nep-hea New Economics Papers
on Health Economics
Issue of 2018‒04‒16
28 papers chosen by
Yong Yin
SUNY at Buffalo

  1. On the Effect of Parallel Trade on Manufacturers’ and Retailers’ Profits in the Pharmaceutical Sector. By Dubois, Pierre; Sæthre, Morten
  2. Pre hospital emergency care in Guernsey, Immersion with « St John Ambulance » By Pauline Lenesley
  3. Improving fitness: Mapping research priorities against societal needs on obesity By Lorenzo Cassi; Agénor Lahatte; Ismael Rafols; Pierre Sautier; Elisabeth De Turckheim
  4. Do work and family care histories predict health in older women? By Benson, Rebecca; Glaser, Karen; Corna, Laurie M.; Platts, Loretta G.; Di Gessa, Giorgio; Worts, Diana; Price, Debora; McDonough, Peggy; Sacker, Amanda
  5. The stimulative effect of an unconditional block grant on the decentralized provision of care By Kattenberg, Mark; Vermeulen, Wouter
  6. Testing Rational Addiction: When Lifetime is Uncertain, One Lag is Enough By D. Dragone; D. Raggi
  7. Controlling Tuberculosis? Evidence from the Mother of all Community-Wide Health Experiments By Karen Clay; Peter Juul Egedes; Casper Worm Hansen; Peter Sandholt Jensen
  8. Estimating the Associations between SNAP and Food Insecurity, Obesity, and Food Purchases with Imperfect Administrative Measures of Participation By Charles Courtemanche; Augustine Denteh; Rusty Tchernis
  9. Human Resources in Healthcare and Health Outcomes in India By Motkuri, Venkatanarayana; Mishra, Uday Shankar
  10. Measuring the Social and Externality Benefits of Influenza Vaccination By Corey White
  11. False diagnoses: pitfalls of testing for asymmetric information in insurance markets By de Meza, David; Webb, David C.
  12. Fom representations of older patients to care management practices: Towards an opportunity of co-production between care staff and patients By Abdelmajid Amine; Audrey Bonnemaizon; Margaret Josion Portail
  13. Tailoring Elderly Patients’ Identities through Healthcare Service Relationships: Toward a Guardian Conception of Vulnerable Publics’ Identities By Abdelmajid Amine; Audrey Bonnemaizon; Margaret Josion Portail
  14. Does unemployment aggravate suicide rates in South Africa? Some empirical evidence By Andrew Phiri; Doreen Mukuka
  15. Early Evidence on Recreational Marijuana Legalization and Traffic Fatalities By Benjamin Hansen; Keaton S. Miller; Caroline Weber
  16. Cost-Sharing Design Matters : A Comparison of the Rebate and Deductible in Healthcare By Remmerswaal, Minke; Boone, Jan; Bijlsma, Michiel; Douven, R.C.M.H.
  17. The Effects of DACA on Health Insurance, Access to Care, and Health Outcomes By Osea Giuntalla
  18. NTDS and Deworming Africa Initiative (DAI) : Madagascar By Fernando Lavadenz; Linda Schultz; Opope Oyaka Tshivuila Matala; Nashira Calvo; Jumana Qamruddin
  19. The Italian healthcare system: the difficult balance between budget sustainability and the quality of services in Regions subject to Financial Recovery Plan By Luciana Aimone Gigio; Demetrio Alampi; Silvia Camussi; Giuseppe Ciaccio; Paolo Guaitini; Maurizio Lozzi; Anna Laura Mancini; Eugenia Panicara; Massimiliano Paolicelli
  20. Smoking, Obesity, and Labor Market Outcomes (Japanese) By MORIKAWA Masayuki
  21. Proposed changes to the reimbursement of pharmaceuticals and medical devices in Poland and their impact on market access and the pharmaceutical industry By Karolina Badora; Aleksandra Caban; Cécile Rémuzat; Claude Dussart; Mondher Toumi
  22. Improving of the Systems of Organization and Payment of Ambulatory Medical Care By Omelyanovsky, Vitaly; Avxentieva, Maria; Zheleznyakova, Inna; Ignatyeva, Victoria; Tyurina, Irina
  23. Human Resources Management and Occupational Health: A Science of Action or Reaction? By Claire Gamassou; Gregor Bouville; Tarik Chakor; Stéphan Pezé; Virginie Moisson
  24. Length of a Healthy Life of the Population of Russia. Modeling, Regional Assessments and Forecasting By Scherbov, Sergei; Shulgin, Sergey
  25. The US Opidemic: Prescription Opioids, Labour Market Conditions and Crime By Deiana, Claudio; Giua, Ludovica
  26. Evaluating Hospital Case Cost Prediction Models Using Azure Machine Learning Studio By Alexei Botchkarev
  27. Palliative Care Movement in Kerala: A Historic Overview By Chacko, Anooja
  28. Tensions between Healh care workers' professional and personal norms: A story of ordinary resistance in the health care services for elderly patients By Abdelmajid Amine; Audrey Bonnemaizon; Margaret Josion Portail

  1. By: Dubois, Pierre (Toulouse School of Economics); Sæthre, Morten (Dept. of Economics, Norwegian School of Economics and Business Administration)
