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Developments in Health Economics and Public Policy

Rosella Levaggi, Francesco Menoncin
The diffusion of the welfare state has produced a widespread involvement of the public sector in financing the production of private goods for paternalistic reasons. In this chapter we model the production of health care as a merit impure local public good whose consumption is subsidized and whose access is free, but not unlimited. The impure local public good aspect means that the production of health care spreads its benefits beyond the geographical boundaries of the Region where it is produced. Finally, we include the (optional) provision of an equalization grant that allows reduction of fiscal imbalance among Regions...
2014: Developments in Health Economics and Public Policy
Marcello Montefiori
The chapter studies hospital competition in a spatially differentiated market in which patient demand reflects the quality/distance mix that maximizes their utility. Treatment is free at the point of use and patients freely choose the provider which best fits their expectations. Hospitals might have asymmetric objectives and costs, however they are reimbursed using a uniform prospective payment. The chapter provides different equilibrium outcomes, under perfect and asymmetric information. The results show that asymmetric costs, in the case where hospitals are profit maximizers, allow for a social welfare and quality improvement...
2014: Developments in Health Economics and Public Policy
Laura Levaggi, Rosella Levaggi
Welfare systems are designed on geographical and membership boundaries. In terms of access to health care this implies that, as a general rule, only individuals residing in their national territory can obtain health care from providers located there. However, in the past few years medical tourism has grown at an explosive pace throughout the world and in Europe. Each year in fact a small, but significant number of European citizens seek medical treatment that is financed by their public insurer in another EU country...
2014: Developments in Health Economics and Public Policy
Luca Crivelli, Paola Salari
According to the economic theory of federalism (Oates 1999), a decentralized decision to collectively fund and supply the quantity and quality of public services will increase economic welfare as long as three conditions are fulfilled: preferences and production costs of the different local constituencies are heterogeneous; local governments are better informed than the central agency because of their proximity to the citizens; and the competition between local governments exerts a significant impact on the performance of the local administration and on the ability of public agencies to implement policy innovation...
2014: Developments in Health Economics and Public Policy
Silvia Balia, Rinaldo Brau, Emanuela Marrocu
This chapter examines patient mobility across Italian regions using data on hospital discharges that occurred in 2008. The econometric analysis is based on Origin-Destination (OD) flow data. Since patient mobility is a crucial phenomenon in contexts of hospital competition based on quality and driven by patient choice, as is the case in Italy, it is crucial to understand its determinants. What makes the Italian case more interesting is the decentralization of the National Health Service that yields large regional variation in patient flows in favor of Centre-Northern regions, which typically are 'net exporters' of hospital treatments...
2014: Developments in Health Economics and Public Policy
Mark Dusheiko
The National Health Service (NHS) has been the body of the health care system in the United Kingdom (UK) for over 60 years and has sought to provide the population with a high quality service free of user charges for most services. The information age has seen the NHS rapidly transformed from a socialist, centrally planned and publicly provided system to a more market based system orientated towards patients as consumers. The forces of globalization have provided patients in the UK with greater choice in their health care provision, with NHS treatment now offered from any public or approved private provider and the possibility of treatment anywhere in the European Economic Area (EEA) or possibly further...
2014: Developments in Health Economics and Public Policy
Irene A Glinos
The chapter explains how health professional mobility impacts on the resources and capacity available within a health system, and how this affects service delivery and access. The contrasting experiences of destination countries, which receive foreign inflows of health professionals, and of source countries, which loose workforce due to outflows, are illustrated with country examples. The evidence opens the debate on how EU countries compete for health workforce, what this means for resource-strained, crisis-hit Member States, and whether there is any room for intra-European solidarity...
2014: Developments in Health Economics and Public Policy
Mathias Kifmann, Caroline Wagner
We examine the implications of the EU directive on the application of patients' rights in cross-border healthcare on the German sickness fund system. Since Germany implemented most requirements of the directive already in 2004, we first review Germany's experience with EU cross-border healthcare. We then focus on the possible effects of increased EU cross-border healthcare. While this gives patients more choice, the German sickness fund system faces a number of challenges. EU cross-border care may undermine efforts to keep healthcare expenditure under control...
2014: Developments in Health Economics and Public Policy
Christian Pfarr, Andreas Schmid, Udo Schneider
Whenever processes are reconfigured or new products are designed the needs and preferences of patients and consumers have to be considered. Although at times neglected, this becomes more and more relevant in health care settings: Which modes of health care delivery will be accepted? What are the patients' priorities and what is the willingness to pay? To which degree are patients mobile and for which kind of services are they willing to travel? Preferences, however, are difficult to measure, as they are latent constructs...
2014: Developments in Health Economics and Public Policy
Kurt R Brekke, Hugh Gravelle, Luigi Siciliani, Odd Rune Straume
Policymakers are increasingly designing policies that encourage patient choice and therefore mobility across providers. Since prices are regulated (fixed) in most countries, providers need to compete on quality to attract patients. This chapter reviews the current theoretical and empirical literature on patient choice and quality competition in health markets. The theoretical literature identifies key factors affecting incentives to provide quality. These include: altruistic motives, cost structure, number of providers, demand responsiveness, GP gatekeeping, degree of specialization, profit constraints and soft budgets...
2014: Developments in Health Economics and Public Policy
Rosella Levaggi, Marcello Montefiori
No abstract text is available yet for this article.
2014: Developments in Health Economics and Public Policy
Pratima Ramful Srivastava
No abstract text is available yet for this article.
2013: Developments in Health Economics and Public Policy
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