Efficiency of health care delivery systems: effects of health insurance coverage

Health insurance expansions may increase the demand for care-creating incentives for health systems to increase input consumption. The possibility remains that added capacity and personnel will have little effect on health outcomes, decreasing the technical efficiency of health care delivery systems. We estimate that a 1 percentage point increase in health insurance coverage decreases the technical efficiency of health care delivery by 1.3 percentage points, translating into approximately 50 billion dollars in additional health expenditures. This finding uncovers a previously unexplored consequence of changes in health insurance on the supply side of health care markets suggesting one avenue through which health care costs growth may occur.     

Evaluation of national science park systems: a theoretical framework and its application to the Italian and Spanish systems

Although many authors have analysed the role and the efficiency of science parks, only a few contributions have analysed national science park systems (SPSs) as a whole. Because of the lack of data, evidence regarding the performance of science parks in a nation is very limited and there is a lack of comparisons between different systems. This paper aims to introduce a simple framework to analyse SPSs and to show its use for comparing the state of development and the main differences of two or more SPSs. Its application to the Italian and Spanish systems shows that science parks play a more important role in Spain than in Italy. The main causes of these differences are argued to be (i) the presence of a set of coherent and particular policies which favour science parks in Spain and (ii) the internal factors of the Spanish science park system, including business models of the science parks and the role of the national association.     

Principal Features of Building Social Accounts Matrix and Improving Statistical Database for Eco-countries

With common borders of the population, total area, and GDP （PPP-based） of Economic Cooperation Organization （ECO） member states are estimated as 416 million persons, 7.9 million m2, and US$2.7 trillion respectively （2010 data）. Although heterogeneous in the extent, there is economic development, overall, with serious energy and transport-transit relations among countries that is reflected in growing trade turnover year-by-year. However, there are still rather unused resources and capacity in such areas of cooperation among countries as exchange of energy, transport services, agricultural and industrial goods, use of opportunities for tourism, promoting investment and innovation processes and other areas. Certainly, maximum and optimal use of these resources calls for availability of analytical means capable of accounting for relations both within member states and among them. The implementation of computable general equilibrium （CGE） modeling in each member state would thus be of great significance in resolution of these problems both in terms of accounting for input-output linkages within the countries as well as enabling impact of main trading partners and goods and services among countries. The analysis carried out indicates that there are a number of problems in application of CGE model in most of the member states. As such, input-output tables are not compiled in some countries, while in others despite the fact that these tables are compiled, there are no attempts to build the model, yet in other countries, even if the CGE model is implemented, there are difficulties in taking into account the real results in the face of serious problems related to improving national accounts system database. Summarizing these problems, it is possible to conclude that to ensure the application of a CGE model,there is a great need to work out procedures of compilation of a social accounts matrix （SAM） that lies on the basis of this model, for which the relevant statistics of a member state must be improved     

The effects of economic freedom on FDI inflows: an empirical analysis

There is a regular emphasis on the significant role of inward Foreign Direct Investment (FDI) in promoting economic growth. This favourable relationship has induced many governments to adopt policies intended to increase FDI inflows and, thereby, to create conducive business and economic conditions for Multinational Enterprises (MNEs). This paper examines the effects of Economic Freedom (EF) and its sub-components reflecting the Quality of Institutions (QIs) on FDI inflows, using indices derived from the Fraser Institute and from the Heritage Foundation. The empirical analysis is carried out for a panel dataset using different econometric methodologies and empirical specifications. The results underline positive effects of EF on FDI inflows. They reveal that EF sub-components have varying impacts on FDI inflows, where rule of law, market openness, and less-restrictive regulatory environment stand out as the major FDI-promoting institutional factors. Also, there is an empirical evidence that the effects of EF sub-components on FDI inflows exhibit variations through the economic characteristics of the host countries and across geo-economic regions. The results suggest that governments should pursue EF-improving policies, which should be tailored according to the economic and geo-economic characteristics of the host countries, to increase FDI inflows.     

The relative efficiency of schizophrenia health care systems: an international comparison using data envelopment analysis

Abstract

Aim

To compare the health economic efficiency of health care systems across nations, within the area of schizophrenia, using a data envelopment analysis (DEA) approach.     

