Tort reform: do details matter?

2021 ◽  
pp. 1-17
Author(s):  
Rachel G. Childers
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Specific Growth ◽  
Health Care Expenditure ◽  
Health Care Expenditures ◽  
Fundamental Difference ◽  
Joint Liability ◽  
Joint And Several Liability ◽  
Different Types ◽  
Care Costs

Abstract One explanation for increases in health care costs has been malpractice lawsuits. States have introduced several types of tort reforms to control increases in health care costs. This paper adds to the literature by examining how the differences in joint and several liability (JSL) reforms affect the state-specific growth rate in health care expenditures. Additionally, the paper addresses the potential for a fundamental difference between states that pass different types of liability reforms. The results show that JSL reforms that limit joint liability based on percentage of blame have statistically and economically significant impacts on health care expenditure growth rates.

scholarly journals CONSUMER BEHAVIOUR, OBESITY AND SOCIAL COSTS. THE CASE OF ITALY

2017 ◽  
Vol 16 (2) ◽  
Author(s):  
Paola Mancini ◽  
Giuseppe Marotta ◽  
Concetta Nazzaro ◽  
Biagio Simonetti
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Consumer Behaviour ◽  
Social Impact ◽  
Multiple Correspondence Analysis ◽  
Health Care Expenditure ◽  
Overweight And Obesity ◽  
Social Costs ◽  
Least Squares Regression ◽  
Care Costs

This study analyses the social impact of obesity, focusing on the direct costs and, in particular,on the health-care expenditure. Using different socio-demographic variables and through theuse of Multiple Correspondence Analysis and Partial Least Squares Regression, the analysis: i)confirms the increase of the incidence of overweight and obesity when moving from Northernto Southern Italy; ii) identifies the main variables related to the growth of obesity; iii) highlightsa positive relationship between BMI and health-care costs and an incidence of 6% on theregional health-care costs. These findings confirm the need to define suitable guidelines fordecision makers and practitioners and to introduce mandatory regulations forcing companiesto effectuate product reformulation and achieve food safety. Indeed, asymmetric informationand consumer behaviour make investing in product reformulation undesirable for companiesbecause the use of attractive brands is more effective in influencing the purchasing decisionseven of a conscious consumer. Uninformed consumers often cling to the national brands,which sometimes, behind an image of familiarity and identity, may hide harmful ingredients(hydrogenated fats) or excessive quantities of certain ingredients (sugar, salt, saturatedfat) responsible for an unbalanced diet. Therefore, this justifies the introduction of bindingregulations.Keywords: Consumer Behaviour; Obesity; Social Costs; Health-Care Expenditure; MultivariateModel.

scholarly journals Burden of health behaviours and socioeconomic position on health care expenditure in Ontario

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 303
Author(s):  
Douglas G. Manuel ◽  
Carol Bennett ◽  
Richard Perez ◽  
Andrew S. Wilton ◽  
Adrian Rohit Dass ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Health Care Costs ◽  
Health Behaviour ◽  
Socioeconomic Position ◽  
Healthcare Costs ◽  
Cost Model ◽  
Health Care Expenditure ◽  
Health Behaviours ◽  
Care Costs

Background: Smoking, unhealthy alcohol consumption, poor diet and physical inactivity are leading risk factors for morbidity and mortality, and contribute substantially to overall healthcare costs. The availability of health surveys linked to health care provides population-based estimates of direct healthcare costs. We estimated health behaviour and socioeconomic-attribute healthcare costs, and how these have changed during a period when government policies have aimed to reduce their burden.  Methods: The Ontario samples of the Canadian Community Health Surveys (conducted in 2003, 2005, and 2007-2008) were linked at the individual level to all records of health care use of publicly funded healthcare. Generalized linear models were estimated with a negative binomial distribution to ascertain the relationship of health behaviours and socioeconomic risk factors on health care costs. The multivariable cost model was applied to unlinked, Ontario CCHS samples for each year from 2004 to 2013 to examine the evolution of health behaviour and socioeconomic-attributable direct health care expenditures over a 10-year period. Results: We included 80,749 respondents, aged 25 years and older, and 312,952 person-years of follow-up. The cost model was applied to 200,324 respondents aged 25 years and older (CCHS 2004 to 2013). During the 10-year period from 2004 to 2013, smoking, unhealthy alcohol consumption, poor diet and physical inactivity attributed to 22% of Ontario’s direct health care costs. Ontarians in the most disadvantaged socioeconomic position contributed to 15% of the province’s direct health care costs. Combined, these health behaviour and socioeconomic risk factors were associated with 34% ($134 billion) of direct health care costs (2004 to 2013). Over this time period, we estimated a 1.9% reduction in health care expenditure ($5.0 billion) attributable to improvements in some health behaviours, most importantly reduced rates of smoking. Conclusions: Adverse health behaviours and socioeconomic position cause a large direct health care system cost burden.

