Product Proliferation under Rational Inattention: Application to Health Insurance

2021 ◽  
Vol 111 ◽  
pp. 554-559
Author(s):  
Zach Y. Brown ◽  
Jihye Jeon
Keyword(s):  
Health Insurance ◽  
Prescription Drug ◽  
Market Share ◽  
Information Acquisition ◽  
Rational Inattention ◽  
Drug Insurance ◽  
Acquisition Costs ◽  
Using Data ◽  
Product Proliferation ◽  
To Receive

In markets with complicated products such as insurance, why do firms offer many products even when consumers appear to receive little benefit? We show that when consumers face information acquisition costs, firms may have an incentive to introduce many undifferentiated products. This allows firms to gain market share and increase markups. We document initial evidence consistent with the model using data from Medicare prescription drug insurance. Insurers that offer more duplicate or similar plans have higher-cost plans. These results suggest a role for policymakers to restrict product proliferation in markets with complicated products.

Quality of inpatient antimicrobial use in hematology and oncology patients

2021 ◽  
pp. 1-10
Author(s):  
Abby P. Douglas ◽  
Lisa Hall ◽  
Rodney S. James ◽  
Leon J. Worth ◽  
Monica A. Slavin ◽  
...  
Keyword(s):  
Marrow Transplant ◽  
Antifungal Prophylaxis ◽  
Neutropenic Fever ◽  
Antibacterial Prophylaxis ◽  
Separate Analysis ◽  
Prescribing Practices ◽  
Oncology Patients ◽  
Antimicrobial Prescribing ◽  
Using Data ◽  
To Receive

Abstract Objectives: To compare antimicrobial prescribing practices in Australian hematology and oncology patients to noncancer acute inpatients and to identify targets for stewardship interventions. Design: Retrospective comparative analysis of a national prospectively collected database. Methods: Using data from the 2014–2018 annual Australian point-prevalence surveys of antimicrobial prescribing in hospitalized patients (ie, Hospital National Antimicrobial Prescribing Survey called Hospital NAPS), the most frequently used antimicrobials, their appropriateness, and guideline concordance were compared among hematology/bone marrow transplant (hemBMT), oncology, and noncancer inpatients in the setting of treatment of neutropenic fever and antibacterial and antifungal prophylaxis. Results: In 454 facilities, 94,226 antibiotic prescriptions for 62,607 adult inpatients (2,230 hemBMT, 1,824 oncology, and 58,553 noncancer) were analyzed. Appropriateness was high for neutropenic fever management across groups (83.4%–90.4%); however, hemBMT patients had high rates of carbapenem use (111 of 746 prescriptions, 14.9%), and 20.2% of these prescriptions were deemed inappropriate. Logistic regression demonstrated that hemBMT patients were more likely to receive appropriate antifungal prophylaxis compared to oncology and noncancer patients (adjusted OR, 5.3; P < .001 for hemBMT compared to noncancer patients). Oncology had a low rate of antifungal prophylaxis guideline compliance (67.2%), and incorrect dosage and frequency were key factors. Compared to oncology patients, hemBMT patients were more likely to receive appropriate nonsurgical antibacterial prophylaxis (aOR, 8.4; 95% CI, 5.3–13.3; P < .001). HemBMT patients were also more likely to receive appropriate nonsurgical antibacterial prophylaxis compared to noncancer patients (OR, 3.1; 95% CI, 1.9–5.0; P < .001). However, in the Australian context, the hemBMT group had higher than expected use of fluoroquinolone prophylaxis (66 of 831 prescriptions, 8%). Conclusions: This study demonstrates why separate analysis of hemBMT and oncology populations is necessary to identify specific opportunities for quality improvement in each patient group.

scholarly journals Humidifier Disinfectant Consumption and Humidifier Disinfectant-Associated Lung Injury in South Korea: A Nationwide Population-Based Study

2021 ◽  
Vol 18 (11) ◽  
pp. 6136
Author(s):  
Jeonggyo Yoon ◽  
Minsun Kang ◽  
Jaehun Jung ◽  
Min Jae Ju ◽  
Sung Hwan Jeong ◽  
...  
Keyword(s):  
Health Insurance ◽  
Lung Injury ◽  
National Health Insurance ◽  
Population Based ◽  
Annual Number ◽  
Population Based Study ◽  
Annual Consumption ◽  
Using Data ◽  
Water Tanks ◽  
Biocidal Product

Humidifier disinfectant (HD) is a household biocidal product used in humidifier water tanks to prevent the growth of microorganisms. In 2011, a series of lung injury cases of unknown causes emerged in children and pregnant women who had used HD in Korea. This study investigated changes in the nationwide number of cases of humidifier disinfectant-associated lung injury (HDLI) in concordance with nationwide HD consumption using data covering the entire Korean population. More than 25 kinds of HD products were sold between 1994 and 2011. The number of diagnosed HDLI, assessed by S27.3 (other injuries of lungs) of the Korea National Health Insurance Service (NHIS) data, sharply increased by 2005, subsequently decreased after 2005, and almost disappeared after 2011 in concordance with the annual number of HD sales. The number of self-reported HDLIs, assessed using data from all suspected HDLI cases registered in the Korea Ministry of Environment, changed with the annual number of HD sales, with a delay pattern, potentially induced by the late awareness of lung injury diseases. The present study suggests that changes in the nationwide annual consumption of HD products were consistent with changes in the annual number of HDLI cases in Korea.