    Abstract: Differences in regulated pharmaceutical prices within the European Economic Area create arbitrage opportunities that pharmacy retailers can use through parallel imports. For prescription drugs under patent, such provision decisions affect the sharing of profits among an innovating pharmaceutical company, retailers, and parallel traders. We develop a structural model of demand and supply in which retailers can choose the set of goods to sell to consumers, thus foreclosing the consumers’ access to some less-profitable drugs, which allows retailers to bargain and obtain lower wholesale prices with the manufacturer and parallel trader. With detailed transaction data, we identify a demand model with unobserved choice sets using supply-side conditions for optimal assortment decisions of pharmacies. Estimating our model, we find that retailer incentives play a significant role in fostering parallel trade penetration. Our counterfactual simulations show that parallel imports of drugs allows retailers to gain profits at the expense of the manufacturer, whereas parallel traders also gain but earn more modest profits. Finally, a policy preventing pharmacies from foreclosing the manufacturer’s product is demonstrated to partially shift profits from pharmacists to both the parallel trader and the manufacturer, and a reduction in the regulated retail price favors the manufacturer even more.
    Keywords: Parallel trade; Pharmaceuticals; vertical contracts; demand estimation; foreclosure.
    JEL: I11 L22
    Date: 2017–12–15
  2. By: Pauline Lenesley (COACTIS - UL2 - Université Lumière - Lyon 2 - UJM - Université Jean Monnet [Saint-Étienne])
    Abstract: This paper is about the specific organization of St John Ambulance in Guernsey. Following a practical view with an institutional analysis and development framework we dig into the specificities of care in a specific context to identify a new pattern of coordination. Mixing theoretical aspects and observational settings we attend to take the big picture of this organization to call for future research in the Guernsey context.
    Keywords: governance,identity,context,institutional analysis and development framework,pre hospital emergency cares,ambulances and care
    Date: 2017–11–30
  3. By: Lorenzo Cassi (Observatoire des Sciences et Techniques - HCERES - Haut Conseil de l'Evaluation de la Recherche et de l'Enseignement Supérieur); Agénor Lahatte; Ismael Rafols; Pierre Sautier; Elisabeth De Turckheim (Délégation à l'évaluation - INRA - Institut National de la Recherche Agronomique)
    Abstract: Science policy is increasingly shifting towards an emphasis in societal problems or grand challenges. As a result, new evaluative tools are needed to help assess not only the knowledge production side of research programmes or organisations, but also the articulation of research agendas with societal needs. In this paper, we present an exploratory investigation of science supply and societal needs on the grand challenge of obesity - an emerging health problem with enormous social costs. We illustrate a potential approach that uses topic modelling to explore: (a) how scientific publications can be used to describe existing priorities in science production; (b) how policy records (in this case here questions posed in the European parliament) can be used as an instance of mapping discourse of social needs; (c) how the comparison between the two may show (mis)alignments between societal concerns and scientific outputs. While this is a technical exercise, we propose that this type of mapping methods can be useful to domain experts for informing strategic planning and evaluation in funding agencies
    Keywords: research agenda,science mapping,societal needs,obesity,topic modeling
    Date: 2017–11
  4. By: Benson, Rebecca; Glaser, Karen; Corna, Laurie M.; Platts, Loretta G.; Di Gessa, Giorgio; Worts, Diana; Price, Debora; McDonough, Peggy; Sacker, Amanda
    Abstract: Background Social and policy changes in the last several decades have increased women’s options for combining paid work with family care. We explored whether specific combinations of work and family care over the lifecourse are associated with variations in women’s later life health. Methods We used sequence analysis to group women in the English Longitudinal Study of Ageing according to their work histories and fertility. Using logistic regression, we tested for group differences in later life disability, depressive symptomology and mortality, while controlling for childhood health and socioeconomic position and a range of adult socio-economic circumstances and health behaviours. Results Women who transitioned from family care to either part-time work after a short break from the labour force, or to full-time work, reported lower odds of having a disability compared with the reference group of women with children who were mostly employed full-time throughout. Women who shifted from family care to part-time work after a long career break had lower odds of mortality than the reference group. Depressive symptoms were not associated with women’s work and family care histories. Conclusion Women’s work histories are predictive of their later life disability and mortality. This relationship may be useful in targeting interventions aimed at improving later life health. Further research is necessary to explore the mechanisms linking certain work histories to poorer later life health and to design interventions for those affected.
