Abstract：
:Despite the rapidly aging population, relatively little is known about how cost sharing affects the elderly's medical spending. Exploiting longitudinal claims data and the drastic reduction of coinsurance from 30% to 10% at age 70 in Japan, we find that the elderly's demand responses are heterogeneous in ways that have not been previously reported. Outpatient services by orthopedic and eye specialties, which will continue to increase in an aging society, are particularly price responsive and account for a large share of the spending increase. Lower cost sharing increases demand for brand-name drugs but not for generics. These high price elasticities may call for different cost-sharing rules for these services. Patient health status also matters: receiving medical services appears more discretionary for the healthy than the sick in the outpatient setting. Finally, we found no evidence that additional medical spending improved short-term health outcomes.
journal_name
J Health Econjournal_title
Journal of health economicsauthors
Fukushima K,Mizuoka S,Yamamoto S,Iizuka Tdoi
10.1016/j.jhealeco.2015.10.005subject
Has Abstractpub_date
2016-01-01 00:00:00pages
115-30eissn
0167-6296issn
1879-1646pii
S0167-6296(15)00117-4journal_volume
45pub_type
杂志文章abstract：:Waiting times for hospital care are a significant issue in the UK National Health Service (NHS). The reforms of the health service in 1990 gave a subset of family doctors (GP fundholders) both the ability to choose the hospital where their patients were treated and the means to pay for some services. One of the key fa...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(01)00129-1
更新日期：2002-03-01 00:00:00
abstract：:This study seeks to simulate the portion of moral hazard that is due to the income transfer contained in the coinsurance price reduction. Healthcare spending of uninsured individuals from the MEPS with a priority health condition is compared with the predicted counterfactual spending of those same individuals if they ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2017.12.003
更新日期：2018-01-01 00:00:00
abstract：:Evaluating Accountable Care Organizations is difficult because there is a great deal of heterogeneity in terms of their reimbursement incentives and other programmatic features. We examine how variation in reimbursement incentives and administration among two Medicaid managed care plans impacts utilization and spendin...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2014.03.001
更新日期：2014-07-01 00:00:00
abstract：:Criteria for initiation of highly active antiretroviral treatments (HAART) in HIV-infected patients remain a matter of debate world-wide because short-term benefits have to be balanced with costs of these therapies, and restrictions placed on future treatment options if resistant viral strains develop. On the other ha...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2005.09.006
更新日期：2006-05-01 00:00:00
abstract：:We propose a measure of household exposure to particularly onerous medical expenses. The measure can be decomposed into the probability that medical expenditure exceeds a threshold, the loss due to predictably low consumption of other goods if it does and the further loss arising from the volatility of medical expense...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2016.01.004
更新日期：2016-03-01 00:00:00
abstract：:A necessary condition for competition to promote quality in hospital markets is that patients are sensitive to differences in hospital quality. In this paper we examine the relationship between hospital quality, as measured by publicly available quality ratings, and patient hospital choice for angioplasty using indivi...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2012.02.001
更新日期：2012-03-01 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：:We study an enhanced fee-for-service model for primary care physicians in the Family Health Groups (FHG) in Ontario, Canada. In contrast to the traditional fee-for-service (FFS) model, the FHG model includes targeted fee increases, extended hours, performance-based initiatives, and patient enrolment. Using a long pane...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2010.10.005
更新日期：2011-01-01 00:00:00
abstract：:This paper estimates a multiproduct variable cost function using data on a sample of California hospitals. The results provide useful insights into the advantages and disadvantages of flexible functional forms for cost analysis. The translog function appears to provide reasonable estimates of marginal costs when evalu...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(90)90038-5
更新日期：1990-06-01 00:00:00
abstract：:This paper examines the relationship between schizophrenia and employment. We use longitudinal register data and show a considerable drop in the employment rate for people with schizophrenia six years before the first treatment at a psychiatric facility. After the first treatment, the employment rate stabilizes at 18%...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2013.08.007
更新日期：2013-12-01 00:00:00
abstract：:In recent decades, China has experienced double-digit economic growth rates and rising inequality. This paper implements a new decomposition approach using the China Health and Nutrition Survey (1991-2006) to examine the extent to which changes in level and distribution of incomes and in income mobility are related to...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2013.10.002
更新日期：2013-12-01 00:00:00
abstract：:Approximately 10% of people have O-negative blood. Because it can be transfused into almost anyone, hospitals particularly value such blood. We use this fact, together with the assumption that blood types are exogenously assigned by nature, to design an empirical inquiry into altruism. We also investigate the timing o...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2008.11.005
更新日期：2009-03-01 00:00:00
abstract：:The Orphan Drug Act (ODA) was designed to spur the development of drugs for rare diseases. In principle, its design also incentivizes pharmaceutical firms to develop drugs for "rare" subdivisions of more prevalent diseases. I find that in response to this incentive, firms develop drugs for ODA-qualifying subdivisions ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2009.06.011
更新日期：2009-09-01 00:00:00
abstract：:This paper presents the results of an eight-country comparative study of equity in the delivery of health care. Equity is taken to mean that persons in equal need of health care should be treated the same, irrespective of their income. Two methods are used to investigate inequity: an index of inequity based on standar...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(92)90013-q
