Tyrimo objektas – Lietuvos privalomojo sveikatos draudimo sistema. Darbo tikslas – pateikti privalomojo sveikatos draudimo lėšų perskirstymo tobulinimo galimybes. Tyrimo dalykas – privalomojo sveikatos draudimo finansavimas ir įvertinimas. Uždaviniai: 1. Nustatyti privalomojo sveikatos draudimo vietą šalies sveikatos apsaugos politikoje. 2. Nustatyti sveikatos draudimo finansavimo ir lėšų paskirstymo būdus ir metodus. 3. Parengti privalomojo sveikatos draudimo sistemos finansavimo vertinimo metodiką. 4. Įvertinti privalomojo sveikatos draudimo finansavimą bei lėšų paskirstymą Lietuvoje ir pateikti tobulinimo galimybes. Tyrimo metodai: 1. Tiriant privalomojo sveikatos draudimo vietą šalies sveikatos apsaugos politikoje bei galimus sveikatos draudimo finansavimo būdus naudoti bendramoksliniai tyrimo metodai – mokslinės literatūros bei teisinių dokumentų analizė ir sintezė, loginė analizė ir sintezė, apibendrinimas. 2. Vertinant privalomojo sveikatos draudimo finansavimo ir lėšų paskirstymo situaciją Lietuvoje – statistiniai duomenų rinkimo bei analizės metodai, teisinių Lietuvos sveikatos draudimo dokumentų analizė ir sintezė, loginė analizė ir sintezė. 3. Statistinei informacijai apdoroti ir sisteminti panaudoti grupavimo, palyginimo, koreliacijos ir grafinio vaizdavimo būdai. Tyrimų rezultatai publikuoti konferencijos „Jaunasis mokslininkas 2009“ straipsnių rinkinyje straipsnyje „Privalomojo sveikatos draudimo sistemos Lietuvoje finansavimo vertinimas“. 4 Pirmojoje darbo... [toliau žr. visą tekstą] / The object of the research- the compulsory health insurance system of Lithuania. The aim of the work- to provide the improvement possibilities of redistribution of the compulsory health insurance funds. The objectives of the research: 1. To determine the location of the compulsory health insurance in the health care policy; 2. To set the health insurance financing and distribution of funding methods and way; 3. To prepare the funding evaluation methodology of the compulsory health insurance. 4. To evaluate the funds of the health insurance and the allocation of the funds in Lithuania and possible opportunities of improvement. Methods of the research: 1. There were used overall scientific methods during the research of the place of the compulsory health insurance in the state health insurance policy and the possible ways of health insurance - the syntesis and analysis of the scientific literature and law documents, logical analysis and synthesis, generalization. 2. There were used statistical data compilation, the synthesis and analysis of law documents of health insurance in Lithuania, logical analysis and synthesis during the assesment of the compulsory health insurance funding and the situation of funds allocation . 3. There were used techniques of batching, comparison, correlation and graphical display to process and organize statistical information. The results of the research were published in the set articles of the conference „A Young Scientist 2009“ in the article... [to full text]

Die beiden Systemen wurden auf die ähnliche Tradition gegründet. Diese Tradition hat seine Wurzeln in Österreich-Ungarn, die bis 1918 in der gleichen Zwischenraum ausgesetzt wurden. Ein weiterer Zusammenhang ist die geographische Beziehung. Die Gesetztformen in der beiden Staaten sind unterschiedlich. In der Tschechische Republik gibt es viele Sozialversicherungsgesetze, in den der jede Typ des Versichertes geregelt ist. In Österreich gibt es für den jeden Type des Versichertes ein Sozialversicherungsgesetz. Die beiden Systemen sind die gesetzlichen öffentlichen Krankenversicherungen. Das tschechische System ist postkommunisch und Österreich ist der korporatische konservative Sozialstaat. Es gibt die Umverteilung in den beiden Systemen, aber in Österreich hat ein Unterschied, weil auch die Umverteilung in der Anstaltspflege enthält. Die vergleichende Systeme der gesetzlichen Krankenversicherungen haben die gemeinsame ethische Grundsätze, die aber in Österreich mehr in den Gesetze geregelt werden. Dieser Fakt macht den Rahmen des Systemes der Krankenversicherung, das viel auf die Patienten sich konzetriert wird. Der Patient hat ein Recht auf aktive Beteiligung in diesem System und auch in der Behandlung. Ein großes Unterschied ist die Verfassungsschutz der Rechte im beiden Staaten. In Tschechien gibt es die...

