The purpose of the study is to determine what effect medicare has had on the distribution of public health care expenditures in the state of Oklahoma. The study tests that there is a significant correlation between medical vendor payments and indigency in Oklahoma or in other words that pre-medicare public health care dollars in Oklahoma were distributed to indigents.

Chronic liver disease is an important disease which affects national healthy in Taiwan. Hepatitis B or C virus infection is strongly relative to chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. However, the early effective treatment can decrease the progression of liver cirrhosis and hepatocellular carcinoma and increase the recovery rate. In order to promote the health care quality for the patients with hepatitis, Bureau of National Health Insurance (BNHI) implemented the ¡§Enhance Hepatitis B or C Health Care Program¡¨ in October of 2003. The new policy sets up the standard treatment models and pay medical costs to encourage the patients to participate this program and fit cost-effectiveness. Therefore, aims of the study are to estimate the effects of the new policy on health care utilization and expenditures for the patients with hepatitis B or C. The study used the database from Bureau of National Health Insurance (BNHI) in 2002 and 2004. The study sample is the patients with hepatitis B or C who enrolled the program from January to June in 2004. We compared the differences of health care utilization and expenditures with these statistics in 2002. Besides, we also analyzed the difference in the characteristics of the patients and hospitals. In health care utilization, we found that number of visits was increased but interval between visits was decreased. Total costs, costs of treatments, prescriptions, total claim amount, and averages of prescription costs in health care expenditures were all increased significantly after the new policy implemented. Otherwise, there were not different on health care utilization and expenditures between different gender and level of the hospitals. On the other hand, there were significantly correlation of ages and number of comorbility. It means that the patients¡¦ ages are older, and their number of visits and total costs are higher but interval between visits is shorter than younger. Furthermore, number of comorbility increases and then interval between visits become short. The new policy certainly affects the health care utilization and expenditures of patients with hepatitis B or C. Implementing the new program can encourage patients adopt treatment actively and physicians have standard treatment protocols to follow. Understanding the changes on health care utilization and expenditures can give a health care guideline of cost-effectiveness. In conclusion, the results can provide the information about payments on patients with hepatitis to BNHI and then use it to be a basis after the new program implemented. Moreover, other countries also can evaluate the implementation of the new policy based on our results.

Diploma thesis "Health care expenditures- future prospects and current situation" is focused on three areas linked to health care expenditures in EU and USA. First area, health expenditures financing, is analyzed in first chapter of the thesis. In the chapter, the development of modern health systems from its beginnings to 2014 is described. Second chapter is based on statistical hypothesis testing- paired two-sample t-tests. Firstly, share of health expenditures on GDP in 2000 and 2014 is tested. Secondly, share of public financing on health expenditures in 2000 and 2014 in tested. Third chapter explores influence of demography factors on health care expenditures and tests structure of health care expenditures in 2004 and 2013.

Objective: To estimate the national prevalence and direct incremental expenditures of musculoskeletal disorders (MSD's) using the 2007 Medical Expenditure Panel Survey data. <br>Methods: A retrospective database analysis was conducted and individuals with MSD's (ICD-9-CM codes 274.00; 710.00-738.00) were identified. Dependent variables were total health care and other service category expenditures. The study utilized descriptive and regression analyses. <br>Results: In 2007, the national prevalence of MSD's was 33 million with incremental costs of $886.49 per person. The inpatient expenditures ($33,461.85) were the highest cost component in MSD's and the predictors of total health care expenditures were age, marital status, and presence of the disease condition. <br>Conclusion: The systematic assessment of MSD's and their associated incremental costs to the society is essential in increasing the awareness of decision makers to implement intervention strategies that are effective in lowering the disease incidence and in reducing the overall cost of disease management. / Mylan School of Pharmacy and the Graduate School of Pharmaceutical Sciences / Pharmacy Administration / MS / Thesis

The determinants of health expenditures have been studied extensively for the past 50 years and income has been seen as the major driver. The focus has rarely left developed countries which raises the question as to whether the same positive relationship exists in developing countries as well. The purpose of this thesis is to answer this question by conducting a fixed effect regression on a sample of 38 countries labelled as the least developed in the world by the United Nations with data stretching between 2000 to 2017. The results indicate a weaker relationship in the sample compared to estimates on developed countries. However, due to a lack of theoretical guidance on how health expenditures are determined and indications that omitted variable bias is present, the results do not provide definitive conclusions.