PROBLEMS OF ASSESSING THE HEALTH CARE COSTS EFFECTIVENESS

2017 ◽  
Vol 11 (6) ◽  
pp. 137-151 ◽  
Author(s):  
Людмила Горшкова ◽  
Lyudmila Gorshkova
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health Care Costs ◽  
Public Expenditure ◽  
Health Care Expenditure ◽  
Important Indicator ◽  
Life Expectancy At Birth ◽  
Logarithmic Curve ◽  
The Cost ◽  
Care Costs

Assessing the effectiveness of health care expenditure is a major economic task. The most important indicator to assess the effectiveness of health care costs is the expected life expectancy (ELE). Infant mortality is also closely related to DLE. The article substantiates the logarithmic model of the dependence of ELE from health care expenditure (per person for a particular year). Each country is represented by a point on the coordinate plane with an ordinate equal to the ELE in this country and an abscissa equal to the health care expenditure in it. The modeling logarithmic curve is taken as the theoret-ical threshold of the cost-effectiveness: the higher the curve is the point repre-senting the country, the more effective the health care costs in this country, and the lower the threshold curve, the costs are more unprofitable. It is shown that the dependence of ELE from GDP (or GRP by regions of Russia) is not so obvious: although there is a tendency to such a dependence, but with a large number of drop-out values. Despite the achievement of the highest average expected life expectancy in Russia in the country's history, it is significantly lower than in developed countries. The main causes of low expected life expectancy at birth are unsatisfactory health indicators, and as a result, high incidence and disability. Traumatism on the roads and suicides are one of the significant reasons for the low expected life expectancy in Russia and are significantly higher than similar indicators in other countries. The article shows the close correlation between the cost of health care per person and expected life expectancy. However, in the Russian Federation, the share of public expenditure in the structure of aggregate health expenditure is decreasing. Social insurance funds are more than half of the health care public expenditure. The author reveals considerable regional differences in health spending per person and average expected life expectancy. The article highlights the insufficient level of health care costs in Russia as a whole and in regions.

Why health care costs more in the US: Comparing health care expenditures between systemic lupus erythematosus patients in Stanford and Montreal

1996 ◽  
Vol 39 (6) ◽  
pp. 979-987 ◽  
Author(s):  
Gail Gironimi ◽  
Ann E. Clarke ◽  
Vivian H. Hamilton ◽  
Deborah S. Danoff ◽  
Daniel A. Bloch ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Health Care ◽  
Health Care Costs ◽  
Lupus Erythematosus ◽  
Health Care Expenditures ◽  
Systemic Lupus ◽  
The Us ◽  
Care Costs

State Insurance Parity Legislation for Autism Services and Family Financial Burden

2012 ◽  
Vol 50 (3) ◽  
pp. 190-198 ◽  
Author(s):  
Susan Parish ◽  
Kathleen Thomas ◽  
Roderick Rose ◽  
Mona Kilany ◽  
Robert McConville
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Financial Burden ◽  
Children With Autism ◽  
Health Care Expenditures ◽  
Family Characteristics ◽  
Children's Health ◽  
Children’S Health ◽  
Care Costs ◽  
Children’S Health Care

Abstract We examined the association between states' legislative mandates that private insurance cover autism services and the health care–related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N  =  2,082 children with autism). State policy characteristics were taken from public sources. The 3 outcomes were whether a family had any out-of-pocket health care expenditures during the past year for their child with autism, the expenditure amount, and expenditures as a proportion of family income. We modeled the association between states' autism service mandates and families' financial burden, adjusting for child-, family-, and state-level characteristics. Overall, 78% of families with a child with autism reported having any health care expenditures for their child for the prior 12 months. Among these families, 54% reported expenditures of more than $500, with 34% spending more than 3% of their income. Families living in states that enacted legislation mandating coverage of autism services were 28% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. Families living in states that enacted parity legislation mandating coverage of autism services were 29% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. This study offers preliminary evidence in support of advocates' arguments that requiring private insurers to cover autism services will reduce families' financial burdens associated with their children's health care expenses.

scholarly journals Translational Effect of Provider-Focused, Multi-State, Multi-Clinic Asthma Care Quality Improvement Program on Patient-Level Health Care Costs