    JEL: R14 J01
    Date: 2017–09–23
  5. By: Kattenberg, Mark; Vermeulen, Wouter
    Abstract: Understanding the impact of central government grants on decentralized healthcare provision is of crucial importance for the design of grant systems, yet empirical evidence on the prevalence of flypaper effects in this domain is rare. We study the decentralization of home care in the Netherlands and exploit the gradual introduction of formula-based equalization to identify the effect of exogenous changes in an unconditional block grant on local expenditure and utilization. A one euro increase in central government grants raises local expenditure by twenty to fifty cents. Adjustments occur through the number of hours as well as through substitution between basic and more advanced types of assistance. These findings suggest that conditioning of grants is not required for the central government to retain a moderate degree of control over the decentralized provision of care.
    Keywords: Intergovernmental transfers; Flypaper effect; Decentralization of health care
    JEL: H42 H51 H71 H75
    Date: 2018–02
  6. By: D. Dragone; D. Raggi
    Abstract: The rational addiction model is usually tested by estimating a linear second-order difference Euler equation, which may produce unreliable estimates. We show that a linear first-order difference equation is a better alternative. This empirical specification is appropriate under the reasonable assumption that people are uncertain about the time of their death, it is based on the same structural assumptions used in the literature, and it retains all policy implications of the deterministic rational addiction model. It is also empirically convenient because it is simple, it allows using efficient estimation strategies that do not require instrumental variables, and it is robust to the possible non-stationarity of the data. As an application we estimate the demand for smoking in the US from 1970 to 2016, and we show that it is consistent with the rational addiction model.
    JEL: D12 I12 L66
    Date: 2018–04
  7. By: Karen Clay (Carnegie Mellon University); Peter Juul Egedes (University of Southern Denmark); Casper Worm Hansen (Department of Economics, University of Copenhagen); Peter Sandholt Jensen (University of Southern Denmark)
    Abstract: This paper studies the immediate and long-run mortality effects of the first communitybased health intervention in the world, which had a particular focus on controlling tuberculosis - the so-called Framingham Health and Tuberculosis Demonstration. Comparing death and TB-mortality rates between Framingham and seven (pre-selected) control towns during the Demonstration period between 1917 and 1923, the contemporary offcial evaluation committee concluded that the Demonstration was highly successful in controlling TB and reducing mortality The Framingham Demonstration subsequently became a health example for the world. The findings in our paper question this very positive assessment. We collected and digitized causes-of-death data for towns/cities in Massachusetts and the United States for the period 1901-1934, allowing us to extend the number of control towns (or cities) and study whether the Demonstration reduced mortality in the long run.Compared to the official seven controls towns, we find that TB mortality in Framingham was on average lower between 1917 and 1923. In the extended control samples, these immediate TB mortality differences are smaller and often more than reversed by 1934.However, we do find robust evidence that the Demonstration reduced infant mortality, and these improvements persisted even after the Demonstration ended.
    Keywords: Public Health; Health Demonstration; Tuberculosis Mortality; Infant Mortality
    JEL: I15 I18 N32
    Date: 2018–03–20
  8. By: Charles Courtemanche (Georgia State University); Augustine Denteh (Georgia State University); Rusty Tchernis (Georgia State University)
    Abstract: Administrative data are considered the “gold standard” when measuring program participation, but little evidence exists on the potential problems with administrative records or their implications for econometric estimates. We explore issues with administrative data using the FoodAPS, a unique dataset that contains two different administrative measures of Supplemental Nutrition Assistance Program (SNAP) participation as well as a survey-based measure. We first document substantial ambiguity in the two administrative participation variables and show that they disagree with each other almost as often as they disagree with self-reported participation. Estimated participation and misreporting rates can be meaningfully sensitive to choices made to resolve this ambiguity and disagreement. We then document similar sensitivity in regression estimates of the associations between SNAP and food insecurity, obesity, and the Healthy Eating Index. These results serve as a cautionary tale about uncritically relying on linked administrative records when conducting program evaluation research.