Restructuring financial systems in transition and developing economies: an approach based on the French financial system

The aim of this paper is to contribute to the debate on the redesigning of financial systems in Central and Eastern European and developing countries by focusing attention on specific financial institutions appropriate to easing the transition and fostering the creation of markets. The paper argues that the immediate emulation of the better-known institutions of the most developed, market-based financial systems, i.e. the US and the UK, should not be taken for granted. It underlines, instead, the importance of drawing inspiration from the experiences of a variety of institutions and financial systems. Particularly relevant are those systems that have experienced forms of transition and a mix, over time, of market and state intervention.
The approach of this paper is one of institutional financial economics (Neave, 1991 and Williamson, 1986), in which structural details of financial institutions and contracts, in our case French financial institutions, are analysed. We argue that the principles on which some French financial institutions are based and aspects of their functioning are of value to reformers. We discuss the lessons that can be learnt from the Crédit National, the Commissariat Général du Plan, the CODEVI and the SOFARIS.     

The effects of national culture on corporate social responsibility disclosure: a cross-country comparison

This article presents a cross-country analysis of the influence of national culture on corporate social responsibility (CSR) disclosure. We analyse the relationship between the Hofstede’s cultural dimensions and the sustainability disclosure with the GDP per capita (GDPPC) of 44 countries, using panel data with information based on the Global Reporting Initiative guidelines. The governance effectiveness and the foreign direct investment are also included in the analysis. The results show that in countries with higher GDPPC, the CSR disclosure is negatively related to individualism and masculinity and positively related to uncertainty avoidance and indulgence. When focusing in countries with lower GDPPC, the results suggest that CSR disclosure is negatively related to power distance and positively related to uncertainty avoidance. Moreover, five of the six Hofstede’s cultural dimensions negatively affect sustainability disclosure in countries with middle GDPPC.     

The effects of technological development on the labor share of national income

In this article, we analyze the effects of increasing automation in production processes on the labor share of national income. For the analyses, we use the DSGE model which contains both the physical capital and the human capital accumulation equations. We improve the model by defining productivity variables for both investment-specific technology and educational activities. In all simulations of the model except base scenario, we give more positive shock to the investment-specific technology compared to the educational activities. In each new simulation, we augment the difference between the shocks to determine the effects of increasing automation on the labor share of national income. The results show that increasing the shock difference decreases the labor share of national income, and this confirms the decline in the labor share of national income in both developed and developing countries since the 1980s.     

The impact of regional competition on the health care industry

We investigate factors that determine firm markups by employing data on prices and quantities of various medical procedures at major hospitals in the United States. We focus on the impact of hospital quality, rival competition and the number of medical procedures upon the health care demand. Our analysis covers health-care markets across the United States with the market definition based upon the hospital referral regions. Our findings highlight potential implications of the relationship between hospital markups and market structure.     

The effects and policy implications of state aids to industry: an economic analysis

The use of state aids to industry is a poorly understood part of competition policy. Currently, the EU Commission presumes that state aids distort competition, yet it approves 98% of applications, often for social or distributional reasons. We argue that proper regulation of state aids should focus on two issues, the externalities generated and the inefficiencies arising from failures in competition between governments. We thus develop a new framework for EU policy and compare its implications with the existing practice of the EU Commission.     

The effectiveness of government spending on education and health care in developing and transition economies

Recent studies show that corruption is associated with higher military spending [Eur. J. Polit. Econ. 17 (2001) 794] and lower government spending on education and health care [J. Publ. Econ. 69 (1998) 263]. This suggests that policies aimed at reducing corruption may lead to changes in the composition of government outlays toward more productive spending. However, little empirical evidence has been presented to support the claim that public spending improves education and health indicators in developing and transition countries. This paper uses cross-sectional data for 50 such countries to show that increased public expenditure on education and health care is associated with improvements in both access to and attainment in schools, and reduces mortality rates for infants and children. The education regressions are robust to different specifications, but the relationship between health care spending and mortality rates is weaker.     

