scholarly journals Do individuals skimp on health care after spouse’s dementia diagnosis? An analysis of spillover effects of dementia

2021 ◽  
Vol 17 (S10) ◽  
Author(s):  
Yi Chen
Keyword(s):  
Health Care ◽  
Spillover Effects ◽  
Dementia Diagnosis

scholarly journals Spillover Effects of Drug Safety Warnings on Preventive Health Care Use

2015 ◽  
Vol 15 (1) ◽  
pp. 179-208
Author(s):  
N. Meltem Daysal ◽  
Chiara Orsini
Keyword(s):  
Health Care ◽  
Women’S Health ◽  
Women's Health ◽  
Preventive Care ◽  
Drug Safety ◽  
Hormone Replacement ◽  
Preventive Health Care ◽  
Spillover Effects ◽  
Health Care Use ◽  
Preventive Health

Abstract We examine how new medical information on drug safety impacts preventive health care use. We exploit the release of the findings of the Women’s Health Initiative Study (WHIS) – the largest randomized controlled trial of women’s health – which demonstrated in 2002 the health risks associated with the long-term use of hormone replacement therapy (HRT). We first show that, after the release of the WHIS findings, HRT use dropped sharply among post-menopausal women. We then estimate the spillover effects of the WHIS findings on preventive care by means of a difference-in-differences methodology comparing changes in preventive care use among 60 to 69 year-old women (who have high rates of HRT use) with the change among women aged 75 and above (who have much lower rates of HRT use). Using data from the Behavioral Risk Factor Surveillance System for the period 1998–2007, we find that women aged 60–69 had statistically and economically significant declines in their annual mammography checks, checkups, cholesterol checks and blood stool tests, when compared to older women.

scholarly journals Health care investments and economic performance in Portugal: an industry level analysis

2019 ◽  
Vol 46 (6) ◽  
pp. 1174-1200 ◽  
Author(s):  
Alfredo M. Pereira ◽  
Rui M. Pereira ◽  
Pedro G. Rodrigues
Keyword(s):  
Health Care ◽  
Economic Performance ◽  
Spillover Effects ◽  
Professional Services ◽  
Policy Implications ◽  
Empirical Literature ◽  
Content Type ◽  
Net Exports ◽  
Capital Spending

Purpose The purpose of this paper, on Portugal, is to determine the economic effects of public and private capital spending on health. Design/methodology/approach The authors use a vector autoregressive model to estimate the elasticities and marginal products of health care investments in Portugal on investment, employment and output. Findings Every €1m invested in health care yields significant positive spillover effects, boosting investment and GDP by €24.74 and €20.45m, respectively, creating 188 net jobs. Adversely, net exports deteriorate, as new capital goods are imported. While only 28.2 percent of the total accumulated increase in GDP occurs within a year, investment is front loaded with a corresponding 73.8 percent. Over this period, 68 workers are displaced for every €1m invested. At a disaggregated level, real estate, construction, and transportation and storage are industries where output shares increase the most. Employment shares increase the most in professional services, construction and basic metals. Research limitations/implications This paper adds to the empirical literature, corroborating, for example, Rivera and Currais (1999a) and McDonald and Roberts (2002) in that health care spending can have a very significant effect on macroeconomic aggregates. In addition to the analysis of the tradable/non-tradable divide, it adds two further novelties by discussing industry-specific effects on economic performance and the distinction between effects on impact and those over the longer term. Practical implications As policy implications, health investments have very significant long-term economic performance effects, but are unhelpful counter cyclically. Also, they will change the industry mix: construction and professional services are the non-traded industries that will benefit the most, while the traded industries of non-metallic minerals, basic metals, and machinery and equipment benefit much less. Social implications Given that capital spending on health boosts economic performance, especially in the long run, it ought to be a part of Portugal’s medium-to-long-term growth strategy. Also, if these projects depress economic activity in the short run, and are thus unhelpful counter cyclically, the timing of when they are launched matters. Furthermore, following a health investment, policies that boost net exports will be required to ensure trade balance. Originality/value The originality of this paper is to estimate, in a dynamic framework, the aggregate and industry-specific elasticities and marginal products on investment, employment and output, allowing the identification of effects both on impact and over the long term. Although health care investments are expected to have important macroeconomic effects, they need not be evenly distributed across industries.

scholarly journals Managed Care and Health Care Expenditures: Evidence from Medicare, 1990-1994

1998 ◽  
Vol 1 (1) ◽  
Author(s):  
Laurence C. Baker ◽  
Sharmila Shankarkumar
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Market Share ◽  
Health Care Policy ◽  
Care Delivery ◽  
Health Care Expenditures ◽  
Spillover Effects ◽  
Fee For Service ◽  
Health Care Market ◽  
Care Activity

