scholarly journals Deregulation and pricing of medical services: a policy experiment based in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenbin Zang ◽  
Mei Zhou ◽  
Shaoyang Zhao
Keyword(s):  
Diagnostic Test ◽  
Medical Service ◽  
Drug Expenditure ◽  
Price Regulation ◽  
Medical Services ◽  
Nonprofit Hospitals ◽  
Inpatient Visit ◽  
Policy Experiment ◽  
The Impact ◽  
Expenditure Structure

Abstract Background Price regulation is a common constraint in Chinese hospitals. Based on a policy experiment conducted in China on the price deregulation of private nonprofit hospitals, this study empirically examines the impact of medical service price regulation on the pricing of medical services by hospitals. Methods Using the claim data of insured inpatients residing in a major Chinese city for the period 2010–2015, this study constructs a DID (difference-in-differences) model to compare the impact of price deregulation on medical expenditure and expenditure structure between public and private nonprofit hospitals. Results The empirical results based on micro data reveal that, price deregulated significantly increased the total expenditure per inpatient visit by 10.5%. In the itemized expenditure, the diagnostic test and drug expenditure per inpatient visit of private nonprofit hospitals decreased significantly, whereas the physician service expenditure per inpatient visit increased significantly. For expenditure structure, the proportions of drug expenditure and diagnostic test expenditure per inpatient visit significantly decreased by 5.7 and 3.1%, respectively. Furthermore, this paper also found that hospitals had larger price changes for dominant diseases than for non-dominant diseases. Conclusions Under price regulation, medical service prices generally become lower than their costs. Therefore, after price deregulation, private nonprofit hospitals increase medical service prices above their cost and achieve the service premium increasing physician medical services. Further, although price deregulation causes patient expenditure to increase to a certain level, it optimizes the expenditure structure, as well.

scholarly journals Deregulation and pricing of medical services: A policy experiment based in China

2020 ◽  
Author(s):  
Wenbin Zang ◽  
Mei Zhou ◽  
Shaoyang Zhao
Keyword(s):  
Diagnostic Test ◽  
Medical Service ◽  
Drug Expenditure ◽  
Price Regulation ◽  
Medical Services ◽  
Nonprofit Hospitals ◽  
Inpatient Visit ◽  
Policy Experiment ◽  
The Impact ◽  
Expenditure Structure

Abstract Background: Price regulation is a common constraint in Chinese hospitals. Based on a policy experiment conducted in China on the price deregulation of private nonprofit hospitals, this study empirically examines the impact of medical service price regulation on the pricing of medical services by hospitals. Methods: Using the claim data of insured inpatients residing in a major Chinese city for the period 2010–2015, this study constructs a DID (difference-in-differences) model to compare the impact of price deregulation on medical expenditure and expenditure structure between public and private nonprofit hospitals. Results: The empirical results based on micro data reveal that, price deregulated significantly increased the total expenditure per inpatient visit by 10.5%. In the itemized expenditure, the diagnostic test and drug expenditure per inpatient visit of private nonprofit hospitals decreased significantly, whereas the physician service expenditure per inpatient visit increased significantly. For expenditure structure, the proportions of drug expenditure and diagnostic test expenditure per inpatient visit significantly decreased by 5.7% and 3.1%, respectively. Conclusions: Under price regulation, medical service prices generally become lower than their costs. Therefore, after price deregulation, private nonprofit hospitals increase medical service prices above their cost and achieve the service premium by providing high-quality medical services and a comfortable medical environment. Further, although price deregulation causes patient expenditure to increase to a certain level, it optimizes the expenditure structure, as well.

scholarly journals Deregulation and pricing of medical services A policy experiment based in China

2020 ◽  
Author(s):  
Wenbin Zang ◽  
Mei Zhou ◽  
Shaoyang Zhao
Keyword(s):  
Diagnostic Test ◽  
Medical Service ◽  
Drug Expenditure ◽  
Price Regulation ◽  
Medical Services ◽  
Nonprofit Hospitals ◽  
Inpatient Visit ◽  
Policy Experiment ◽  
The Impact ◽  
Expenditure Structure