    Keywords: Supplemental Nutrition Assistance Program, Food stamps, SNAP, food insecurity, obesity, body mass index, food purchases, food expenditures, healthy eating index, misreporting, measurement error
    JEL: C81 H51 I12 I18
    Date: 2018–04
  9. By: Motkuri, Venkatanarayana; Mishra, Uday Shankar
    Abstract: The paper examined the growth and adequacy of the workforce engaged in health care sector in India for two decades based on Census data along with the association between health workers density and educational development and then selected health outcome (i.e. IMR). Despite the remarkable improvement in health workers density particularly during 2001-11, the country is falling short of the same. It is observed that there is a significantly positive association between density of health workforce and educational development. There is a significant and strong positive relationship / association between the density of health workers and health outcomes.
    Keywords: Human Resources in Health, Health Workers, Health, Health Outcomes, India
    JEL: I10 I18 I19 I2
    Date: 2018–03
  10. By: Corey White (Department of Economics, California Polytechnic State University)
    Abstract: Vaccination represents a canonical example of externalities in economics, yet there are few estimates of their magnitudes. I provide evidence on the social and externality benefits of influenza vaccination in two settings. First, using pre-existing differences in state-level vaccination rates interacted with exogenous annual variation in vaccine quality, I estimate of the impacts of aggregate vaccination rates on mortality and work absences in the United States. Scaled nationally, I find that a one percentage point increase in the vaccination rate results in 1,134 fewer deaths and 8.9 million fewer work hours lost due to illness each year. The mortality reductions are concentrated among individuals 75 and older, but over half of the effect is attributable to the vaccination of people under 75, suggesting a considerable externality effect. Second, I examine a setting in which vaccination is targeted at a group with extremely high externality benefits: vaccination mandates for health care workers. I find that mandates lead to reductions in hospital diagnoses for influenza in affected counties, consistent with substantial externality impacts. For both the general population and the population of health care workers, the estimates suggest that programs increasing vaccine take-up are likely to be cost-effective under reasonable assumptions about the costs.
    Keywords: Vaccine, Vaccination, Influenza, Flu, Externality, Health
    JEL: I12 I18 D62 H23
    Date: 2018
  11. By: de Meza, David; Webb, David C.
    Abstract: Established tests for asymmetric information in insurance markets are examined. The most commonly used, that information is symmetric if high and low cover contracts have the same loss rate, is inconsistent with standard assumptions that imply that under symmetric information, all contracts o¤er full-cover. Incomplete cover and symmetric information can be reconciled if there are claim-processing costs, but now existing tests fare badly, partly due to the divergence between marginal and average selection effects. Ignoring the nature of loading factors may cause recent studies to mismeasure the welfare costs of asymmetric information but these problems are remedial.
    JEL: G32 F3 G3
    Date: 2017–04–05
  12. By: Abdelmajid Amine (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Audrey Bonnemaizon (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Margaret Josion Portail (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12)
    Abstract: La relation de service engageant des publics vulnérables (i.e. patients âgés) s'inscrit dans un rapport asymétrique, au désavantage de ce dernier, nourri par les représentations du patient âgé vulnérable et par la légitimité dans l'administration des soins que s'octroient les personnels de santé. Cette asymétrie est amenée à s'incarner dans les pratiques de soins qui vont se (re)configurer le long des expériences de service entre personnels de santé et patients âgés. En mobilisant une approche qualitative auprès du personnel soignant d'un service de Gériatrie, cette recherche montre des instrumentalisations variées de la vulnérabilité du patient âgé soit pour accentuer la tutelle et le contrôle sur ce dernier, soit au contraire pour se délester de certaines tâches rentrant dans la relation de soins sur cette population ouvrant la voie à davantage de co-production des soins, à un « faire avec » les patients âgés (avec une palette de situations intermédiaires liées à la variété des contextes d'interaction). Mots-clés : Représentations du patient âgé, personnel de santé, co-production, service de soins, ruse, bricolage Abstract The service relationship engaging vulnerable individuals (i.e. elderly patients) is seen as an asymmetrical relationship, to the disadvantage of the latter, fed by the representations of the vulnerable elderly patient and by the legitimacy in the administration of the care that the Health workers give themselves. This asymmetry is incumbent on the practices of care that will be (re)configured along the service experiences between health personnel and elderly patients. By mobilizing a qualitative approach with the healthcare staff of a Geriatric service, this research shows a varied instrumentalisation of the vulnerability of the elderly patient either to accentuate the guardianship and the control on the latter or, on the contrary, to relieve certain tasks included within the care relationship on this population paving the way for more co-production of care, and to "do with" elderly patients (with a palette of intermediate situations related to the variety of interaction contexts).
