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EQUITY IN THE FINANCE OF HEALTH-CARE - SOME INTERNATIONAL COMPARISONS

JOURNAL OF HEALTH ECONOMICS 1992年第4期11卷 361-387页

作者： WAGSTAFF, A VANDOORSLAER, E ERASMUS UNIV 3000 DR ROTTERDAMNETHERLANDS

This paper presents the results of a ten-country comparative study of health care financing systems and their progressivity characteristics. It distinguishes between the tax-financed systems of Denmark, Portugal and the U.K., the social insurance systems of France, the Netherlands and Spain, and the predominantly private systems of Switzerland and the U.S. It concludes that tax-financed systems tend to be proportional or mildly progressive, that social insurance systems are regressive and that private systems are even more regressive. Out-of-pocket payments are in most countries an especially regressive means of raising health care revenues.

关键词：文化交叉比较卫生保健提供/经济学卫生保健提供/统计学和数值数据欧洲筹资政府/经济学筹资政府/方法筹资政府/统计学和数值数据卫生经费支出/统计学和数值数据卫生服务研究保险健康/经济学国际性模型经济计量学国家卫生规划/经济学国家卫生规划/组织和管理国家卫生规划/统计学和数值数据回归分析公费医疗/经济学公费医疗/组织和管理公费医疗/统计学和数值数据税款/经济学美国

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ADVERSE SELECTION, MORAL HAZARD, AND WEALTH EFFECTS IN THE MEDIGAP INSURANCE MARKET

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JOURNAL OF HEALTH ECONOMICS 1991年第4期10卷 433-459页

作者： WOLFE, JR GODDEERIS, JH MICHIGAN STATE UNIV DEPT ECONE LANSINGMI 48824 USA

Using data from a longitudinal study of the recently retired we attempt to separate the moral hazard effect of Medicare supplementary (Medigap) insurance on health care expenditures from the adverse selection effect of poor health on Medigap coverage. We find evidence of adverse selection, but its magnitude is unlikely to create serious efficiency problems. Taking adverse selection into account reduces the estimate of the moral hazard effect. In addition, we find a strong positive wealth effect on the demand for supplementary insurance.

关键词：费用效益分析卫生经费支出/统计学和数值数据卫生服务需求/经济学卫生服务需求/统计学和数值数据收入/统计学和数值数据保险选择偏倚保险 Medigap/经济学保险 Medigap/统计学和数值数据最小二乘法分析模型经济计量学道德社会经济因素美国老年人女(雌)性人类男(雄)性

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The share of Medicaid for nursing home care.

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Journal of health & social policy 1990年第3期1卷 35-53页

作者： Swan, J.H. Institute for Health and Aging University of California San Francisco 94143.

Over one-third of Medicaid dollars go to nursing homes, a share that is decreasing but that varies widely among the states. This paper examines demand, supply, and policy factors explaining interstate variation over time in the nursing home share of state Medicaid dollars. Nursing home bed stock shows strong effects;Medicaid expenditures for acute hospital and for ICF-MR care are important;and various demand factors also explain nursing home share. In this model, residual nursing home share of Medicaid declines over time, which is interpreted to reflect omitted state policy factors explaining state ability to constrain Medicaid nursing home utilization and expenditures.

关键词：卫生经费支出/统计学和数值数据医院病床数中间诊疗设施/经济学 Medicaid/统计学和数值数据精神发育迟滞/经济学回归分析技术性护理设施/经济学州卫生计划/经济学美国人类

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EQUITY IN THE DELIVERY OF HEALTH-CARE - SOME INTERNATIONAL COMPARISONS

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JOURNAL OF HEALTH ECONOMICS 1992年第4期11卷 389-411页

作者： VANDOORSLAER, E WAGSTAFF, A UNIV SUSSEX SCH SOCIAL SCIARTS BLDGBRIGHTON BN1 9QNENGLAND ERASMUS UNIV 3000 DR ROTTERDAMNETHERLANDS

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 standardized expenditure shares, and a regression-based test. The results suggest that inequity exists in most of the eight countries, but that there is no simple one-to-one correspondence between a country's delivery system and the degree to which persons in equal need are treated the same.

关键词：文化交叉比较卫生保健提供/经济学卫生保健提供/标准卫生保健提供/统计学和数值数据欧洲卫生经费支出/统计学和数值数据卫生服务易得程度/经济学卫生服务易得程度/标准卫生服务易得程度/统计学和数值数据卫生服务研究收入/分类保险健康/经济学保险健康/标准保险健康/统计学和数值数据国际性模型经济计量学国家卫生规划/经济学国家卫生规划/标准国家卫生规划/统计学和数值数据回归分析社会正义/经济学社会经济因素公费医疗/经济学公费医疗/标准公费医疗/统计学和数值数据美国

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Prospects for national health care in the united states

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Journal of Health and Social Policy 1992年第3期3卷 1-17页

作者： Soifer, Steven Lou Balassone, Mary Johnstone, Jaime University of Washington School of Social Work Seattle WA 98195 4101 15th Avenue NE JH-30 United States

This paper provides an overview of both the current health care crisis in the United States and various reform proposals (some based on Canadian and British models) being considered at the federal and state levels. The proposals discussed fall into three categories—multiple payer national health insurance programs, one payer national health insurance programs, and a national health service program. The authors review four important criteria (cost, quality, access, and equity) that must be considered in evaluating the proposals for reform. Information is provided to assist health care professionals in understanding the various national health care proposals, applying evaluative criteria to these proposals, and advocating for needed changes. © 1992 Taylor and Francis Group, LLC.