Impact of Health Plan Deductibles and Health Insurance Marketplace Enrollment on Health Care Experiences

2018 ◽  
Vol 77 (5) ◽  
pp. 483-497
Author(s):  
Weiwei Chen ◽  
Timothy F. Page
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
The United States ◽  
Health Plans ◽  
Medical Needs ◽  
Care Access ◽  
Health Care Experiences ◽  
Monitoring Survey ◽  
Using Data ◽  
The Impact

High-deductible health plans (HDHPs) have become increasingly prevalent among employer-sponsored health plans and plans offered through the Health Insurance Marketplace in the United States. This study examined the impact of deductible levels on health care experiences in terms of care access, affordability, routine checkup, out-of-pocket cost, and satisfaction using data from the Health Reform Monitoring Survey. The study also tested whether the experiences of Marketplace enrollees differed from off-Marketplace individuals, controlling for deductible levels. Results from multivariable and propensity score weighted regression models showed that many of the outcomes were adversely affected by deductible levels and Marketplace enrollment. These results highlight the importance of efforts to help individuals choose the plan that fits both their medical needs and their budgets. The study also calls for more attention to improving provider acceptance of HDHPs and Marketplace plans as these plans become increasingly common over time.

scholarly journals PSYCHOLOGICAL PROFILE OF PATIENTS ELIGIBLE FOR BARIATRIC SURGERY

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 27-30 ◽  
Author(s):  
Graziela Aparecida Nogueira de Almeida RIBEIRO ◽  
Helenice Brizolla GIAMPIETRO ◽  
Lídia Barbieri BELARMINO ◽  
Wilson SALGADO-JÚNIOR
Keyword(s):  
Bariatric Surgery ◽  
Binge Eating ◽  
Average Score ◽  
Psychological Profile ◽  
Psychosocial Characteristics ◽  
The Mean ◽  
Low Levels ◽  
Using Data ◽  
Binge Eating Scale ◽  
To Receive

Abstract Background: The psychologist who works in bariatric surgery has a role to receive, evaluate, prepare and educate the patient who will undergo the surgical procedure. Psychological evaluation becomes important in so far as allows us to obtain data on personal and familiar history and allow tracing of possible psychopathology. Aim: To collect data on psychological evaluations of patients in a bariatric surgery service of a public hospital in order to describe the psychological profile of patients in this service. Method: Data were collected from 827 patients between 2001 and 2015, using data from an interview, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Binge Eating Scale (BES). Results: The mean age of patients before surgery was 39 years+/- 10, the mean BMI was 51 kg/m²+7, and most patients (81%) were female. The average score on the BDI was 14.8+8 and women had significantly higher scores than men. On the BAI the average score was 11+8 and on the ECAP was 14+8, both with no difference between groups. Conclusions: Psychosocial characteristics of the patients points to the significant presence of indicators of depression, with low levels of anxiety and binge eating.

scholarly journals Factors Contributing to Increases in Prescription Drug Expenditures Borne by National Health Insurance in South Korea

2016 ◽  
Vol 57 (4) ◽  
pp. 1016 ◽  
Author(s):  
Jeong-Sook Jo ◽  
Young-Man Kim ◽  
Kyung Won Paek ◽  
Min Hee Bea ◽  
Kihong Chun ◽  
...  
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Prescription Drug ◽  
National Health Insurance ◽  
National Health ◽  
Drug Expenditures

scholarly journals Faktor-faktor yang berhubungan dengan pemberian air susu ibu eksklusif di Kabupaten Sleman

2017 ◽  
Vol 33 (8) ◽  
pp. 391
Author(s):  
Safitri Dwicahyani ◽  
Yayi Suryo Prabandari
Keyword(s):  
Health Insurance ◽  
Exclusive Breastfeeding ◽  
Maternal Education ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Dominant Factor ◽  
Cross Sectional ◽  
Lactating Mothers ◽  
Health Promotion Programs ◽  
To Receive

Determinants of exclusive breastfeeding in SlemanPurposeThe purpose of this paper was to determine the factors associated with the exclusive provision of breast milk in Sleman.MethodsA cross-sectional study was conducted using secondary data derived from HDSS Sleman Cycles I and II. The sample in this study were 218 mothers with children aged 7 to <24 months.ResultsThe ownership of health insurance and the use of bottles and pacifiers were significantly associated with exclusive breastfeeding. Maternal age, maternal education, and maternal occupation were not significantly associated with exclusive breastfeeding. Mothers with health insurance are 2.14 times more likely to exclusively breastfeed than those without health insurance. Infants who never use bottles, and pacifiers before the age of 6 months are 5.14 times more likely to receive exclusive breastfeeding than those who used bottles / dots before the age of 6 months.ConclusionThe use of bottles, and pacifiers is the most dominant factor associated with exclusive breastfeeding. Coverage of health insurance, especially in pregnant and lactating mothers and effective health promotion programs related to exclusive breastfeeding needs to be improved. HDSS Sleman needs to analyze the data more in-depth on exclusive breast-feeding.