Examining the global environmental impact of regional consumption activities — Part 1: A technical note on combining input-output and ecological footprint analysis

In recent years there have been a number of attempts to develop a more comprehensive approach to the issue of measuring resource use and/or pollution generation embodied in trade flows, including contributions that combine input-output techniques and Ecological Footprint analysis. In this two-part paper we describe how to enumerate the resource and/or pollution content of inter-regional and inter-national trade flows (Part 1) and we present a literature review of recent methodological and empirical developments (Part 2). It is straightforward in principle to extend the basic input-output approach to capture international trade flows. However, in practice, problems of data availability and compatibility, and of computability of extended input-output matrices, mean that simplifying assumptions are generally applied, but with the implications of these assumptions often not made fully explicit. What appears to be absent from previous applications is an account of the analytical method by which Ecological Footprints should ideally be estimated in an international input-output accounting analysis. This allows an explicit analysis of the problems that prevent the application of the full method and identification of the most appropriate short-cut methods in a transparent way. The objective of this paper is to provide such an account.     

The effects of multinationals on host economies: A CGE approach

This paper offers a new perspective regarding the effects on a host economy of the entry of multinational enterprises (MNEs). We use a computable general equilibrium (CGE) approach, through a version of the Global Trade Analysis Project (GTAP) model extended to incorporate MNEs. The analysis is applied to the Czech Republic, a country that has received substantial inflows of foreign direct investment in the last few years. A special attention has been paid to the issue of profit repatriation. We find that the negative effects of profit repatriation are sizeable, and might even offset the positive impact of the entry of MNEs.     

Spillover effects of FDI inflows on output growth: An analysis of aggregate and disaggregated FDI inflows of 13 MENA economies

This paper examines the effect of foreign direct investment (FDI) inflows on overall growth, as well as its sector-specific spillovers in the Middle Eastern and North African region during the period from 2000 to 2020. Our major innovation is our ability to disaggregate FDI into primary, secondary and tertiary and examine their individual impact on growth, as well as their sector-specific spillovers by using dynamic panel GMM methodology. We find prima facie evidence that total FDI significantly stimulates growth. However, when we turn to the disaggregated FDI data, primary sector FDI adversely affects the gross domestic product (GDP) growth in the service sector and overall GDP growth. On the other hand, secondary FDI has a ‘double-edged’ effect, benefiting its own sector (the service sector's GDP growth), but not other sectors. In contrast, service sector FDI stimulates GDP growth in mining, manufacturing and service sectors, thereby enhancing overall economic growth. Our findings have important policy implications regarding the incentives provided by governments to encourage FDI, which need to be fine-tuned to attract certain types of FDI (tertiary), with less focus on the primary sector     

The impact of recall periods on reported morbidity and health seeking behavior

Between 2000 and 2002, we followed 1621 individuals in Delhi, India using a combination of weekly and monthly-recall health questionnaires. In 2008, we augmented these data with another 8 weeks of surveys during which households were experimentally allocated to surveys with different recall periods in the second half of the survey. We show that the length of the recall period had a large impact on reported morbidity, doctor visits; time spent sick; whether at least one day of work/school was lost due to sickness and; the reported use of self-medication. The effects are more pronounced among the poor than the rich. In one example, differential recall effects across income groups reverse the sign of the gradient between doctor visits and per-capita expenditures such that the poor use health care providers more than the rich in the weekly recall surveys but less in monthly recall surveys. We hypothesize that illnesses – especially among the poor – are no longer perceived as “extraordinary events” but have become part of “normal” life. We discuss the implications of these results for health survey methodology, and the economic interpretation of sickness in poor populations.     

Impact of chondroitin sulphate on health utility in patients with knee osteoarthritis: towards economic analysis

Abstract

Objectives: The first objective was to assess the effect of the chondroitin 4 and 6 sulphate (CS) on health-related quality of life using utility values in patients with knee osteoarthritis (OA) during a 24-month treatment course. The second objective was, using these data, to conduct economic analyses.

