This is a theoretical paper examining the effect of user fee on patients’ welfare and social welfare under three forms of provider reimbursements: full cost, prospective payment and cost sharing. The paper extends Ri...This is a theoretical paper examining the effect of user fee on patients’ welfare and social welfare under three forms of provider reimbursements: full cost, prospective payment and cost sharing. The paper extends Rickman and McGuire (1999) by introducing user fee to the public sector and maintaining the assumption that providers can work in both the private and public health sectors. Contrary to previous studies, this study shows that efficiency is possible under the full cost reimbursement. The paper also shows the conditions under which efficiency is possible under each reimbursement scheme. Patient’s welfare can improve with the introduction of user fee when services in the public and private sector are complementary.展开更多
Early discharge policy, common in the developed countries, refers to the reduction of hospital length of stay as a way of reducing the cost of care. The effect of the policy on quality of care has received a lot of at...Early discharge policy, common in the developed countries, refers to the reduction of hospital length of stay as a way of reducing the cost of care. The effect of the policy on quality of care has received a lot of attention in the literature. Some of the earlier papers have ignored the endogeneity of length of stay in the readmission equation, an approach that could lead to inconsistent estimation. This study develops a statistical technique for the consistent estimation of the effect of the early discharge policy. An instrument that can be used extensively across different diagnostic groups is provided, hence solving the difficult problem of finding an instrument for length of stay. The exogeneity test in Gorgger (1990), the test for weak instruments in Staiger and Stock (1997) as well as the Hensen (1982) for over identification confirmed respectively that length of stay is endogenous the instrument is strong and the valid.展开更多
The difficulty of assessing funds to directly fund healthcare for the poor makes governments adopt user fee in the health system. Many studies have shown how user fee can cause the poor to under utilize healthcare but...The difficulty of assessing funds to directly fund healthcare for the poor makes governments adopt user fee in the health system. Many studies have shown how user fee can cause the poor to under utilize healthcare but not on how it can lead to the waste of resources. The current study is theoretical and it examines the efficiency of regulated user fee and the factors affecting the efficiency. Efficiency focused mainly on the extent to which resources are wasted as a result of regulated user fee. The results show that the asymmetric information between the provider of healthcare and the patient combined with the costliness of investigation by the government as well as the costliness of revenue collection caused three sources of waste: excessive treatment of the rich or the non-poor, investigation and revenue collection. Comparative statics were done to examine the effect of various factors on the level of waste. The study then examined the conditions under with regulated user fee is more efficient than direct financing of healthcare by the government. Some recommendations were made to reduce wastes.展开更多
文摘This is a theoretical paper examining the effect of user fee on patients’ welfare and social welfare under three forms of provider reimbursements: full cost, prospective payment and cost sharing. The paper extends Rickman and McGuire (1999) by introducing user fee to the public sector and maintaining the assumption that providers can work in both the private and public health sectors. Contrary to previous studies, this study shows that efficiency is possible under the full cost reimbursement. The paper also shows the conditions under which efficiency is possible under each reimbursement scheme. Patient’s welfare can improve with the introduction of user fee when services in the public and private sector are complementary.
文摘Early discharge policy, common in the developed countries, refers to the reduction of hospital length of stay as a way of reducing the cost of care. The effect of the policy on quality of care has received a lot of attention in the literature. Some of the earlier papers have ignored the endogeneity of length of stay in the readmission equation, an approach that could lead to inconsistent estimation. This study develops a statistical technique for the consistent estimation of the effect of the early discharge policy. An instrument that can be used extensively across different diagnostic groups is provided, hence solving the difficult problem of finding an instrument for length of stay. The exogeneity test in Gorgger (1990), the test for weak instruments in Staiger and Stock (1997) as well as the Hensen (1982) for over identification confirmed respectively that length of stay is endogenous the instrument is strong and the valid.
文摘The difficulty of assessing funds to directly fund healthcare for the poor makes governments adopt user fee in the health system. Many studies have shown how user fee can cause the poor to under utilize healthcare but not on how it can lead to the waste of resources. The current study is theoretical and it examines the efficiency of regulated user fee and the factors affecting the efficiency. Efficiency focused mainly on the extent to which resources are wasted as a result of regulated user fee. The results show that the asymmetric information between the provider of healthcare and the patient combined with the costliness of investigation by the government as well as the costliness of revenue collection caused three sources of waste: excessive treatment of the rich or the non-poor, investigation and revenue collection. Comparative statics were done to examine the effect of various factors on the level of waste. The study then examined the conditions under with regulated user fee is more efficient than direct financing of healthcare by the government. Some recommendations were made to reduce wastes.