    Keywords: ruse,bricolage,health care,Representations of elderly patient,health personnel,co-production
    Date: 2017–05–16
  13. By: Abdelmajid Amine (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Audrey Bonnemaizon (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Margaret Josion Portail (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12)
    Date: 2017–10–26
  14. By: Andrew Phiri (Department of Economics, Nelson Mandela University); Doreen Mukuka (Department of Economics, Finance and Business Studies, CTI Potchefstroom Campus)
    Abstract: Our study investigates the cointegration relationship between suicides and unemployment in South Africa using annual data collected between 1996 and 2015 applied to the ARDL model. Furthermore, suicide data is further disintegrated into ‘sex’ and ‘age’ demographics. Our empirical results indicate that unemployment is insignificantly related with suicide rates with the exception for citizens above 75 years. On the other hand, other control variables such as per capita GDP, inflation and divorce appear to be more significantly related with suicides. Collectively, these findings have important implications for policymakers.
    Keywords: Unemployment, Suicide, Cointegration, Causality, South Africa, Sub Saharan Africa (SSA).
    JEL: C22 C51 E24 E31
    Date: 2017–07
  15. By: Benjamin Hansen; Keaton S. Miller; Caroline Weber
    Abstract: Over the last few years, marijuana has become legally available for recreational use to roughly a quarter of Americans. Policy makers have long expressed concerns about the substantial external costs of alcohol, and similar costs could come with the liberalization of marijuana policy. Indeed, the fraction of fatal accidents in which at least one driver tested positive for THC has increased nationwide by an average of 10 percent from 2013 to 2016. For Colorado and Washington, both of which legalized marijuana in 2014, these increases were 92 percent and 28 percent, respectively. However, identifying a causal effect is difficult due to the presence of significant confounding factors. We test for a causal effect of marijuana legalization on traffic fatalities in Colorado and Washington with a synthetic control approach using records on fatal traffic accidents from 2000-2016. We find the synthetic control groups saw similar changes in marijuana-related, alcohol-related and overall traffic fatality rates despite not legalizing recreational marijuana.
    JEL: H23 I12 I28 K42 R4 R41
    Date: 2018–03
  16. By: Remmerswaal, Minke (Tilburg University, TILEC); Boone, Jan (Tilburg University, TILEC); Bijlsma, Michiel (Tilburg University, TILEC); Douven, R.C.M.H.
    Abstract: Since 2006, the Dutch population has faced two different cost-sharing schemes in health insurance for curative care: a mandatory rebate of 255 euros in 2006 and 2007, and since 2008 a mandatory deductible. Using administrative data for the entire Dutch population, we compare the effect of both cost-sharing schemes on healthcare consumption between 2006 and 2013. We use a regression discontinuity design which exploits the fact that persons younger than eighteen years old neither face a rebate nor a deductible. Our fixed effect estimate shows that for individuals around the age of eighteen, a one euro increase of the deductible reduces healthcare expenditures 18 eurocents more than a euro increase of the rebate. These results demonstrate that differences in the design of a cost-sharing scheme can lead to substantial different effects on total healthcare expenditure.
    Keywords: deductible; rebate; cost-sharing; healthcare consumption; regression discontinuity; panel data
    Date: 2017
  17. By: Osea Giuntalla
    Abstract: This paper studies the effects of the 2012 Deferred Action for Childhood Arrivals (DACA)initiative on health insurance coverage, access to care, health care use, and health outcomes. Weexploit a difference-in-differences that relies on the discontinuity in program eligibility criteria.We find that DACA increased insurance coverage. In states that granted access to Medicaid, theincrease was driven by an increase in public insurance take-up. Where public coverage was notavailable, DACA eligibility increased individually purchased insurance. Despite the increase ininsurance coverage, there is no evidence of signi cant increases in health care use, although thereis some evidence that DACA increased demand for mental health services. After 2012, DACA-eligible individuals were more likely to report a usual place of care and less likely to delaycare because of financial restrictions. Finally, we fi nd some evidence that DACA improvedself-reported health, and reduced depression symptoms, indicators of stress and anxiety, andhypertension. These improvements are concentrated among individuals with income below thefederal poverty level.