Abstract Background: Price regulation is a common constraint in Chinese hospitals. Based on a policy experiment conducted in China on the price deregulation of private nonprofit hospitals, this study empirically examines the impact of medical service price regulation on the pricing of medical services by hospitals. Methods: Using the claim data of insured inpatients residing in a major Chinese city for the period 2010–2015, this study constructs a DID (difference-in-differences) model to compare the impact of price deregulation on medical expenditure and expenditure structure between for-profit and nonprofit hospitals. Results: The empirical results based on micro data reveal that, price deregulated significantly increased the total expenditure per inpatient visit by 10.5%. In the itemized expenditure, the diagnostic test and drug expenditure per inpatient visit of private nonprofit hospitals decreased significantly, whereas the physician service expenditure per inpatient visit increased significantly. For expenditure structure, the proportions of drug expenditure and diagnostic test expenditure per inpatient visit significantly decreased by 5.7% and 3.1%, respectively. Conclusions: Under price regulation, medical service prices generally become lower than their costs. Therefore, after price deregulation, private nonprofit hospitals increase medical service prices above their cost and achieve the service premium by providing high-quality medical services and a comfortable medical environment. Further, although price deregulation causes patient expenditure to increase to a certain level, it optimizes the expenditure structure, as well.

scholarly journals Rapid response and learning for later: establishing high quality information networks and evaluation frameworks for the National Ambulance Service response to COVID-19 – the ENCORE COVID Project Protocol

2021 ◽  
Vol 3 ◽  
pp. 68
Author(s):  
Siobhán Masterson ◽  
Eithne Heffernan ◽  
Dylan Keegan ◽  
Bridget Clarke ◽  
Conor Deasy ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Ambulance Service ◽  
Information Networks ◽  
Medical Services ◽  
Routine Service ◽  
Emergency Medical ◽  
National Quality ◽  
The Impact

Background: The National Ambulance Service (NAS) is at the forefront of Ireland’s response to the COVID-19 pandemic. As directed in Ireland’s National Action Plan, NAS significantly expanded prehospital services, including provision of a novel COVID-19 testing service. Additionally, other health services rely on NAS’s capacity to assess, transport and/or treat COVID-19 patients. In a climate of innovation and adaptation, NAS needs to learn from international ambulance services and share experience. Evaluation of the NAS response to COVID-19 is required to facilitate evidence-based planning for subsequent waves or future pandemics, and to identify innovative practice for mainstreaming into routine service provision. Aims: This project aims to test the utility of novel information networks and develop a tool that is tailored to evaluating pandemic-imposed change in an emergency medical service. Methods: The first aim will be to introduce and measure the impact of ambulance-specific research and information updates for NAS. Secondly, the usefulness to members of an international network of senior ambulance and research personnel (‘AMBULANCE+COVID19’ network), and the clarity and feasibility of a short-survey instrument, the Emergency Medical Services Five Question Survey (EMS-5QS), will be assessed. Finally, an evaluation framework for assessing pandemic-imposed change will be developed to enable NAS determine innovations: (1) for reactivation in another wave or new pandemic; (2) to be sustained as part of routine service. The framework will be developed in collaboration with NAS and the National Quality Improvement Team. The Research Team includes expertise from academia, ambulance services and the National Public Health Emergency Team. Conclusions: This project will facilitate the prompt introduction of information sharing processes to an emergency medical service and assess the impact of those processes. By developing a process for evaluating pandemic-imposed change in NAS, this project will add to the toolbox for future pandemic planning in emergency medical services internationally.

scholarly journals The Impact of the Coronavirus Disease (COVID-19) on the Health and Social Needs of Sex Workers in Singapore

2021 ◽  
Author(s):  
Rayner Kay Jin Tan ◽  
Vanessa Ho ◽  
Sherry Sherqueshaa ◽  
Wany Dee ◽  
Jane Mingjie Lim ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Sex Work ◽  
Sex Workers ◽  
Social Needs ◽  
Medical Services ◽  
Substantial Impact ◽  
Sex Worker ◽  
Permanent Resident ◽  
The Impact ◽  
Depth Interviews

