcomes? A systematic review.

    abstract:OBJECTIVE:the nature of care delivered in emergency departments has changed due to increased demand. In response, one relatively new change is the introduction of a physiotherapy service. There have been anecdotal reports that this may reduce patient waiting times and lead to more effective use of other health care sta...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章,评审


    authors: Kilner E

    更新日期:2011-01-01 00:00:00

  • Evaluation of public involvement in research: time for a major re-think?

    abstract::The way that public involvement in research has been evaluated as a complex intervention has derailed the development of an evidence base. Two alternative approaches are available for constructing and evaluating patient involvement, each of which requires us to revisit the purposes and values that underpin it in each ...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Edelman N,Barron D

    更新日期:2016-07-01 00:00:00

  • Open heart surgery in public and private practice.

    abstract:OBJECTIVES:To compare open heart surgery services provided by public and private hospitals in Catalonia (Spain) according to case mix, procedures undergone and surgical mortality. METHODS:Data on all adult patients undergoing open heart surgery procedures were collected prospectively in a sample of public and privatel...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Pons J,Moreno V,Borras J,Espinas J,Almazan C,Granados A

    更新日期:1999-04-01 00:00:00

  • An economic analysis of implementing the SIGN third molar guideline: implications for the design and analysis of implementation studies.

    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


    authors: Tilley C,McIntosh E,Bahrami M,Clarkson J,Deery C,Pitts N

    更新日期:2005-07-01 00:00:00

  • Shifting services from secondary to primary care: stakeholders' views of the barriers.

    abstract:OBJECTIVES:To identify the barriers to shifting services from secondary to primary care perceived by the involved stakeholders. METHODS:Forty-five semi-structured interviews with stakeholders from primary care, acute and community hospitals, purchasers (health authorities) and other agencies involved in two contrastin...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: O'Cathain A,Musson G,Munro J

    更新日期:1999-07-01 00:00:00

  • Do managers pay their way? The impact of management input on hospital productivity in the NHS internal market.

    abstract:INTRODUCTION:Levels of management staffing in the UK National Health Service (NHS) have received considerable political and media attention in the last four years or so. Both the previous and current governments committed themselves to reducing management expenditure in the health service, and significant cuts appear t...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Söderlund N

    更新日期:1999-01-01 00:00:00

  • Why 'knowledge transfer' is misconceived for applied social research.

    abstract::'Knowledge transfer' has become established as shorthand for a wide variety of activities linking the production of academic knowledge to the potential use of such knowledge in non-academic environments. While welcoming the attention now being paid to non-academic applications of social research, we contend that terms...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Davies H,Nutley S,Walter I

    更新日期:2008-07-01 00:00:00

  • How useful are Cochrane reviews in identifying research needs?

    abstract:OBJECTIVES:To determine the extent to which reports of Cochrane reviews recommend the need for further research and, if so, the extent to which they make suggestions regarding that research. METHODS:We examined all 2535 reviews in Issue 4, 2005 of The Cochrane Library. Each review was categorized on the basis of wheth...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Clarke L,Clarke M,Clarke T

    更新日期:2007-04-01 00:00:00

  • Why patients of low socioeconomic status with mental health problems have shorter consultations with general practitioners.

    abstract:OBJECTIVE:Poor people receive shorter consultations in general practice than more affluent people. Our aim was to study the two reasons generally advanced for this for patients consulting with mental health problems: people of low socioeconomic status (SES) demand shorter consultations or they tend to match with practi...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Videau Y,Saliba-Serre B,Paraponaris A,Ventelou B

    更新日期:2010-04-01 00:00:00

  • Variation in hospital use and avoidable patient morbidity.

    abstract:OBJECTIVES:To determine whether geographical areas with relatively low overall hospitalization rates have higher population-based rates of admission of patients with advanced stages of disease. METHODS:Age- and sex-standardized hospital admission rate were calculated for the residents of the 80 Local Health Units in L...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Taroni F,Repetto F,Louis DZ,Moro ML,Yuen EJ,Gonnella JS

    更新日期:1997-10-01 00:00:00

  • Cost-effectiveness of a physiotherapist-led service for orthopaedic outpatients.

    abstract:OBJECTIVE:Non-surgical treatment can be effective for many musculoskeletal conditions. Improving access to these options may improve the efficiency of hospitals. The Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service offers early comprehensive assessment and coordinated, patient-centred care withi...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Comans T,Raymer M,O'Leary S,Smith D,Scuffham P

    更新日期:2014-10-01 00:00:00

  • End-of-life decisions: the policy issue that will not die.

    abstract::In most jurisdictions, public policy regarding assisted death has not advanced beyond simple prohibition. However, this issue is increasingly likely to reach the policy agenda. Policy-makers may be tempted to turn for guidance to the three places in the world with developed policy or legislation: the Netherlands; the ...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Shortt S,Lavery J

    更新日期:1999-10-01 00:00:00

  • Patient preferences in randomised trials: threat or opportunity?

    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


    authors: Torgerson DJ,Klaber-Moffett J,Russell IT

    更新日期:1996-10-01 00:00:00

  • Challenges and opportunities associated with the introduction of assistant practitioners supporting the work of registered nurses in NHS acute hospital trusts in England.