    Date: 2018–01
  18. By: Fernando Lavadenz; Linda Schultz; Opope Oyaka Tshivuila Matala; Nashira Calvo; Jumana Qamruddin
    Abstract: NTDS and Deworming Africa Initiative (DAI) : Madagascar
    Keywords: Deworming; Neglected Tropical Disease, NTDs, DALYs
    Date: 2018–02
  19. By: Luciana Aimone Gigio (Bank of Italy); Demetrio Alampi (Bank of Italy); Silvia Camussi (Bank of Italy); Giuseppe Ciaccio (Bank of Italy); Paolo Guaitini (Bank of Italy); Maurizio Lozzi (Bank of Italy); Anna Laura Mancini (Bank of Italy); Eugenia Panicara (Bank of Italy); Massimiliano Paolicelli (Bank of Italy)
    Abstract: In this work we analyse the developments that necessitated the adoption of Financial Recovery Plans (Piani di Rientro) for the healthcare systems of some Italian regions and how these plans evolved over time. We look at the measures adopted by the eight Italian regions that were obliged to adopt a Financial Recovery Plan as well as their implications for healthcare infrastructures. We examine service quality and waiting times as well as patient mobility in the eight regions, including by comparison with Italy’s other regions. Our results show that the plans achieved mixed economic results: they were effective in nudging Piedmont, Sicily and Campania towards a balanced budget, but Lazio, Molise and Calabria still suffer from deficits, even substantial ones. The improvement in service quality was even more mixed. While quality did improve in all the regions that adopted a plan, only Piedmont was able to guarantee the national minimum standard of service quality over time, while Calabria and Campania were never able to meet this standard.
    Keywords: public health care system, Piani di Rientro, financial costs, patient mobility, quality of servicies
    JEL: H75 I18
    Date: 2018–03
  20. By: MORIKAWA Masayuki
    Abstract: This study, using original survey data, presents evidence in Japan on the relationship between smoking and obesity on the one hand, and labor market outcomes and subjective well-being on the other hand. According to the results, first, after accounting for various individual characteristics, wages of both male and female smokers are significantly higher than those of non-smokers. This unexpected finding is different from past studies and general perception. In addition, the labor participation rate of smokers is higher than that of non-smokers. Second, there is a wage discount for obesity only among male workers. This is also an unexpected finding, as a large number of past studies have detected wage discounts for obese females. Third, smoking and obesity are associated with low life satisfaction and job satisfaction among females, but the relationships are unclear among males.
    Date: 2018–03
  21. By: Karolina Badora (Creativ-Ceutical Poland, Cracow, Poland.); Aleksandra Caban (Creativ-Ceutical Poland, Cracow, Poland.); Cécile Rémuzat (Creativ-Ceutical, Paris , France); Claude Dussart (P2S - Parcours santé systémique - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon, Faculté de Médecine Laennec, Université de Lyon, Lyon, France.); Mondher Toumi (Faculté de Médecine, Laboratoire de Santé, Université de la Méditerranée, Marseille, France.)
    Abstract: In Poland, two proposed amendments to the reimbursement act are currently in preparation ; these are likely to substantially change the pricing and reimbursement landscape for both drugs and medical devices. Proposed changes include: alignment of medical device reimbursement with that of pharmaceuticals; relaxing the strict reimbursement criteria for ultra-orphan drugs; establishment of an additional funding category for vaccines; introduction of compassionate use, and a simplified reimbursement pathway for well-established off-label indications; appreciation of manufacturers' innovation and research and development efforts by creating a dedicated innovation budget; introduction of a mechanism preventing excessive parallel import; prolonged duration of reimbursement decisions and reimbursement lists; and increased flexibility in defining drug programmes. Both amendments are still at a draft stage and many aspects of the new regulations remain unclear. Nonetheless, the overall direction of some of the changes is already evident and warrants discussion due to their high expected impact on pharmaceutical and device manufacturers. Here we evaluate the main changes proposed to the reimbursement of drugs, vaccines, and medical devices, and examine the impact they are likely to have on market access and pharmaceutical industry in Poland. ARTICLE HISTORY
    Keywords: medical devices,drug policy,Poland,pharmaceuticals,Pricing and reimbursement,reimbursement policy
    Date: 2017–07–26
  22. By: Omelyanovsky, Vitaly (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Avxentieva, Maria (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Zheleznyakova, Inna (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Ignatyeva, Victoria (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Tyurina, Irina (Russian Presidential Academy of National Economy and Public Administration (RANEPA))
    Abstract: At present ambulatory-policlinic institutions of domestic healthcare system works inefficiently thereby forming excessive workload for higher levels of system. The particular result of inefficient work of primary health care level is the transfer to inpatient services the treatment of some diseases and conditions for which effective health care could be provided by outpatient services. The paper presents estimation of financial losses from unjustified hospital admissions and recommendations for preventing such losses. The recommendations are based on the results of policy of strengthening primary healthcare in foreign countries analysis and the data from experts in domestic health care system survey.