关键词：加拿大费用效益分析大不列颠卫生经费支出/统计学和数值数据卫生经费支出/发展趋势卫生政策/经济学卫生政策/发展趋势卫生服务易得程度/组织和管理国家健康保险美国/经济学规划技术卫生保健质量州卫生计划/经济学州卫生计划/组织和管理州卫生计划/发展趋势美国

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ON THE MEASUREMENT OF HORIZONTAL INEQUITY IN THE DELIVERY OF HEALTH-CARE

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JOURNAL OF HEALTH ECONOMICS 1991年第2期10卷 169-205页

作者： WAGSTAFF, A VANDOORSLAER, E PACI, P ERASMUS UNIV 3000 DR ROTTERDAMNETHERLANDS CITY UNIV LONDON LONDON EC1V 0HBENGLAND

This paper offers a critical appraisal of the various methods used to date to investigate inequity in the delivery of health care. It concludes that none of the methods used to date is particularly well equipped to provide unbiassed estimates of the extent of inequity. It also concludes that Le Grand's (1978) approach is likely to point towards inequity favouring the rich even when none exists. The paper offers an alternative approach, which builds on the approaches to date but seeks to overcome their deficiencies.

关键词：急性病慢性病文化交叉比较卫生保健提供/标准人口统计学欧洲卫生经费支出/统计学和数值数据卫生服务研究/方法模型统计学回归分析社会正义社会经济因素人类

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HEALTH-CARE REFORM - A CONTRARY OPINION

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HEALTH CARE ANALYSIS 1995年第3期3卷 244-248页

作者： COUTO, JS Porto Portugal

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THE DISTRIBUTION OF HEALTH-CARE REVISITED - A COMMENTARY

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JOURNAL OF HEALTH ECONOMICS 1991年第2期10卷 239-245页

作者： LEGRAND, J UNIV LONDON LONDON SCH ECON & POLIT SCI SUNTORY TOYOTA INT CTR ECON & RELATED DISCIPLINESLONDON WC2A 2AEENGLAND

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Changing the public-private mix: An assessment of the health reforms in Greece

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HEALTH CARE ANALYSIS 1998年第4期6卷 277-285页

作者： Liaropoulos, LL Kaitelidou, D Univ Athens Ctr Hlth Serv Management & Evaluat GR-15126 Athens Greece

The 1983 health reform in Greece was a major political event in the social policy agenda. The main objective of the reform was the institution of a National Health System and the expansion of the health sector, improved equity, and the assumption of full responsibility for health services delivery by the state. An assessment of the results 10 years after full implementation of the reform shows that despite the expansion of the public sector, the public-private mix in financing and delivery has changed in favour of the private sector, making the Greek health system the most 'privatised' among the EU countries. The main reasons why the health reform failed to meet its objectives was the restrictive enforcement of full-time and exclusive hospital employment for doctors, the virtual ban on private hospital expansion, the much faster introduction and diffusion of new health technology by the private sector, and poor management, planning and control in the public sector. A new health reform voted into law in the summer of 1997 shows promise of redressing some of the shortcomings of the 1983 reform. (C) 1998 John Wiley & Sons, Ltd.

关键词：行政管理人员筹资政府筹资组织/统计学和数值数据筹资组织/发展趋势希腊卫生保健改革/组织和管理卫生保健部门卫生经费支出/统计学和数值数据卫生经费支出/发展趋势保险健康医务人员医院国家卫生规划/经济学政治私营部门/经济学公营部门/经济学

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Medicare's mental health benefits: Coverage, use, and expenditures

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JOURNAL OF AGING AND HEALTH 1996年第1期8卷 54-71页

作者： Sherman, JJ UNIV S CAROLINA COLL NURSINGCOLUMBIASC 29208 USA

Estimates of the proportion of persons aged 65 and older with diagnosable mental disorders, residing both in the community and in institutions, range from 13.5% to 22%. Mental health services, both inpatient and outpatient, short and long term, are necessary for the well-being of these older Americans. Mental health benefits are covered under Medicare. However, less than 3% of the $90.5 billion Medicare budget in 1988 was spent on mental health services. Of that 3%, $2.2 billion was used for Part A (hospital insurance) and $300 million for Part B (medical insurance). In contrast, in the same year, payments for mental health services represented 20% to 30% of total health expenditures made by private insurers. Differences in payments abound when comparing freestanding psychiatric facilities with both exempt and nonexempt psychiatric units in general hospitals. This article describes these differences and how they influence the use of mental health services by Medicare beneficiaries.

关键词：卫生经费支出/统计学和数值数据保险赔偿费 Medicare/利用精神卫生服务/经济学精神卫生服务/利用偿还途径美国老年人人类

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