    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


    authors: Spilsbury K,Adamson J,Atkin K,Bloor K,Carr-Hill R,McCaughan D,McKenna H,Wakefield A

    更新日期:2011-04-01 00:00:00

  • Investigating Choice Experiments for Preferences of Older People (ICEPOP): evaluative spaces in health economics.

    abstract::This paper deals with three concerns about the evaluative framework that is currently dominant within health economics. These concerns are: that the evaluative framework is concerned entirely with health; that the evaluative framework has an individualistic focus on patients alone; and that the methods used to estimat...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Coast J,Flynn T,Sutton E,Al-Janabi H,Vosper J,Lavender S,Louviere J,Peters T

    更新日期:2008-10-01 00:00:00

  • Learning from experience: privacy and the secondary use of data in health research.

    abstract::Health services research must continually address the question: Under what conditions may data not collected specifically for research, such as primary medical data, be re-used for research without compromising the privacy of the data-subjects? For secondary use of data in research there are basically three options. O...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Lowrance W

    更新日期:2003-07-01 00:00:00

  • Using economics to prioritize research: a case study of randomized trials for the prevention of hip fractures due to osteoporosis.

    abstract:OBJECTIVES:To assess the role of economics, in combination with clinical judgement, for setting research priorities, using osteoporosis prevention (and, as a result, hip fracture prevention) as an example. METHODS:Modelling the cost and effectiveness of each of six potential interventions to prevent hip fractures over...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Torgerson D,Donaldson C,Reid D

    更新日期:1996-07-01 00:00:00

  • Being open about unanticipated problems in health care: the challenges of uncertainties.

    abstract::Discussion of unanticipated problems in care with patients and their families ('open disclosure') is now widely advocated. Despite international efforts and the introduction of a range of policies and guidance to promote such discussions, the expectations of policy makers and patients are often not matched in practice...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Birks Y,Entwistle V,Harrison R,Bosanquet K,Watt I,Iedema R

    更新日期:2015-01-01 00:00:00

  • Failures in childbirth care.

    abstract::The study, first published in 2003, looks at the root causes of adverse events and near misses in obstetrics at seven hospital maternity units by interviewing 93 members of staff, identifying the areas of mismanagement in each case and thematically analysing them. ...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Ashcroft B

    更新日期:2010-01-01 00:00:00

  • Impact of star performance ratings in English acute hospital trusts.

    abstract:OBJECTIVE:To explore some of the impacts of star performance ratings in acute hospital trusts in England. METHODS:A multiple case study design was used which incorporated purposeful sampling of 'low' and 'high' performing trusts using the star rating system. In each case study site, data collection comprised semi-stru...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Mannion R,Davies H,Marshall M

    更新日期:2005-01-01 00:00:00

  • The art and science of non-evaluation evaluation.

    abstract::This essay considers some limitations of programme theory evaluation in relation to healthcare policies. This approach, which seeks to surface 'programme theories' or construct 'logic models', is often unable to account for empirical observations of policy implementation in real-world contexts. I argue that this failu...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Jones L

    更新日期:2018-10-01 00:00:00

  • Toward a general theory of indifference to research-based evidence.

    abstract::Evidence-based medicine (EBM) and evidence-based decision-making (EBDM) were intended to revolutionize health care and health policy. Thus far they have not. A great deal of research has demonstrated the persistent ubiquity of error in health care, wide and unjustifiable variations in practice and the minimal impact o...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Lewis S

    更新日期:2007-07-01 00:00:00

  • Integrating mental health services through reimbursement reform and managed mental health care.

    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


    authors: Mechanic D

    更新日期:1997-04-01 00:00:00

  • How patients with atrial fibrillation value different health outcomes: a standard gamble study.

    abstract:BACKGROUND AND PURPOSE:The assessment of any health care intervention should consider both risks and benefits and take patients' preferences about these into account. The study reported in this paper aimed to elicit patient valuations of health states relevant to assessment of the prevention of stroke by warfarin antic...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Robinson A,Thomson R,Parkin D,Sudlow M,Eccles M

    更新日期:2001-04-01 00:00:00

  • Quality of medical care during and shortly after acute care restructuring in Newfoundland and Labrador.

    abstract:OBJECTIVES:To critically evaluate the quality of hospital medical care at the beginning, during and shortly after regionalization of health boards in Newfoundland and Labrador, and aggregation of hospitals in the St John's region. METHODS:Retrospective chart audits for the years 1995/96, 1998/99 and 2000/01 (at the be...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Curtis B,Gregory D,Parfrey P,Kent G,Jelinski S,Kraft S,O'Reilly D,Barrett B

    更新日期:2005-10-01 00:00:00

  • Presentational approaches used in the UK for reporting evidence synthesis using indirect and mixed treatment comparisons.

    abstract:OBJECTIVES:To establish current guidance and practice in UK on presentation of indirect comparison and mixed treatment comparison analyses; to provide recommendations to improve indirect comparison/mixed treatment comparison reporting and to identify research priorities for improved presentation. METHODS:Existing inst...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Tan SH,Bujkiewicz S,Sutton A,Dequen P,Cooper N

    更新日期:2013-10-01 00:00:00

  • The impact of income on private patients' access to GP services in Ireland.

    abstract:OBJECTIVES:To examine the extent to which proximity to the income threshold for free GP care results in significant differences in GP visiting. Approximately 30% of the Irish population receives free GP care (medical card patients), while the remaining 70% pays in full (private patients). Medical card eligibility exert...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章


    authors: Nolan A

    更新日期:2008-10-01 00:00:00

  • Impact of payment method on behaviour of primary care physicians: a systematic review.

    abstract:OBJECTIVE:To review the impact of payment systems on the behaviour of primary care physicians. METHODS:All randomised trials, controlled before and after studies, and interrupted time series studies that compared capitation, salary, fee-for-service or target payments (mixed or separately) that were identified by compu...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章,评审


    authors: Gosden T,Forland F,Kristiansen IS,Sutton M,Leese B,Giuffrida A,Sergison M,Pedersen L

    更新日期:2001-01-01 00:00:00