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Sirikan Rojanasarot ◽  
Angeline M. Carlson ◽  
Wendy L. St. Peter ◽  
Pinar Karaca-Mandic ◽  
Julian Wolfson ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care Costs ◽  
Health Care Expenditures ◽  
Economic Benefits ◽  
Care Quality ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
Implementation Period ◽  
Care Costs

Introduction/Objectives: Enhancing Care for Patients with Asthma (ECPA), a year-long provider-focused, multi-state, multi-clinic quality improvement program, decreased avoidable utilizations among patients with asthma, but its effects on health care expenditures were not determined. This study examined the translational and sustainable effects of improved care through ECPA on individual-level total health care costs due to asthma. Methods: We conducted a retrospective pretest-posttest quasi-experimental study in which attributed 1683 patients in a 12-month pre-ECPA implementation period served as their own control. We constructed the total annual asthma-related health care costs per patient occurred during pre-ECPA implementation, ECPA implementation, and post-ECPA completion. We used 3-level generalized linear mixed models (GLMMs) to estimate the ECPA effect on the annual health care costs and account for correlation between the repeated outcome measures for each patient and nested clinic. All costs were adjusted for inflation to 2014 U.S. dollars, the last year of program observation. Results: Total asthma-related health care costs among the 1683 included patients decreased from an average of $7033 to $3237 per person-year (pre-ECPA implementation vs implementation). Using the cost data from the 12-month pre-ECPA implementation period as a reference, GLMMs found that the ECPA implementation was associated with a reduction in total annual asthma-related health care costs by 56.4% (95% CI −60.7%, −51.8%). During the 12-months after ECPA completion period, health care costs were also found to be significantly lower, experiencing a 57.3% reduction. Conclusions: The economic benefits of ECPA provide a justification to adopt this quality improvement initiative to more primary care clinics at a national level.

scholarly journals Growth of Health Costs: Myths and Reality

2019 ◽  
pp. 24-34
Author(s):  
Yulia Vladimirovna Kuftova ◽  
Olga Valerevna Obukhova ◽  
Irina Nikolaevna Bazarova
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Russian Federation ◽  
Health Indicators ◽  
Health Care Expenditures ◽  
Developed Countries ◽  
Positive Trend ◽  
The Usa ◽  
The Russian Federation ◽  
Care Costs

Government spending are the basic of the health economics of any developed countries. We are overwhelmingly confident that an increase in the financing of the health care system makes it possible to improve the population’s access to medical care, which, accordingly, it is reflected on an increasing quality of life and its duration. Undoubtedly, investments in the healthcare industry should lead to the creation of new jobs, the development and introduction of advanced medical technologies and innovative drugs into clinical practice. In recent years, in the Russian Federation, there has been a positive trend in the volume of funds allocated by the state to protect public health. The article is devoted to the study of possible factors causing this growth. The authors made an attempt to answer the questions whether the increase in health care costs is due only to the political will of decision makers at the federal level, whether unhealthy lifestyles of the country’s citizens affect health care costs, which primarily depend on the costs of health care resources and others. To answer these questions, the authors analyzed the behavior of individual indicators reflecting health care expenditures and population health indicators for the Russian Federation in comparison with the countries of the Organization for Economic Development and Cooperation (OECD) – Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the USA.

scholarly journals DETERMINANTS OF SUCCESSFUL TRANSFORMATION OF THE MEDICAL SYSTEM IN THE EU AND UKRAINE: COMPARATIVE ANALYSIS

2021 ◽  
Author(s):  
Pavlo Ivanchov
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Health Care Costs ◽  
Health Care Expenditures ◽  
Well Being ◽  
Economic Security ◽  
Medical System ◽  
State Management ◽  
Life Expectancy At Birth ◽  
Care Costs

The need to study the effectiveness of the health care system in developed countries in order to assess the state of development of the medical system and analyze the key determinants of its effective transformation is emphasized in the article. The idea, that general indicator that characterizes the efficiency of the medical industry is the indicator of life expectancy, is determined. The dependences of the level of life expectancy on the level of well-being and total health care costs are studied. It was found that life expectancy significantly depends on the level of real gross domestic product per capita at the purchasing power parity of the population in countries with lower levels of socio-economic security and quality of life, a lower life expectancy is recorded. It has been determined that increasing health care expenditures to a certain level has a positive impact on the efficiency of the medical sector, although it depends more on the scheme of attracting and allocating financial resources. In addition, the dynamics of the development of medical systems in Eastern Europe by indicators of life expectancy at birth, the level of expenditures on medicine in general and funding schemes, the share of health care costs “out of pocket”, the level of costs for medical facilities and reimbursement medicines for the population, etc. are analyzed. It is determined that the experience of countries similar in level of socio-economic development to Ukraine can be extrapolated to the domestic practice of state management of the medical system.

