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Chris Sampson’s journal round-up for 22nd March 2021

Every Monday our authors provide a round-up of the latest peer-reviewed journal publications. We cover all issues of major health economics journals as well as some other notable releases. If you’d like to write one of our weekly journal round-ups, get in touch.

The European Journal of Health Economics

Volume 22, Issue 2

This issue of EJHE opens with an editorial on the use of telemedicine after COVID-19. The pandemic has forced a shift towards remote consultations and the like, particularly in primary care. So, could primary care look radically different in Europe, post-pandemic? The authors think it could, but that the diffusion of new technologies – in health care and among the public – could be the primary barrier to a fair and efficient telecare future.

Another COVID-related study in this issue focuses on inequality. It shows how the regional level of income inequality in France explains the number of COVID infections and deaths. The authors plug district-level data into some regression models and find that the level of dispersion across incomes was an important explanatory factor. A 1% increase in the Gini coefficient was associated with 0.08% more deaths. Keeping with inequalities, a study from Australia reveals that chronic disease patients with lower socioeconomic status are more likely to experience adverse outcomes in hospital. This partially explains a higher level of resource use for these patients.

A couple of articles in this issue explore questions relating to health care costs and expenditures. One study looked at the explanatory factors for growing health care expenditures in Switzerland. The researchers analysed inpatient costs for patients in Zurich across 100 diseases between 2013 and 2017. They found that the rising cost-per-day of inpatient stays was the key driver, along with population dynamics. Another study focussing on hospital expenditures estimated the impact of skeletal-related events for patients with bone metastases in Germany. An analysis of the efficiency of health care in China evaluated the impact of a 2009 reform. The authors focussed on non-communicable diseases and found that the reform was associated with a decline in efficiency and productivity in many settings.

On costing methods for economic evaluation, there’s a study informing analyses that adopt a societal perspective in Australia. The researchers surveyed 274 businesses to identify the time and costs of replacing an employee, providing estimates that analysts can use when adopting a friction cost approach to estimate productivity losses.

There’s an interesting analysis of individuals’ behaviour with voluntary private health insurance in Russia. The researchers used household panel data to model self-reported health outcomes and behaviours along with insurance status. The results suggest that people with supplementary insurance exhibit both ex-post and ex-ante moral hazard; they use more health care and change their health behaviours.

A study from Sweden explains some complicated associations between petrol prices and alcohol consumption. It turns out that the relationship depends on people’s distance from national borders. It seems that a coincidental increase in petrol prices prevented an expected increase in private alcohol imports when restrictions were lifted in 2004. On a related note, a survey from France shows that different factors explain men’s and women’s preferences for cigarette brands.

The issue also includes a study from some of my colleagues that looks at NICE’s role in influencing competition in the market for generics in the UK. The researchers found that NICE recommendations influence uptake but don’t really affect market entry. There’s also a mapping study to derive EQ-5D-5L values from the MacNew Heart Disease Quality of Life questionnaire. Its novelty is in its use of a ‘deep neural network’ machine learning technique.

International Journal of Health Economics and Management

Volume 21, Issue 1

There’s some shoddy copyediting on display in the latest issue of IJHEM. The opening article has an abstract that borders on gibberish, but it’s still an interesting study. Using data from 145 million stays, the author demonstrates that the introduction of more granular DRG reimbursement in France resulted in upcoding behaviour by hospitals. However, the behaviour change favoured for-profit hospitals, supporting a redistribution of funds away from public non-research hospitals.

‘Who’s making a profit?’ seems to be a popular question in the context of the pandemic. A study in this issue looks at the profits of manufacturers and ‘middlemen’ in the pharmaceutical supply chain. The authors use firm-level data from S&P 500 companies (plus a few others), focussing on 33 relevant manufacturers and 14 middlemen firms. In making comparisons with other S&P 500 companies, the presence of excess profits depends on whether R&D is treated as an investment or an expense. As an investment, excess profits are lower than the average across S&P 500 firms for pharmaceutical companies but not for the likes of wholesalers and retailers. The implication is that competition should be encouraged in different parts of the supply chain and not just among manufacturers.

There’s a paper setting out a theoretical model of investment in personalised medicine. The authors show that the implementation of personalised medicine is likely to depend on the extent to which a health authority can observe a firm’s efforts to improve drug quality. There’s also a study looking at how national health insurance impacts maternal care in Ghana and a study modelling the health system in Indonesia.


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