Methods: Data from the STOPP study was used. This study was a randomised, double-blind, placebo (PL) -controlled trial of 2-year duration. In the STOPP study, authors assessed quality of life using the Western Ontario and McMaster Osteoarthritis Index (WOMAC). WOMAC scores were translated into Health Utility Index (HUI) scores using a specific formula. Incremental cost effectiveness ratio (ICER) was calculated taking into account the cost of CS and its effect on HUI scores, compared to PL.

Results: At baseline, the mean (SD) HUI scores were 0.59 (0.17), and 0.59 (0.18) for the PL and CS groups, respectively (p=0.31 between the two groups). The mean (SD) HUI scores changes from baseline to 6 months were 0.02 (0.02), and 0.05 (0.01) for the PL and CS groups, respectively (p=0.03). After 24 months of follow-up, HUI score increases by 0.04 (0.02) in the PL group and by 0.05 (0.02) in the CS group (p=0.37). Using the price bracket of CS in Europe, ICER assessment always resulted in a cost below €30,000 per QALY gained, after 6, 12 and 24 months of treatment.

Conclusion: CS treatment increases health utilities in patients with knee OA compared to PL over the first 6 months of treatment. Economic evaluation based on these data suggests that CS treatment could be considered as cost-effective in patients with knee OA up to a period of 24 months. A limitation in this study is the absence of direct utility assessment as well as the absence of effective treatment as comparator.     

The effects of public health spending on self-assessed health status: an ordered probit model

This paper explores the relationship between public health expenditure and self-assessed health status. Medical resources are imputed according to where individuals reside. The analysis draws upon data from the 1993 National Health Survey. Controlling for a number of individual characteristics, which also determine health status, the estimations indicate that increases in public health expenditure significantly improve both physiological and physical health. The results remain consistent when the model is reestimated and the change in the probability at the mean of the independent variable is calculated.     

The effects of land market development on economic growth： an empirical analysis based on Chinese panel data, 1999-2005

Optimized land resources allocation is important for economic growth because land is one of the basic elements for economic development. And urban land resources allocation has had an increasingly important influence since the Chinese socialist market economy system was established. This paper estimates the production function of both the secondary and the tertiary industries of China＇s 31 provinces, autonomous regions and municipalities directly under the central government through an analysis of the panel data of the total output value of the secondary and the tertiary industries, invested capital, invested labor jorces and the land market-jeatured management of the above-mentioned regions during the period of 1999-2005. and examines the positive influence of the above- mentioned factors on regional economic output, This study concludes that urban economic output is positively related with the level of urban land resources market-featured management, since the rate of economic growth of those regions approximates 14. 7% under the condition of urban land market running during the period of 1999-2005.     

Effects of health insurance on labour supply: evidence from the health care fund for the poor in Vietnam

The expansion of health insurance in emerging countries raises concerns about the unintended negative effects of health insurance on labour supply. This article examines the labour supply effects of the Health Care Fund for the Poor (HCFP) in Vietnam in terms of the number of work hours per month and labour force participation (the probability of employment). Employing various matching methods combined with a Difference-in-Differences approach on the Vietnam Household Living Standard Surveys 2002–2006, we show that the HCFP, which aims to provide poor people and disadvantaged minority groups with free health insurance, has a negative effect on labour supply. This is manifested in both the average number of hours worked per month and the probability of employment, suggesting the income effect of the HCFP. Interestingly, the effects are mainly driven by the non-poor recipients living in rural areas, raising the question of the targeting strategy of the programme.     

The economic effects of a counterinsurgency policy in India: A synthetic control analysis

Using the synthetic control method, we analyze the economic effects of a unique counterinsurgency response to the Naxalite insurgency in India. Of all the states affected by Naxalite violence, only one state, Andhra Pradesh, raised a specially trained and equipped police force in 1989 known as the Greyhounds, dedicated to combating the Naxalite insurgency. Compared to a synthetic control region constructed from states affected by Naxalite violence that did not raise a similar police force, we find that the per capita NSDP of Andhra Pradesh increased significantly over the period 1989–2000. Further, we find that the effects on the manufacturing sector are particularly strong. Placebo tests indicate that these results are credible and various difference-in-difference specifications using state and industry level panel data further corroborate these findings.