    Date: 2018–03
  23. By: Claire Gamassou (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Gregor Bouville (DRM - Dauphine Recherches en Management - Université Paris-Dauphine - CNRS - Centre National de la Recherche Scientifique); Tarik Chakor (IREGE - Institut de Recherche en Gestion et en Economie - USMB [Université de Savoie] [Université de Chambéry] - Université Savoie Mont Blanc); Stéphan Pezé (DRM - Dauphine Recherches en Management - Université Paris-Dauphine - CNRS - Centre National de la Recherche Scientifique); Virginie Moisson (CEMOI - Centre d'Économie et de Management de l'Océan Indien - UR - Université de la Réunion)
    Abstract: Although Human Resources Management (HRM) examines the issue of people at work and their management from the angle of how best to serve an organization's performance, occupational health issues are still a blind spot in its research. Following the lead of Chakor, Abord de Chatillon, and Bachelard (20152) in their review of occupational health and safety research, we attempted to find out how scientific managerial approaches are constructed and how researchers in HRM position themselves with regard to occupational health. A sizeable corpus of texts - which were selected from three sources that were identified as representative of the management sub-discipline that is HRM - were subjected to both thematic content and descriptive statistical analyzes. We demonstrated the gradual empowerment of HRM researchers by building a managerial corpus for workplace health and we identified the salient features that characterize occupational health research in HRM in terms of research objects, methodologies, interdisciplinarity, and stances. This article concludes with a proposed research agenda for HRM scholars working on occupational health.
    Abstract: Aunque la gestión de recursos humanos (GRH) coloca en el centro de sus reflexiones la cuestión del humano en el trabajo y de su gestión con la óptica de servir al desempeño de las organizaciones, las cuestiones de salud ocupacional han sido durante mucho tiempo un punto ciego de sus realizaciones. En la continuidad de la revisión de las investigaciónes en salud y seguridad en el trabajo realizada por Chakor, Abord de Chatillon & Bachelard (20151), que han establecido el lugar de la multidisciplinariedad, en la emergencia de este campo de la GRH, buscamos saber cómo los enfoques en ciencia de la gestión se construyen y que posturas adoptan los investigadores en GRH. Con este fin, una gran cantidad de literatura, seleccionada de tres fuentes identificadas como representativas de la subdisciplina de gestión que es la GRH, ha sido sometida a análisis de contenido temático y análisis estadísticos descriptivos. Mostramos la progresiva autonomización de los investigadores en GRH mediante la construcción de un corpus gerencial sobre la salud ocupacional e identificamos los elementos más destacados que caracterizan esta investigación sobre la salud ocupacional en GRH, en términos de objetos de investigación, metodologías, interdisciplinariedad y posturas. Concluimos con las propuestas de líneas de desarrollo para la investigación en GRH sobre salud ocupacional.
    Abstract: Bien que la Gestion des Ressources Humaines (GRH) place au cœur de ses réflexions la question de l’humain au travail et de sa gestion dans l’optique de servir la performance des organisations, les questions de santé au travail ont longtemps été un point aveugle de ses travaux. Dans la continuité de la revue des recherches en santé et sécurité au travail menée par Chakor, Abord de Chatillon et Bachelard (20151), qui ont établi la place de la pluridisciplinarité dans l’émergence de ce champ en GRH, nous cherchons à savoir comment les approches en sciences de gestion se construisent et quelles postures les chercheurs en GRH adoptent. À cette fin, un large corpus de textes, sélectionnés à partir de trois sources identifiées comme représentatives de la sous-discipline gestionnaire qu’est la GRH, a été soumis à une analyse de contenu thématique et des analyses statistiques descriptives. Nous montrons la progressive autonomisation des chercheurs en GRH par la construction d’un corpus gestionnaire sur la santé au travail et nous identifions les éléments saillants qui caractérisent ces recherches en santé au travail en GRH, en matière d’objets de recherche, de méthodologies, d’interdisciplinarité et de postures. Nous concluons par des propositions d’axes de développement pour les recherches en GRH sur la santé au travail.
    Keywords: human resources management,management,health,work,interdisciplinarity,gestión de recursos humanos,gestión,salud,trabajo,interdisciplinariedad,gestion des ressources humaines,santé,travail,interdisciplinarité
    Date: 2018
  24. By: Scherbov, Sergei (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Shulgin, Sergey (Russian Presidential Academy of National Economy and Public Administration (RANEPA))
    Abstract: In this paper, we estimate the expected duration of healthy life for the regions of Russia. For this, the Sanderson-Shcherbov model is estimated on the microdata of the World Health Organization collected in the SAGE survey for countries with an average life expectancy. Using the obtained model estimates and mortality tables (for Russia in general and for individual Russian regions), estimates are made for the age-related prevalence of health status. Using the Sullivan model and estimated age-related prevalence rates, extended mortality tables are constructed and estimates of the expected duration of healthy life are made. This approach is used to obtain Russian regional estimates for 2015 and Russian forecast trajectories.