scholarly journals Universal drug coverage and socioeconomic disparities in health care costs among persons with diabetes

2020 ◽  
Author(s):  
Wanrudee Isaranuwatchai ◽  
Ghazal S. Fazli ◽  
Arlene S. Bierman ◽  
Lorraine L. Lipscombe ◽  
Nicholas Mitsakakis ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Socioeconomic Status ◽  
Health Care Costs ◽  
Health Care Expenditures ◽  
Drug Coverage ◽  
Younger Adults ◽  
Physician Visits ◽  
Neighborhood Socioeconomic Status ◽  
Care Costs

<b>Objective: </b>To examine whether neighborhood socioeconomic status (SES) is a predictor of non-drug-related health care costs among Canadian adults with diabetes, and if so, whether SES disparities in costs are reduced after age 65, when universal drug coverage commences as an insurable benefit. <p><b>Methods: </b>Administrative health databases were used to examine publicly-funded health care expenditures among 698,113 younger (20-64 years) and older adults (≥65 years) with diabetes in Ontario from April 2004 to March 2014. Generalized linear models were constructed to examine relative and absolute differences in health care costs (total and non-drug-related) across neighborhood socioeconomic status (SES) quintiles, by age, adjusting for differences in age, sex, diabetes duration, and comorbidity. </p> <p><b>Results:</b> Unadjusted costs per person-year in the lowest (Q1) versus highest (Q5) SES quintile were 39% higher among younger adults ($5,954 vs. $4,270 Canadian dollars), but only 9% higher among older adults ($10,917 vs. $9,993). Adjusted non-drug costs (primarily for hospitalizations and physician visits) were $1,569 per person-year higher among younger adults in Q1 vs. Q5 (modeled relative cost difference: +35.7%) and $139.3 million per year among all individuals in Q1. Scenarios in which these excess costs per person-year were decreased by ≥10% or matched the relative difference among seniors suggested a potential for savings in the range of $26.0 to $128.2 million per year among all lower SES adults under age 65 (Q1-4). </p> <p><b>Conclusions: </b>Socioeconomic status is a predictor of diabetes-related health care costs in our setting, more so among adults under age 65, a group that lacks universal drug coverage under Ontario’s health care system. Non-drug related health care costs were more than one-third higher in younger, low SES adults, translating to >$1 billion more in health care expenditures over 10 years.</p>

scholarly journals Association of body mass index with health care expenditures in the United States by age and sex

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247307
Author(s):  
Zachary J. Ward ◽  
Sara N. Bleich ◽  
Michael W. Long ◽  
Steven L. Gortmaker
Keyword(s):  
Health Care ◽  
Body Mass Index ◽  
Body Mass ◽  
Health Care Costs ◽  
Severe Obesity ◽  
Health Care Expenditures ◽  
Medical Expenditures ◽  
Excess Costs ◽  
Using Data ◽  
Care Costs

Background Estimates of health care costs associated with excess weight are needed to inform the development of cost-effective obesity prevention efforts. However, commonly used cost estimates are not sensitive to changes in weight across the entire body mass index (BMI) distribution as they are often based on discrete BMI categories. Methods We estimated continuous BMI-related health care expenditures using data from the Medical Expenditure Panel Survey (MEPS) 2011–2016 for 175,726 respondents. We adjusted BMI for self-report bias using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2016, and controlled for potential confounding between BMI and medical expenditures using a two-part model. Costs are reported in $US 2019. Results We found a J-shaped curve of medical expenditures by BMI, with higher costs for females and the lowest expenditures occurring at a BMI of 20.5 for adult females and 23.5 for adult males. Over 30 units of BMI, each one-unit BMI increase was associated with an additional cost of $253 (95% CI $167-$347) per person. Among adults, obesity was associated with $1,861 (95% CI $1,656-$2,053) excess annual medical costs per person, accounting for $172.74 billion (95% CI $153.70-$190.61) of annual expenditures. Severe obesity was associated with excess costs of $3,097 (95% CI $2,777-$3,413) per adult. Among children, obesity was associated with $116 (95% CI $14-$201) excess costs per person and $1.32 billion (95% CI $0.16-$2.29) of medical spending, with severe obesity associated with $310 (95% CI $124-$474) excess costs per child. Conclusions Higher health care costs are associated with excess body weight across a broad range of ages and BMI levels, and are especially high for people with severe obesity. These findings highlight the importance of promoting a healthy weight for the entire population while also targeting efforts to prevent extreme weight gain over the life course.

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