Tyrimo objektas – Lietuvos privalomojo sveikatos draudimo sistema. Tyrimo dalykas – privalomasis sveikatos draudimas. Darbo tikslas – įvertinus Lietuvos privalomojo sveikatos draudimo sistemą nustatyti ir pateikti tobulinimo galimybes. Uždaviniai: išnagrinėti sveikatos draudimo teorinius aspektus, sukurti sveikatos draudimo sistemos įvertinimo metodiką, įvertinti Lietuvos sveikatos draudimo modelį, atlikus Privalomojo sveikatos draudimo fondo pajamų ir išlaidų analizę, nustatyti veiksnius, įtakojančius pajamų ir išlaidų kitimą, nustatyti Lietuvos sveikatos draudimo sistemos perspektyvas, pateikti pasiūlymus sveikatos draudimo sistemos tobulinimui. Iškeltai problemai tirti ir rezultatams gauti naudoti šie tyrimo metodai: specialiosios literatūros bendrieji moksliniai tyrimo metodai – literatūros analizė ir sintezė, loginė analizė ir sintezė, indukcija ir dedukcija, loginio ir grafinio modeliavimo metodai, daugiafaktorinė regresinė analizė, laiko eilutės prognozavimas naudojant statistines funkcijas TREND, LINEST ir GROWTH, LOGEST, laiko eilutės suglodinimas ir prognozavimas. Nagrinėjant Lietuvos autorių mokslinius straipsnius, periodinę spaudą, užsienio autorių mokslinius darbus apie sveikatos draudimo sistemą, atlikta Lietuvos privalomojo sveikatos draudimo sistemos analizė ir pateikti pasiūlymai jos tobulinimui. / Research object: Lithuanian compulsory health insurance system. Research subject: compulsory health insurance. Research aim: to evaluate the financing system of compulsory health insurance in Lithuania and to define the opportunity of improvement. Objectives: to analyse the theoretical aspects of health insurance and process of health insurance system in Lithuania, to delineate the government resources for health insurance, to value advantages and disadvantages of health care model, to analyse income and outcome of compulsory health insurance fund budget, to underline evidences which cause the fluctuation of incomings and expenses, to detect health insurance system prospects and to provide the recommendations for the improvement of Lithuanian compulsory health insurance system. For solving problems and research results are used these research methods: analysis and synthesis of literature, systemic analysis, logical analysis and synthesis, regression analysis, forecast calculations statistical function TREND, LINEST and GROWTH, LOGEST, methods of graphic and logical modeling. During doing the research of Lithuanian health insurance system, scientific articles by Lithuanian and foreign scientist were used to analyse Lithuanian health insurance system and to introduce the recommendations for its improvement.

This paper analyzes the role that demographics, health services utilization, and knowledge play in determining the choice of insurance plan. Using data from a 2014 National Opinion Research Center (NORC) report and by estimating a probit model, I examine the effect of the three variable categories on the probability of selecting a High Deductible Health Plan (HDHP). While many of the results align with the existing literature, I contribute to prior insurance studies by finding that confusion over health services and plan benefits is the largest driver in HDHP choice, as it increases the probability that an individual enrolls in an HDHP by over 15 percentage points. This result provides evidence to policymakers that insurance education should be more widely available to ensure that individuals are choosing a plan that best fits their needs.