AbstractWe evaluated the impact of the coronavirus disease (COVID-19) on the sex work industry and assessed how it has impacted the health and social conditions of sex workers in Singapore. We conducted a sequential exploratory mixed methods study amidst the COVID-19 pandemic from April to October 2020, including in-depth interviews with 24 stakeholders from the sex work industry and surveyor-administered structured surveys with 171 sex workers. COVID-19 had a substantial impact on sex workers' income. The illegality of sex work, stigma, and the lack of work documentation were cited as exclusionary factors for access to alternative jobs or government relief. Sex workers had experienced an increase in food insecurity (57.3%), housing insecurity (32.8%), and sexual compromise (8.2%), as well as a decrease in access to medical services (16.4%). Being transgender female was positively associated with increased food insecurity (aPR = 1.23, 95% CI [1.08, 1.41]), housing insecurity (aPR = 1.28, 95% CI [1.03, 1.60]), and decreased access to medical services (aPR = 1.74, 95% CI [1.23, 2.46]); being a venue-based sex worker was positively associated with increased food insecurity (aPR = 1.46, 95% CI [1.00, 2.13]), and being a non-Singaporean citizen or permanent resident was positively associated with increased housing insecurity (aPR = 2.59, 95% CI [1.73, 3.85]). Our findings suggest that COVID-19 has led to a loss of income for sex workers, greater food and housing insecurity, increased sexual compromise, and reduced access to medical services for sex workers. A lack of access to government relief among sex workers exacerbated such conditions. Efforts to address such population health inequities should be implemented.

scholarly journals Franco-British responses to chemical warfare 1915–8, with special reference to the medical services, casualty statistics and the threat to civilians

2021 ◽  
Vol 65 (2) ◽  
pp. 101-120
Author(s):  
Hanene Zoghlami
Keyword(s):  
Scientific Collaboration ◽  
Historical Narrative ◽  
Home Front ◽  
Medical Services ◽  
Striking Similarity ◽  
Chemical Weapon ◽  
The Impact ◽  
Compare And Contrast ◽  
British Chemical ◽  
Material Exchange

AbstractThis dual-focussed examination will critically compare and contrast the British Royal Army Medical Corps and the French Medical Service’s involvement in the Western Front chemical campaign between 1915 and 1918. Because the Anglophone historiography has tended to marginalise the French contribution to the allied chemical war, this article will attempt to re-balance the historical narrative by emphasising the collective nature and importance of this joint Franco-British enterprise. By interrogating a raft of under-utilised primary evidence in the French and British archives, this investigation will contribute to the ‘alliance literature’ by arguing that when it comes to aspects of the Franco-British chemical war such as the co-operation of the medical services, the appellation ‘together but alone’ does not fully hold. The article will explore avenues of the two national armies evolving process of mutual medical assistance, material exchange and scientific collaboration. The striking similarity of French and British gas casualty statistics is highlighted with reference to the overall congruence of their anti-gas strategies – notwithstanding the problematic nature of these statistics. In addition to enhancing soldiers’ resistance to the poison gas threat on the battlefield, the Medical Services were also responsible for the protection of local civilians in the war zones. With reference mainly to France, this investigation will discuss the significance and implications of the poison gas threat to the home front. Finally, the impact of chemical weapon production upon civilian war workers in France and Britain will be commented upon.

Feedback to Emergency Medical Services Providers: The Good, the Bad, and the Ignored

1997 ◽  
Vol 12 (2) ◽  
pp. 74-77 ◽  
Author(s):  
Elisabeth F. Mock ◽  
Keith D. Wrenn ◽  
Seth W. Wright ◽  
T. Chadwick Eustis ◽  
Corey M. Slovis
Keyword(s):  
Emergency Department ◽  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Service Providers ◽  
Medical Services ◽  
Emergency Medical Service System ◽  
Constructive Feedback ◽  
Emergency Medical ◽  
Emergency Medical Service Provider

AbstractHypothesis:To determine the type and frequency of immediate unsolicited feedback received by emergency medical service (EMS) providers from patients or their family members and emergency department (ED) personnel.Methods:Prospective, observational study of 69 emergency medical services providers in an urban emergency medical service system and 12 metropolitan emergency departments. Feedback was rated by two medical student observers using a prospectively devised original scale.Results:In 295 encounters with patients or family, feedback was rated as follows: 1) none in 224 (76%); 2) positive in 51 (17%); 3) negative in 19 (6%); and 4) mixed in one (<1%). Feedback from 254 encounters with emergency department personnel was rated as: 1) none in 185 (73%); 2) positive in 46 (18%); 3) negative in 21 (8%); and 4) mixed in 2 (1%). Patients who had consumed alcohol were more likely to give negative feedback than were patients who had not consumed alcohol. Feedback from emergency department personnel occurred more often when the emergency medical service provider considered the patient to be critically ill.Conclusion:The two groups provided feedback to emergency medical service providers in approximately one quarter of the calls. When feedback was provided, it was positive more than twice as often as it was negative. Emergency physicians should give regular and constructive feedback to emergency medical services providers more often than currently is the case.

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