Environmental pollution, population aging and social medical insurance fund expenditure

2021 ◽  
Vol 8 (1) ◽  
pp. 599-609
Author(s):  
XU SI
Keyword(s):  
Health Care ◽  
Environmental Pollution ◽  
Health Care Cost ◽  
Population Aging ◽  
Clean Energy ◽  
Medical Insurance ◽  
Health Care Expenditures ◽  
Insurance Fund ◽  
Social Medical Insurance ◽  
The Impact

Although China's economy has maintained rapid growth since 21st century, the problem of environmental pollution has become increasingly serious. Environmental pollution has a serious impact on people in all aspects of clothing, food, housing and transportation. Based on the panel data of 31 provinces and regions in China from 2005 to 2017, this paper establishes a fixed-effect model and divides China into three regions of central, east and west and analyzes the impact of environmental pollution and the population aging on the expenditure of China's social medical insurance funds (SMIF). The study found that the more severe environmental pollution, the worse health status of the residents, then induces the higher SMIF; the more serious aging of population, the higher risk of disease and cause higher SMIF. It is recommended to innovate clean energy technologies, increase environmental governance, in order to reduce health care expenditures and restrain the increase of the health care cost.

Health Care Cost Growth

2011 ◽  
pp. 307-328 ◽  
Author(s):  
Michael E. Chernew ◽  
Dustin May
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Population Aging ◽  
Health Care Systems ◽  
Developed Countries ◽  
The United States ◽  
Care Utilization ◽  
Care Plans ◽  
Cost Growth ◽  
The Impact

Health care cost growth is among the most important issues facing the United States and other developed countries. This article describes the rapid growth in expenditure in most developed countries, and discusses the factors that have driven this growth, such as population aging, general economic growth, and the adoption and use of new medical technologies. The public financing aspect of health care spending adds an additional dimension to assessing the impact of rapid health care cost growth. The article considers a range of strategies for slowing cost growth, including economic evaluation of technologies. Most health care systems employ some method of cost sharing as a means to reduce health care utilization. This article also discusses managed care plans that integrate the financing and delivery of care. However, as costs grow, pressures to control spending will grow and distributional issues will become even more salient.

scholarly journals Why Do Some Firms Spend So Much on Medical Care? Accounting for Variation

2000 ◽  
Vol 3 (1) ◽  
Author(s):  
Matthew Eichner ◽  
Mark McClellan ◽  
David A. Wise
Keyword(s):  
Health Care ◽  
Health Care Cost ◽  
Health Care Expenditures ◽  
Cost Of Treatment ◽  
Consistent Method ◽  
The Difference ◽  
The Cost ◽  
Cost Differences ◽  
Average Expenditure

We are engaged in a long-term project to analyze the determinants of health care cost differences across firms. An important first step is to summarize the nature of expenditure differences across plans. The goal of this article is to develop methods for identifying and quantifying those factors that account for the wide differences in health care expenditures observed across plans.We consider eight plans that vary in average expenditure for individuals filing claims, from a low of $1,645 to a high of $2,484. We present a statistically consistent method for decomposing the cost differences across plans into component parts based on demographic characteristics of plan participants, the mix of diagnoses for which participants are treated, and the cost of treatment for particular diagnoses. The goal is to quantify the contribution of each of these components to the difference between average cost and the cost in a given firm. The demographic mix of plan enrollees accounts for wide differnces in cost ($649). Perhaps the most noticeable feature of the results is that, after adjusting for demographic mix, the difference in expenditures accounted for by the treatment costs given diagnosis ($807) is almost as wide as the unadjusted range in expenditures ($838). Differences in cost due to the different illnesses that are treated, after adjusting for demographic mix, also accounts for large differences in cost ($626). These components of cost do not move together; for example, demographic mix may decrease expenditure under a particular plan while the diagnosis mix may increase costs.Our hope is that understanding the reasons for cost differences across plans will direct more focused attention to controlling costs. Indeed, this work is intended as an important first step toward that goal.