    Date: 2018–03
  25. By: Deiana, Claudio; Giua, Ludovica
    Abstract: In response to the recent opioid crisis, US states have implemented several policies to reduce the dispensing of opioids and contain drug mortality. We analyse the effectiveness of these laws and their unintended fallouts on labour participation and crime at the local level. Using multiple data sources and a difference-in-difference set-up, we show that the laws targeting the supply for opioids yield larger reductions in prescribed drugs compared to the demand-side policies, particularly in the absence of cross-bordering effects. We observe an improvement in labour market participation and higher crime rates following the enforcement of some of the policies considered.
    Keywords: Prescription Opioids, Drugs, Labour Market, Crime.
    JEL: E24 I18 K14
    Date: 2018–03
  26. By: Alexei Botchkarev
    Abstract: Ability for accurate hospital case cost modelling and prediction is critical for efficient health care financial management and budgetary planning. A variety of regression machine learning algorithms are known to be effective for health care cost predictions. The purpose of this experiment was to build an Azure Machine Learning Studio tool for rapid assessment of multiple types of regression models. The tool offers environment for comparing 14 types of regression models in a unified experiment: linear regression, Bayesian linear regression, decision forest regression, boosted decision tree regression, neural network regression, Poisson regression, Gaussian processes for regression, gradient boosted machine, nonlinear least squares regression, projection pursuit regression, random forest regression, robust regression, robust regression with mm-type estimators, support vector regression. The tool presents assessment results arranged by model accuracy in a single table using five performance metrics. Evaluation of regression machine learning models for performing hospital case cost prediction demonstrated advantage of robust regression model, boosted decision tree regression and decision forest regression. The operational tool has been published to the web and openly available for experiments and extensions.
    Date: 2018–04
  27. By: Chacko, Anooja
    Abstract: From ancient period itself, Kerala holds a rich heritage of a plethora of curing practices. Several systems of treatments have emerged and flourished here to offer cure and relief to patients. Kerala, the birthplace of ayurveda, still attracts patients from all over the world. In addition to it, several ethnic medical systems also have rooted in Kerala. Generally these systems offer vital thrust on curing diseases with immediate and minimal effect. The aspect of relief for those beyond cure has yet to be acquired enough attention in these systems. Moreover the emotional dimensions of miseries of those on the verge of death have not attained sufficient momentum. The system of palliative care is a novel attempt towards this limited thrust area. Malabar region in Kerala has become a forerunner in it by showing way for the entire Kerala. Now the concept is slowly gaining momentum all over the state even seeking the attention of organised government mechanism. Hence it would be worthy to trace the history and functioning of palliative care movement and the present paper tries to evaluate the nature of evolution and role of palliative movement in the medical system of Kerala.
    Keywords: "palliative care", "grey population"
    JEL: I18 I3 I31 I38
    Date: 2017–11–21
  28. By: Abdelmajid Amine (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Audrey Bonnemaizon (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Margaret Josion Portail (IRG - Institut de Recherche en Gestion - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12)
    Abstract: *Université Paris-Est, IRG (EA 2354) Place de la Porte des Champs, route de Choisy, 94010 Créteil Cedex Résumé : Cette recherche a pour objectif d'explorer une relation de service encore mal connue : la prestation de soins aux patients en milieu hospitalier. Au travers d'une étude qualitative menée auprès du personnel soignant d'un service de gériatrie en Ile de France, nous mettons à jour un phénomène de résistance ordinaire aux normes prescrites, né de deux niveaux de tensions : tensions entre le temps du patient et le temps de l'organisation, d'une part, et entre prescription du pouvoir d'agir du patient et la perception de sa vulnérabilité limitant potentiellement ses capacités à agir. Cette résistance ordinaire s'exprime dans du bricolage et des ruses amenant les soignants à hybrider leurs pratiques quotidiennes pour assurer leur mission de soins. Au fil du temps, ces pratiques hybridées se diffusent et s'institutionnalisent. Abstract: This research aims at exploring an unfamiliar service relationship: healthcare services to hospitalized elderly patients. A qualitative study is conducted through interviews of healthcare workers in the geriatric ward of a French hospital. Our results uncover an ordinary resistance to prescribed standards, as a result of two levels of tensions: tensions between the time of the patient and the time of the organization, on the one hand; and tensions between a will to protect elderly patients' decision-making ability, and a perception of their physical and cognitive limitations, on the other hand. Bricolage and tricks are used by health care workers to fulfill their care mission, leading to the creation of hybrid practices which gradually disseminate in the organization.
    Keywords: elderly patient,norms,ordinary resistance,health marketing,Relation de service,normes,résistance ordinaire,marketing de la santé,patients âgés Keywords: Service relationship
    Date: 2017–05–16

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