Social health . lnsurance in developed countries , lS facing problems concerning cost control. In developing countries, problems are of low coverage, the provision of care to include access to the private sector, equity in access to services, as well as cost control. In Thailand, the recently introduced social insurance scheme requires the insured or their employer to select a main contractor to provide care a general hospital with >100 beds - which is paid on a capitation basis. In response the private sector is developing provider networks to ensure health services to be more accessible and to attract insured workers to enroll with the network. The primary concern of the research is to evaluate MEDSEC, the biggest private network in terms of the number of facilities and insured covered. Nopparat, the biggest publicly-organized network, was selected for comparison with MEDSEC. The aim is to identify policy recommendations regarding networks and their internal payment mechanisms. The obj ecti ves are to examine: how MEDSEC is organized and how it has grown over time; the health seeking behaviour of the insured of MEDSEC; and the utilization rate, payment system, and quality of care of MEDSEC. Four substudies were done: the MEDSEC operating and financial system; the health seeking behaviour of the insured, their utilization rate, knowledge, and satisfaction; the providers' knowledge and attitudes; and evaluation of quality of care concerning four aspects: infrastructure, patient satisfaction, outpatient drug treatment, and inpatient care. The study identifies policy implications concerning the functions of a good network office, the monitoring of a network's quality of care, the payment system of networks, and improving the knowledge of the insured concerning the regulation on access to care.

This research study analyses a conceptual model investigating the relationship between the level of health insurer product innovation and entrepreneurial orientation (EO); the relationship between the level of health insurer product innovation and external collaboration between health insurers and healthcare service providers. This study also analyses whether low presence of perceived strategic regulatory factors, necessary for encouraging health insurer product innovation in the private healthcare industry in South Africa, weakens the relationship between the level of new health insurer product innovation and EO, as well as the relationship between the level of new health insurer product innovation and external collaboration between health insurers and healthcare service providers. The research study, focusing on major actors in both the demand and supply side structures of the private healthcare value chain, found that organisational-level EO is a very strong predictor of health insurer product innovation in the South African private healthcare industry. The research study also found that external collaboration between health insurers and healthcare service providers is a weak predictor of health insurer product innovation. An important finding of this study was that the low presence of strategic regulatory factors (which are necessary for encouraging health insurer product innovation in the South African private healthcare industry) means that the relationship between health insurer product innovation and EO is not moderated, and neither is the relationship between health insurer product innovation and external collaboration between health insurers and healthcare service providers. These findings contribute to the South African private healthcare industry in terms of innovation, regulation, external collaboration and entrepreneurial orientation literature and studies.

Private healthcare financing in South Africa has undergone several regulatory reforms, the most recent of which saw the enactment of the Medical Schemes Act No. 131 of 1998. The stated reforms, most especially open enrolment and community rating, were touted by the government as necessary to address the undesirable effects of adverse selection. However, it was never questioned whether in fact adverse selection is a feature of the South African medical schemes landscape. Adverse selection is found to be absent. Thus, government’s supposition that adverse selection, as a consequence of the deregulation that took place during the late 1980s and early 1990s, is responsible for the deterioration in medical scheme coverage for the elderly, unhealthy or poor is fallacious. Since the ostensible reason for the current legislation does not stand up to scrutiny, regulatory capture is offered as the plausible alternative explanation for the promulgation of the current legislation governing medical schemes business.

Thesis advisor: Andrew Beauchamp / Thesis advisor: Mathis Wagner / This dissertation considers changes of health insurance system of United States that affect health outcomes and labor market outcomes of population. The first chapter examines how Medicaid policy aimed to improve health status of low-income parents affects the health outcomes of young children. Estimates from variations in Medicaid rules across states and over time, show that there exist positive spillover effects on children from Medicaid expansions targeting parents. The child mortality declines more in states with higher level of generosity in Medicaid policy and the effect is larger among black children. Simulations indicate that recent Medicaid expansion under Affordable Care Act Reform can deepen the existing child mortality disparity across states due to different adoption of Medicaid expansion for low income adult population. The second chapter examines Massachusetts health care reform and its impact on labor market outcomes of older males approaching retirement. I find that older males are more likely to remain in full-time employed status rather to choose early retirement, and part-time employment increased only among low-income population who are eligible for subsidized health insurance. The results suggests that there exists employment-lock effect from increase of employers providing employersponsored health insurances following the reform. / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Economics.

Thesis (M.B.A.)--Boston University.

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