The relationships between obesity-increasing risk factors for public health, environmental impacts, and health expenditures worldwide

2018 ◽  
Vol 29 (1) ◽  
pp. 131-147 ◽  
Author(s):  
Eduardo Botti Abbade
Keyword(s):  
Public Health ◽  
Health Care ◽  
Environmental Impact ◽  
Environmental Impacts ◽  
Health Care Cost ◽  
Health Care Systems ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Public Health Care ◽  
Content Type

Purpose The purpose of this paper is to investigate the associations between obesogenic severity, the public health situation, environmental impacts, and health care expenditures in populations worldwide. Design/methodology/approach This ecological study is based on official data available for approximately 140 countries worldwide. This study defines four main variables: obesogenic severity, environmental impact, public health implications (PHI), and health expenditures, all measured through specific indicators. Data were obtained mainly from the WHO, World Bank, and IDF. The indicators were reduced to the main variables through factorial reduction and multiple regression analyses were used to test the main hypotheses. Findings Obesogenic severity strongly and positively affects environmental impacts (β=0.6578; p<0.001), PHI-1 (cardiovascular risk factor) (β=0.3137; p<0.001) and PHI-2 (blood glucose and diabetes diagnoses) (β=0.3170; p<0.001). Additionally, environmental impacts strongly and positively affect PHI-1 (β=0.4978; p<0.001) but not PHI-2. Thus, results suggest that environmental impact, PHI-1, and PHI-2 strongly affect health expenditures (β=0.3154; p<0.001, β=0.5745; p<0.001, and β=−0.4843; p<0.001, respectively), with PHI-2 negatively affecting the health expenditures. Practical implications This study presents evidence that can aid in decision making regarding public and private efforts to better align budgets and resources as well as predict the needs and expenditures of public health care systems. Originality/value This investigation finds that the main variables addressed are strongly associated at the worldwide level. Thus, these analytical procedures can be used to predict public health and health care cost scenarios at the global level.

scholarly journals The Effect of Initiation of Anti-TNF Therapy on the Subsequent Direct Health Care Costs of Inflammatory Bowel Disease

2019 ◽  
Vol 25 (10) ◽  
pp. 1718-1728 ◽  
Author(s):  
Laura E Targownik ◽  
Eric I Benchimol ◽  
Julia Witt ◽  
Charles N Bernstein ◽  
Harminder Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Expenditures ◽  
Population Based ◽  
World Population ◽  
Median Cost ◽  
Future Health ◽  
Before And After ◽  
Future Health Care ◽  
The Cost ◽  
The Impact

Abstract Background Anti–tumor necrosis factor (anti-TNF) drugs are highly effective in the treatment of moderate-to-severe Crohn’s disease (CD) and ulcerative colitis (UC), but they are very costly. Due to their effectiveness, they could potentially reduce future health care spending on other medical therapies, hospitalization, and surgery. The impact of downstream costs has not previously been quantified in a real-world population-based setting. Methods We used the University of Manitoba IBD Database to identify all persons in a Canadian province with CD or UC who received anti-TNF therapy between 2004 and 2016. All inpatient, outpatient, and drug costs were enumerated both in the year before anti-TNF initiation and for up to 5 years after anti-TNF initiation. Costs before and after anti-TNF initiation were compared, and multivariate linear regression analyses were performed to look for predictors of higher costs after anti-TNF initiation. Results A total of 928 people with IBD (676 CD, 252 UC) were included for analyses. The median cost of health care in the year before anti-TNF therapy was $4698 for CD vs $6364 for UC. The median cost rose to $39,749 and $49,327, respectively, in the year after anti-TNF initiation, and to $210,956 and $245,260 in the 5 years after initiation for continuous anti-TNF users. Inpatient and outpatient costs decreased in the year after anti-TNF initiation by 12% and 7%, respectively, when excluding the cost of anti-TNFs. Conclusions Direct health care expenditures markedly increase after anti-TNF initiation and continue to stay elevated over pre-initiation costs for up to 5 years, with only small reductions in the direct costs of non-drug-related health care.

The Impact of Contract Primary Care on Health Care Expenditures and Quality of Care

2007 ◽  
Vol 65 (3) ◽  
pp. 300-314 ◽  
Author(s):  
Chuan-Fen Liu ◽  
Michael K. Chapko ◽  
Mark W. Perkins ◽  
John Fortney ◽  
Matthew L. Maciejewski
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Quality Of Care ◽  
Health Care Expenditures ◽  
The Impact

scholarly journals The Impact of Environmental Pollution on the Health of Middle-Aged and Older Adults in China

2021 ◽  
Author(s):  
Hongli Fan ◽  
Yingcheng Wang ◽  
Ying Wang ◽  
Peter C Coyte
Keyword(s):  
Older Adults ◽  
Environmental Pollution ◽  
Fixed Effects ◽  
Elderly Women ◽  
Population Aging ◽  
Pollution Prevention ◽  
Fixed Effects Model ◽  
Middle Aged ◽  
The Government ◽  
The Impact

