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on Health Economics |
| By: | Wanchuan Lin (UCLA) |
| Date: | 2006–02–01 |
| URL: | http://d.repec.org/n?u=RePEc:cla:uclawp:849&r=hea |
| By: | Philip de Jong (Wilms & Goudriaan Public Economics BV, and Universiteit van Amsterdam); Maarten Lindeboom (Vrije Universiteit Amsterdam, IZA, HEB, and Netspar); Bas van der Klaauw (Vrije Universiteit Amsterdam, SCHOLAR, IFAU, IZA, and CEPR) |
| Abstract: | This paper investigates the effects of intensified screening of disability insurance benefit applications. A large-scale experiment was setup where in 2 of the 26 Dutch regions case workers of the disability insurance administration were instructed to screen applications more intense. The empirical results show that intense screening reduces long-term sickness absenteeism and disability insurance applications. This provides evidence both for direct effects of the more intensive screening on work resumption during sickness absenteeism and for self-screening by potential disability insurance applicants. We do not find any spillover effects to the inflow into unemployment insurance. A cost-benefit analysis shows that the costs of the intensified screening are only a small fraction of its benefits. |
| Keywords: | disability insurance; sickness absenteeism; policy evaluation; self-screening; experiment |
| JEL: | J28 J65 |
| Date: | 2006–02–14 |
| URL: | http://d.repec.org/n?u=RePEc:dgr:uvatin:20060018&r=hea |
| By: | Alexandra Bibbee; Flavio Padrini |
| Abstract: | In recent years, a series of wide-ranging reforms designed to make greater use of market mechanisms has succeeded in eliminating shortages, raising efficiency and improving citizen satisfaction. Nevertheless, spending accelerated after the reforms, and per capita spending on health is now one of the highest in the OECD. Centralisation of hospital ownership may have increased political influence, encouraging spending that cannot be justified on cost-benefit grounds. Co-payments by patients are modest, and the background of swelling oil wealth may have sapped willingness to control costs. Diagnosis related group (DRG) procedures are arguably too well-remunerated in some areas, leading to supply-driven interventions, while their absence in others (e.g. psychiatry) may have resulted in sub-optimal supply. Generalist doctors have a gatekeeper role, but are said to over-refer patients to hospitals. Although cost controlling mechanisms exist in Norway, they are too often sidestepped by pressure by citizens on politicians to approve new drugs and treatments. Thus, future health reforms in Norway should concentrate on value for money. This paper relates to the 2005 OECD Economic Survey of Norway (www.oecd.org/eco/survey/norway). <P>Trouver l'équilibre entre qualité des soins et maîtrise des coûts Ces dernières années, une série de réformes de grande ampleur visant à davantage utiliser les mécanismes de marché ont permis d'éliminer les files d'attentes, d'accroître l'efficacité du système de santé et d'améliorer la satisfaction des citoyens. Néanmoins, les dépenses ont accéléré, conduisant la Norvège à un des niveaux les plus élevés des pays de l'OCDE en terme de dépenses de santé par habitant. Le transfert de la propriété des hôpitaux aux administrations centrales a peut-être permis de laisser la place aux pressions politiques et encouragé les dépenses qui ne peuvent se justifier du strict point de vue de l'efficacité économique. La participation financière des patients est peu élevée et l'accroissement de la richesse pétrolière a sans nul doute nui à la volonté de maîtriser les coûts. Le système des groupes homogènes de malades aboutit probablement à des rémunérations excessives dans certains domaines, entraînant des interventions induites par l'offre, alors que l'absence de groupes de ce type dans d'autres domaines (comme la psychiatrie) a donné lieu à une offre insuffisante. Les généralistes jouent un rôle de filtrage, mais auraient tendance à trop orienter les malades vers les hôpitaux. Bien que des mécanismes de contrôle des coûts existent en Norvège, ceux-ci sont trop souvent court-circuités, les citoyens exerçant des pressions sur les élus pour approuver de nouveaux médicaments et traitements. Ainsi, les futures réformes du système de santé en Norvège devraient davantage se concentrer sur les aspects efficacité - coûts. Ce document de travail se rapporte à l'Etude économique de la Norvège 2005 (www.oecd.org/eco/etudes/norvege). |
| Keywords: | Norway, Norvège, long-term care, health care reforms, réforme des systèmes de santé, activity based financing, financement par activité, primary care, specialised care, soins spécialisés, hospital, secteur hospitalier, pharmaceuticals, secteur pharmaceutique, health care human resources, soins de ville |
| JEL: | I10 I11 I18 |
| Date: | 2006–02–17 |
| URL: | http://d.repec.org/n?u=RePEc:oec:ecoaaa:481-en&r=hea |
| By: | A. WILLEM; M. BUELENS; I. DE JONGHE |
| Abstract: | Background<br> Nurses’ job satisfaction is an important issue because of its impact on the quality of the nursing job. Therefore, it receives a lot of attention in the international nursing literature but insight into the sources of nurses’ job satisfaction is yet insufficient, in particular for sources related to organizational structure. <br>Objectives<br>We contribute by investigating the relationship between the organizational structure variables, formalization, centralization and specialization, and nurses’ job satisfaction. This allows us to learn whether structural changes can help to improve satisfaction, and therefore nurses’ work quality. <br>Design<br>Data was collected by questionnaires in a random sample of 764 non-managing nurses in three Belgian general care hospitals. We measured satisfaction by Stamps and Piedmont’s work satisfaction index. Structure was also measured by an existing scale. <br>Results<br>The results showed the negative effect of centralization and the clearly positive effects of specialization and formalization on nurses’ job satisfaction. These effects differ according to the different dimensions of satisfaction. Furthermore, pay is the most important dimension of nurses job satisfaction but the dimension least influenced by organizational structure. <br>Conclusions<br>The importance of the dimension pay in nurses’ job satisfaction, which is not a function of organizational structure, is limiting hospitals in improving nurses’ job satisfaction. However, organizational structure does impact the other dimensions of satisfaction. Especially, the fact that specialization and formalization have, contrary to our hypotheses, only positive effects on satisfaction is important from a practice perspective and for further research. Furthermore, our data indicates that there is a need to refine one of the dimensions of Stamps and Piedmont index. |
| Keywords: | hospital nurses, job satisfaction, organizational structure, survey |
| Date: | 2005–11 |
| URL: | http://d.repec.org/n?u=RePEc:rug:rugwps:05/347&r=hea |
| By: | Jacqueline Senker (SPRU, University of Sussex) |
| Abstract: | This paper reviews how research collaborations between dedicated biotechnology firms and multinational pharmaceutical companies have changed over the past 25 years. A discussion of the impact that developments in the biotechnology have had on the process of pharmaceutical R&D will set the context for reviewing the various theoretical approaches used to analyse and understand these alliances, identifying changes in the nature of alliances over time and indicating the future in store for dedicated biotechnology firms. |
| Keywords: | biotechnology, dedicated biotechnology firms, pharmaceuticals sector, post-genome era, research alliances |
| JEL: | O33 I10 D85 |
| Date: | 2006–02–27 |
| URL: | http://d.repec.org/n?u=RePEc:sru:ssewps:137&r=hea |