scholarly journals Trends and Differentials in Receipt of Sexual and Reproductive Health Services in the United States: Services Received and Sources of Care, 2006–2019

2021 ◽  
Author(s):  
Jennifer J. Frost ◽  
Jennifer Mueller ◽  
Zoe H. Pleasure
Keyword(s):  
Health Insurance ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
The United States ◽  
Reproductive Age ◽  
Hiv Care ◽  
Publicly Funded ◽  
Private Providers ◽  
Contraceptive Services ◽  
To Receive

Key Points Seven in 10 U.S. women of reproductive age, some 44 million women, make at least one medical visit to obtain sexual and reproductive health (SRH) services each year. While the overall number of women receiving any SRH service remained relatively stable between 2006–2010 and 2015–2019, the number of women receiving preventive gynecologic care fell and the number receiving STI testing doubled. Disparities in use of SRH services persist, as Hispanic women are significantly less likely than non-Hispanic White women to receive SRH services, and uninsured women are significantly less likely to receive services than privately insured women. Publicly funded clinics remain critical sources of SRH care for many women, with younger women, lower income women, women of color, foreign-born women, women with Medicaid coverage and women who are uninsured especially likely to rely on publicly funded clinics. Among women who go to clinics for SRH care, two-thirds report that the clinic is their usual source for medical care. Among those relying on both private providers and public clinics, the proportion of women who reported receiving a combination of contraceptive and STI/HIV care increased between 2006–2010 and 2015–2019. Implementation of the Affordable Care Act has likely contributed to some of the changes observed in where women receive contraceptive and other SRH services and how they pay for that care: The share of women receiving contraceptive services who go to private providers rose from 69% to 77% between 2006–2010 and 2015–2019, in part because more women gained private or public health insurance coverage and there was a greater likelihood that their health insurance would cover SRH services. There was a complementary drop in the share of women receiving contraceptive services who went to a publicly funded clinic, from 27% in 2006–2010 to 18% in 2015–2019. For non-Hispanic Black women, immigrant women and uninsured women, there was no increase in the use of private providers for contraceptive care from 2006–2010 to 2015–2019. Among women served at publicly funded clinics between 2006–2010 and 2015–2019, there were significant increases in the use of both public and private insurance to pay for their care.

scholarly journals Modeling a Bridge When Survey Questions Change: Evidence from the Current Population Survey Health Insurance Redesign

2019 ◽  
Vol 35 (1) ◽  
pp. 189-202
Author(s):  
Brett O’Hara ◽  
Carla Medalia ◽  
Jerry J. Maples
Keyword(s):  
Health Insurance ◽  
Current Population Survey ◽  
Time Trend ◽  
Population Survey ◽  
The United States ◽  
Community Survey ◽  
Historical Time ◽  
Current Population ◽  
Using Data ◽  
The Impact

Abstract Most research on health insurance in the United States uses the Current Population Survey Annual Social and Economic Supplement. However, a recent redesign of the health insurance questions disrupted the historical time trend in 2013. Using data from the American Community Survey, which has a parallel trend in the uninsured rate, we model a bridge estimate of the uninsured rate using the traditional questions. Also, we estimate the effect of changing the questionnaire. We show that the impact of redesigning the survey varies substantially by subgroup. This approach can be used to produce bridge estimates when other questionnaires are redesigned.

scholarly journals Inflation and Price Escalation Adjustments in Estimating Program Cost: F-35 Case Study

2020 ◽  
Vol 27 (92) ◽  
pp. 194-217
Author(s):  
Stanley Horowitz ◽  
Bruce Harmon
Keyword(s):  
Price Index ◽  
Hedonic Price ◽  
Cost Estimating ◽  
Program Cost ◽  
Defense Systems ◽  
Price Indexes ◽  
Acquisition Costs ◽  
Using Data ◽  
Price Escalation

Applying price indexes presents a challenge in estimating the costs of new defense systems. An inappropriate price index—one not closely linked to the inputs to the systems being costed—can introduce errors in both development of cost estimating relationships (CER) and in development of out-year budgets. To help cost analysts understand the impacts of different price indexes, this article applies two sets of price indexes to the F-35 program. Using hedonic price indexes derived from CERs, the authors isolate changes in price due to factors other than changes in quality by developing a “Baseline” CER model using data on historical tactical aircraft programs available early in the F-35 program. The focus of the work is to improve estimates of acquisition costs. All the data used in the econometric analysis are acquisition cost data. Better cost estimates should improve projections of budget requirements.

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