更新日期：1992-12-01 00:00:00
abstract：:In this paper, we propose a flexible "two-part" random effects model (Olsen and Schafer, 2001; Tooze et al., 2002) for correlated medical cost data. Typically, medical cost data are right-skewed, involve a substantial proportion of zero values, and may exhibit heteroscedasticity. In many cases, such data are also obta...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2009.11.010
更新日期：2010-01-01 00:00:00
abstract：:This article introduces a model in which individuals incur adjustment costs associated with adaptations made following changes in their health. With adjustment costs, patients' preferences for health states depend on their initial health in such a way that improvements have lower values than corresponding deterioratio...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2003.12.004
更新日期：2004-03-01 00:00:00
abstract：:Who pays the healthcare costs associated with obesity? Among workers, this is largely a question of the incidence of the costs of employer-sponsored coverage. Using data from the National Longitudinal Survey of Youth and the Medical Expenditure Panel Survey, we find that the incremental healthcare costs associated wit...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2009.02.009
更新日期：2009-05-01 00:00:00
abstract：:The production of health care services has the unique feature that physicians do not face explicit costs for hospital inputs. This paper develops models of the production process given alternative hospital and medical staff relationships, and analyzes the impact of the change in hospital reimbursement under Medicare f...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(90)90016-v
更新日期：1990-09-01 00:00:00
abstract：:Intergenerational transmission of human capital from parents to offspring is widely documented. However, whether there are upward spillovers from children to parents remains understudied. This paper uses data from the China Health and Retirement Longitudinal Study to estimate the causal impact of educational attainmen...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2019.06.004
更新日期：2019-07-01 00:00:00
abstract：:Policymakers in countries around the world are faced with rising health care costs and are debating ways to reform health care to reduce expenditures. Estimates of price elasticity of expenditure are a key component for predicting expenditures under alternative policies. Using unique individual-level data compiled fro...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2012.07.002
更新日期：2012-12-01 00:00:00
abstract：:We investigate whether there was a causal effect of income changes on the health satisfaction of East and West Germans in the years following reunification. Our data source is the German Socio-Economic Panel (GSOEP) between 1984 and 2002, and we fit a recently proposed fixed-effects ordinal estimator to our health mea...
journal_title：Journal of health economics
pub_type： 杂志文章,评审
doi：10.1016/j.jhealeco.2005.01.004
更新日期：2005-09-01 00:00:00
abstract：:Using administrative data from Norway, we examine the extent to which family doctors influence their clients' propensity to claim sick-pay. The analysis exploits exogenous switches of family doctors occurring when physicians quit, retire, or for other reasons sell their patient lists. We find that family doctors have ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2013.10.005
更新日期：2013-12-01 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：:This paper presents an application of the Duclos et al. [Duclos, J.-Y., Jalbert, V., Araar A., 2003. Classical horizontal inequity and reranking: an integrated approach. Research on Economic Inequality 10, 65-100] decomposition to an analysis of the 1998 Swiss health system financing. We see that in addition to measur...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2008.07.009
更新日期：2008-12-01 00:00:00
abstract：:Tradeoffs between health and wealth are among the most important decisions individuals make, and are central to social and economic policy. Yet, only a few studies have investigated the utility of health and wealth empirically. This paper investigates this utility function both theoretically and empirically. We conduc...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2012.02.003
更新日期：2012-03-01 00:00:00
abstract：:Estimates of the surplus loss due to physician practice variation measure the area under the 'shifted' demand curve. This method is valid only if the unshifted demand curve is derived form the distribution of true(ex post) values of care. If the unshifted demand curve does not reflect the true value of care, then the ...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/0167-6296(95)00005-3
更新日期：1995-06-01 00:00:00
abstract：:This paper studies life-cycle preferences over consumption and health status. We show that cost-effectiveness analysis is consistent with cost-benefit analysis if the lifetime utility function is additive over time, multiplicative in the utility of consumption and the utility of health status, and if the utility of co...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/s0167-6296(99)00014-4
更新日期：1999-12-01 00:00:00
abstract：:We analyse the properties of optimal price adjustment to hospitals when no lump-sum transfers are allowed and when prices differ to reflect observable exogenous differences in costs. We find that: (a) when the marginal benefit from treatment is decreasing and the cost function is the power function, price adjustment f...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2010.09.001
更新日期：2011-01-01 00:00:00
abstract：:The last time that federal excise taxes on alcoholic beverages were increased was 1991. The changes were larger than the typical state-level changes that have been used to study price effects, but the consequences have not been assessed due to the lack of a control group. Here we develop and implement a novel method f...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2012.11.003
更新日期：2013-01-01 00:00:00
abstract：:We quantify the lasting effects of childhood health and economic circumstances on adult health, employment and socioeconomic status, using data from a birth cohort that has been followed from birth into middle age. Controlling for parental income, education and social class, children who experience poor health have si...
journal_title：Journal of health economics
pub_type： 杂志文章
doi：10.1016/j.jhealeco.2004.09.008
更新日期：2005-03-01 00:00:00