Increases in the activity of managed care organizations may have "spillover effects," influencing the entire health care delivery system's performance, so that care for both managed-care and non–managed-care patients is affected. Some proposals for Medicare reform have incorporated spillover effects as a way that increasing Medicare HMO enrollment could contribute to savings for Medicare.This paper investigates the relationship between HMO market share and expenditures for the care of beneficiaries enrolled in traditional fee-for-service Medicare. We find that increases in systemwide HMO market share (which includes both Medicare and non-Medicare enrollment) are associated with declines in both Part A and Part B fee-for-service expenditures. The fact that managed care can influence expenditures for this population, which should be well insulated from the direct effects of managed care, suggests that managed-care activity can have broad effects on the entire health care market. Increases in Medicare HMO market share alone are associated with increases in Part A expenditures and with small decreases in Part B expenditures. This suggests that any spillovers directly associated with Medicare HMO enrollment are small.For general health care policy discussions, these results suggest that assessment of new policies that would influence managed care should account not only for its effects on enrollees but also for its systemwide effects. For Medicare policy discussions, these findings imply that previous results that seemed to show large spillover effects associated with increases in Medicare HMO market share, but inadequately accounted for systemwide managed-care activity and relied on older data, overstated the magnitude of actual Medicare spillovers.

Primary care-led dementia diagnosis services in South Gloucestershire: Themes from people and families living with dementia and health care professionals

Dementia ◽  
2016 ◽  
Vol 15 (6) ◽  
pp. 1586-1604 ◽  
Author(s):  
Emily Dodd ◽  
Richard Cheston ◽  
Sarah Cullum ◽  
Rosalyn Jefferies ◽  
Sanda Ismail ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals ◽  
Dementia Diagnosis

scholarly journals Life expectancy and health care utilization of individuals with dementia in Ontario, Canada: A population-level study

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Stacey Fisher ◽  
Douglas G Manuel ◽  
Sarah Spruin ◽  
Geoffrey Anderson ◽  
Monica Taljaard ◽  
...  
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Home Care ◽  
End Of Life ◽  
Long Term Care ◽  
Formal Care ◽  
Dementia Diagnosis ◽  
Term Care ◽  
Dementia Patients

IntroductionIt is important for dementia patients, their families and caregivers, and health planners to have an understanding of life expectancy and the likely care experience of patients from dementia diagnosis to end-of-life. Objectives and ApproachUsing administrative health data of all dementia patients in Ontario, Canada (2014 to 2017) and period life table methodology, life expectancy and average health care use and cost for individuals from dementia diagnosis to death was examined. Dementia was ascertained by a validated case ascertainment definition and information from long-term care, home care and complex continuing care assessments. Formal care was categorized as inpatient, outpatient, home care or long-term care. ResultsLife expectancy at dementia diagnosis was 8.7 years and 9.8 years for men and women diagnosed prior to age 75, of which 3.7 years (42%) and 4.7 years (49%) was spent receiving formal care, respectively. Life expectancy was 4.4 and 5.2 years for men and women diagnosed after age 75, of which 2.2 years (50%) and 3.1 years (60%) was spent receiving care, respectively. Women received proportionally more long-term and home care compared to men, while men received more inpatient and outpatient care. In the year prior to dementia diagnosis, individuals received formal care for 20 days per 100 person-days. Those at the end-of-life received care for 79 days per 100 person-days, including 55 long-term care days and 7.8 inpatient care days. Average direct health care costs from diagnosis to end-of-life was $230,000 and was higer for women and those diagnosed before age 75. ConclusionThe burden of formal care for those with dementia is substantial. The results of this study will be used by physicians to inform conversations with patients, their families and caregivers around what to expect after a dementia diagnosis, and by health care planners for population health planning.

Spillover Effects of Mission Activities on Revenues in Nonprofit Health Care: The Case of Aravind Eye Hospitals, India

2018 ◽  
Vol 55 (6) ◽  
pp. 884-899 ◽  
Author(s):  
Sachin Gupta ◽  
Omkar D. Palsule-Desai ◽  
C. Gnanasekaran ◽  
Thulasiraj Ravilla
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Historical Data ◽  
Spillover Effects ◽  
Market Prices ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
Marketing Activities ◽  
Cross Subsidization

Nonprofit health care organizations in low- and middle-income countries often pursue a cross-subsidization business model wherein services are offered to poor patients for free through surpluses generated by serving some patients at market prices. This approach allows such organizations to fulfill their mission-oriented and revenue-generation goals. Conventional wisdom holds that mission activities need financial subsidies from revenue-generating activities. The authors examine this dependence in the context of Aravind Eye Hospitals, which delivers eye care services in India. They measure whether the marketing activities (outreach camps) of Aravind that are targeted only to poor patients produce the spillover benefit of attracting paying patients to its hospitals. Using nine years of patient-level historical data, the authors find that camps increase the flow of paying patients. These effects are comparable to the camps acting as advertising for Aravind. Using model estimates, the authors compute the incremental revenue accruing to Aravind from a camp and find that it exceeds the incremental cost of a camp. The findings challenge conventional beliefs about the subsidies required by mission activities.