Abstract While several studies have demonstrated the negative impacts of environmental pollution on population health, in general, few studies have examined the potential differential effects on the health of middle-aged and older populations, i.e. 45 years and older. Given the twin concerns of environmental pollution and population aging in China, this article employed a fixed effects model to infer the impact of environmental pollution on public health with a particular focus on middle-aged and older adults. The analyses were based on data from the 2011–2018 waves of the CHARLS and pollutant data from prefecture-level cities. The results showed that environmental pollution significantly increased the risk of chronic diseases and negatively impacted the health of middle-aged and older adults. Environmental pollution had its greatest negative effect on the health of the elderly, women, urban residents and those with lower incomes than for their counterparts. We further found that the main channels of effect were through reduced physical exercise and an increase in depressive symptoms, and the pollution prevention actions alleviated the health deterioration of environmental pollution for the middle-aged and elderly. It is imperative for the government to urgently reinforce policy's enforcement to decrease air and water pollution, and enhance the ability to circumvent pollution for the lower socioeconomic groups.

scholarly journals Does Social Medical Insurance Achieve a Poverty Reduction Effect in China?

2022 ◽  
Vol 9 ◽  
Author(s):  
Ji-Le Sun ◽  
Ran Tao ◽  
Lei Wang ◽  
Li-Min Jin
Keyword(s):  
Utility Maximization ◽  
Poverty Reduction ◽  
Positive Impact ◽  
Medical Insurance ◽  
Causal Link ◽  
Insurance Reform ◽  
Insurance Reimbursement ◽  
Reduction Effect ◽  
Social Medical Insurance ◽  
The Impact

This paper aims to explore the impact of social medical insurance (SMI) on poverty reduction (PR) in China. Considering the time-varying characteristics of factors, this paper uses the bootstrap Granger full sample causality and subsample rolling window model to find the relationship between SMI and PR. The results highlight that in some periods, there is a bidirectional causal link between SMI and PR. Influenced by the medical insurance reform and medication measures. Social medical insurance does not have a positive impact on poverty reduction in some periods. These results are supported by the Utility Maximization Model of Insurance Consumption, which highlights that individuals make utility maximization choices when choosing insurance. The effect of medical insurance on poverty alleviation depends on whether an individual's investment in medical insurance can maximize its utility. If the proportion of social medical insurance reimbursement is too low, individuals will give up buying social medical insurance. Thus, the anti-poverty effect of social medical insurance is difficult to achieve. Therefore, authorities need to pay attention to specific contexts and social medical insurance policies and further improve the social medical insurance system to promote the realization of the anti-poverty of social medical insurance.

scholarly journals Application of Smart Healthcare in LTCI, Outpatient Mutual-Aid Guarantee Mechanism, and Sustainability of Medical Insurance Fund for Urban Employees

2022 ◽  
Vol 2022 ◽  
pp. 1-10
Author(s):  
Yating Ren ◽  
Zhe Yang
Keyword(s):  
Long Term Care ◽  
Population Aging ◽  
Medical Insurance ◽  
Insurance Fund ◽  
Mutual Aid ◽  
Care Needs ◽  
Term Care ◽  
Smart Healthcare ◽  
Long Run

With the aggravation of population aging and the increase of life expectancy, long-term care insurance (LTCI) system has been established to meet the medical and long-term care needs of the increasing elderly population. In China, LTCI system is currently not a stand-alone insurance, but it is attached to the national basic medical insurance fund for urban employees (MIUE). As a result, the expenditure of LTCI is a part of the expenditure of the MIUE, which has an impact on the sustainability of the MIUE. By modeling the income and expenditure of MIUE, especially including the expenditure of LTCI, this study optimized an LTCI system with a higher individual out-of-pocket payment ratio of LTCI and implementation of the outpatient mutual-aid guarantee mechanism (OMAGM), which could improve the sustainability of the MIUE. The study also reveals the following: (i) solely increasing individual out-of-pocket payment ratio of LTCI to 20%–50% can only postpone the deficit on Social Pooling Accounts (SPAs) by 1 or 2 years, and the effect is very limited. (ii) Besides a higher individual out-of-pocket payment ratio, further implementation of a partial OMAGM from 2022 will postpone the deficit on SPAs by 7–9 years, and the implementation of a complete OMAGM from 2022 will postpone the deficit by 14–18 years. Accordingly, China should implement OMAGM as soon as possible to enhance the solvency of MIUE fund, and, in the long run, an independent LTCI scheme should be established to ensure the stability and sustainability of the LTCI fund and the MIUE fund.

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