AbstractThis thesis examines convergence and increased efficiency in European healthcare systems after 1950 and beyond. The countries that is included in the study are Sweden, Norway, Finland, Denmark, Germany, the Netherlands, and the United Kingdom. The purpose that has been answered is, from an economic-historical perspective, contribute to a higher knowledge to European health care systems historical growth, expansion, and structural reforms, and then to analyze in more depth the period 1950 and forward. The questions that have been answered are how European universal and conservative healthcare systems have developed and if it has been a convergence between different models in recent decades. Another question that has been answered if there are any differences in system efficiency measured as the ability of the different systems to affect healthcare-related mortality.At the beginning of the 20th century, the construction of the European countries healthcare systems began. However, it was not until after World War II that the expansion took place and a therefore even a strong increase of cost as a share of GDP.In Europe, two different healthcare models dominate the Nordic universal model and a social insurance system where Germany is the best example. In the Nordic countries, all citizens were included, and the financing was through the tax. In that model, the state was ultimately the guarantor of the individual’s welfare. In the conservative model, different groups could have different insurance solutions for their welfare.The thesis shows a strong convergence of these two models. The collective tax collective has an increasingly important role in both models. Nowadays, there are no major differences on that point. Today, public funding accounts for about 75–80 percent of the total health care costs in both tax- and insurance-financed systems. On the other hand, there are differences in the fact that the social insurance systems are operated by actors other than the region or state. Social insurance systems also tend to provide more equal care in terms of how care is consumed between different socioeconomic groups. In other respects, system efficiency is similar, even though Sweden probably has a lower system efficiency in terms of the resources used.Keywords: Keywords: Universalism, Social insurance systems, Health care, Health care expenditures and Economic history

We consider the effect of disability status on Medicare expenditures. Disabled elderly historically have accounted for a significant portion of Medicare expenditures. Recent demographic trends exhibit a decline in the size of this population, causing some observers to predict declines in Medicare expenditures. There are, however, reasons to be suspicious of this rosy forecast. To better understand the effect of disability on Medicare expenditures, we develop and estimate a model using the generalized method of moments technique. We find that newly disabled elderly generally spend more than those who have been disabled for longer periods of time. Also, we find that increases in expenditures have risen much more quickly for those disabled Medicare beneficiaries who were at the higher ends of the expenditure distribution before the increases.

No description available.

Since the late 1990s accelerated growth in health care spending coupled with a cost shift of health insurance from employers to employees has created an increased financial burden for many families. Past research suggests that financial burden due to out-of-pocket (OOP) health care costs limits access to health care and may reduce spending on other basic needs, such as food. The primary objective of this study was to assess the relationship between out-of-pocket health care expenditures and food insecurity among families with children. Secondarily, this study examined the relationship between the health status of children and household food security. This study used data from the Panel Study of Income Dynamics (PSID, 2003) to test whether higher out of pocket health care expenditures increase household food insecurity for families with children. Respondents reported out of pocket expenditures for both medical services and insurance premiums in 2001 and 2002. Food insecurity was measured for the previous 12 months using the 18-item USDA Food Security Survey Module. Multivariate weighted logit analysis was conducted to model the relationship between OOP health care costs and household food security status; and child health status and household food security. There was no evidence that higher OOP health care costs were associated with household food insecurity. However, among families earning less than 300 percent of the federal poverty threshold, having private insurance did increase the likelihood of experiencing food insecurity (OR =4.77, 95% CI = 0.05 - 1.02). Households with a child in poor health were not more likely to experience food insecurity; however having a wife in poor health was associated with food insecurity (OR = 4.00, 95% CI =1.67-9.52). The findings from this study suggest that programs designed to limit OOP health care spending among moderate and low income families should evaluate the impact on household food security. / Graduation date: 2013 / Access restricted to the OSU Community at author's request from July 23, 2012 - July 23, 2013

Background: While value-based payment models emphasizing care coordination have been widely implemented to improve quality and lower expenditures, supporting empirical evidence is sparse. Our objective was to quantify the impact of specialist-to-primary care physician involvement within accountable care organization (ACO) and its association with lower spending. Methods: We conducted a retrospective cohort study of Medicare Shared Savings Program ACOs from 2012-2016 using publicly available data provided by the Centers for Medicare and Medicaid Services at the ACO level. We examined the association between the proportion of primary care services delivered by specialists versus other types of care providers and ACO spending using a generalized estimating equation model. Results: The analytic dataset included 1381 MSSP-years. When compared to ACOs at the lowest (60) levels of providing primary care services through specialists, ACOs who had 35% to 40% of primary care services delivered by specialists spent $1,124 (95% CI, $358 to $1,891) and $969 (95% CI, $250 to $1,688) less per capita, respectively. When stratified at varying levels of specialists providing primary care services, having four years of experience in the Medicare Shared Savings Program was consistently associated with lower spending when compared to having one to three years of experience. Conclusions and Relevance: The optimal portion of specialists providing primary care services - to reduce spending - was found to be 35% to 40%. These findings suggest that integrating specialists in to the activities and objectives of MSSP ACOs could lead to lower spending and better performance.