scholarly journals Do Individuals Skimp on Health Care After Spouse’s Dementia Diagnosis?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 17-18
Author(s):  
Yi Chen
Keyword(s):  
Health Care ◽  
Fixed Effects ◽  
Time Frame ◽  
Policy Support ◽  
Dementia Diagnosis ◽  
Doctor Visits ◽  
Before And After ◽  
Flu Shot ◽  
Socio Demographic Factors ◽  
The Impact

Abstract Dementia is a costly disease that places great burden on individuals and families. The substantial time and financial resources taken away by living with persons with dementia (PWDs) may make their spouses forgo essential health care, thus deteriorating long-term health and increasing downstream healthcare costs. However, such negative externality is understudied. This paper studied the impacts of spouse's incident dementia diagnosis on an individual's use of needed care, defined as annual flu shot and regular doctor visits for those with preexisting conditions. Using HRS linked to Medicare claims, I employed a fixed effects approach to compare the use of flu shot and doctor visit during 1 year before and after the index, for individuals whose spouse had dementia (N=691) and otherwise similar controls (N=5,073). After adjusting for time-varying health, caregiving roles, and other socio-demographic factors, spouse’s dementia onset was associated with greater likelihood of getting flu shot and seeing doctors. Among those transitioning into caregiving, spouses of PWDs had a marginally higher risk of skimping on doctor visits, compared to controls (p=0.053). In this broadly representative sample, there lacks evidence for rationed health care ensuing spouse’s dementia incidence, at least within a 1-year time frame. However, for new spousal caregivers, the impact of dementia is more profound and complex than deprivation of time. This group may face a trade-off between caring for spouses with dementia and caring for themselves, for whom policy support merits further study and consideration.

Health Care Reform and Workers’ Compensation: Evidence from Massachusetts

ILR Review ◽  
2019 ◽  
pp. 001979391989142
Author(s):  
Erin Todd Bronchetti ◽  
Melissa P. McInerney
Keyword(s):  
Health Care ◽  
Emergency Room ◽  
Health Care Reform ◽  
Spillover Effects ◽  
Injured Workers ◽  
Workers Compensation ◽  
Comprehensive Health Care ◽  
Comprehensive Health ◽  
Per Capita ◽  
Using Data

The authors provide evidence of important spillover effects of comprehensive health care reform on workers’ compensation (WC) that are likely to reduce WC costs. Using data on more than 20 million emergency room (ER) discharges in Massachusetts and three comparison states, they find that Massachusetts health care reform caused a 6.2 to 8.2% decrease in the per capita number of ER discharges billed to WC. The authors document heterogeneity in the impacts of the reform, shedding light on the mechanisms generating the overall decline in ER discharges billed to WC. Results indicate a larger decrease in WC claiming for weekday admissions than for weekend admissions and for harder-to-verify musculoskeletal discharges than for wounds. The decline in WC discharges is driven both by injured workers increasingly seeking care outside of the ER and by changes in the propensity to bill WC for a given ER discharge.

scholarly journals The Cost of Being Under the Weather: Droughts, Floods, and Health-Care Costs in Sri Lanka

2019 ◽  
Vol 36 (2) ◽  
pp. 185-214
Author(s):  
Diana De Alwis ◽  
Ilan Noy
Keyword(s):  
Health Care ◽  
Sri Lanka ◽  
Health Care Costs ◽  
Spillover Effects ◽  
Extreme Weather Events ◽  
Care Utilization ◽  
Droughts And Floods ◽  
Floods And Droughts ◽  
The Impact ◽  
Care Costs

We measure the impact of extreme weather events—droughts and floods—on health-care utilization and expenditures in Sri Lanka. We find that frequently occurring local floods and droughts impose a significant health risk when individuals are directly exposed to these hazards. Individuals are also at risk when their communities are exposed even if they themselves are unaffected. These impacts, especially the indirect spillover effects to households not directly affected, are associated with land use in affected regions and access to sanitation and hygiene. Finally, both direct and indirect health risks associated with floods and droughts have an economic cost: our estimates suggest that Sri Lanka spends $19 million per year directly on health-care costs associated with floods and droughts. This cost is divided almost equally between the public purse and households, with 83% of it spent on flood-related health care and the rest on drought-related health care. In Sri Lanka, both the frequency and intensity of droughts and floods are likely to increase because of climatic change. Consequently, the health burden associated with these events will likely increase.

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