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Sample records for catastrophic health expenditure

  1. Catastrophic health expenditure and impoverishment in Mongolia

    OpenAIRE

    Dorjdagva, Javkhlanbayar; Batbaatar, Enkhjargal; Svensson, Mikael; Dorjsuren, Bayarsaikhan; Kauhanen, Jussi

    2016-01-01

    Background The social health insurance coverage is relatively high in Mongolia; however, escalation of out-of-pocket payments for health care, which reached 41 % of the total health expenditure in 2011, is a policy concern. The aim of this study is to analyse the incidence of catastrophic health expenditures and to measure the rate of impoverishment from health care payments under the social health insurance scheme in Mongolia. Methods We used the data from the Household Socio-Economic Survey...

  2. Determinants of Catastrophic Health Expenditure in Iran

    Directory of Open Access Journals (Sweden)

    M Ramezanian

    2013-01-01

    Full Text Available Background: This study will provide detailed specification of those variables and determinants of unpredictable health expenditure in Iran, and the requirements to reduce extensive effects of the factors affecting households’ payments for health and other goods and services inappropriately.Method: This study aims to identify measures of fair financing of health services and determinants of fair financing contribution, regarding the required share of households that prevents their catastrophic payments. In this regard, analysis of shares of households’ expenditures on main groups of goods and services in urban and rural areas and in groups of deciles in the statistics from households’ expenditure surveys was applied.Results: The growth of spending in nominal values within the years 2002-2008 was considerably high and the rate for out-of-pocket payments is nearly the same or greater than the rate for total health expenditure. In 2008, urban and rural households in average pay 6.4% and 6.35% of their total expenditure on health services. Finally three categories of determinants of unfair and catastrophic payments by households were recognized in terms of households’ socio-economic status, equality/inequality conditions of the distribution of risk of financing, and economic aspects of health expenditure distribution.Conclusion: While extending the total share of government and prepayment sources of financing health services are considered as the simplest policy for limiting out-of-pocket payments, indicators and policies introduced in this study could also be considered important and useful for the development of health sector and easing access to health services, irrespective of health financing fairness

  3. Catastrophic Medical Expenditure Risk

    OpenAIRE

    O'Donnell, Owen; Flores, Gabriela

    2012-01-01

    textabstractMedical expenditure risk can pose a major threat to living standards. We derive decomposable measures of catastrophic medical expenditure risk from reference-dependent utility with loss aversion. We propose a quantile regression based method of estimating risk exposure from cross-section data containing information on the means of financing health payments. We estimate medical expenditure risk in seven Asian countries and find it is highest in Laos and China, and is lowest in Mala...

  4. Catastrophic Health Expenditure and Household Impoverishment: a case of NCDs prevalence in Kenya

    Directory of Open Access Journals (Sweden)

    Daniel Mwai

    2016-03-01

    Full Text Available Introduction and problem: Non-Communicable Diseases (NCDs have become one of the leading causes of morbidity and mortality in Kenya. Their claim on financial and time resources adversely affects household welfare. Health care cost for NCDs in Kenya is predominantly paid by households as OOP. Health expenditure on NCD stands at 6.2% of Total Health Expenditure which is 0.4 % of the total gross domestic product of the country. This expenditure scenario could have implications on household welfare through catastrophic expenditure in Kenya. Most studies done on catastrophic expenditure in Kenya have not looked at the effect of NCD on poverty. Methodology: The paper has investigated the determinants of catastrophic health spending in a household with special focus on the NCDs. It has also investigated the effect of catastrophic expenditure on household welfare.A National household level survey data on expenditure and utilization is used. Controlling for endogeneity, the results revealed that NCDs and communicable diseases contribute significantly to the likelihood of a household incurring catastrophic expenditure. Results: Although all types of sicknesses have negative effects on household welfare, NCDs have more severe impacts on impoverishment. Policy wise, government and development partners should put in place a health financing plan entailing health insurance and resource pooling as a mean towards social protection. Key words:  Non-Communicable Diseases (NCD, Catastrophic Health Expenditure, endogeneity Impoverishment

  5. Household catastrophic health expenditure: evidence from Georgia and its policy implications

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    Zoidze Akaki

    2009-04-01

    Full Text Available Abstract Background To quantify extent of catastrophic household health expenditures, determine factors influencing it and estimate Fairness in Financial Contribution (FFC index in Georgia to establish the baseline for expected reforms and contribute to the design and fine-tuning of the major reforms in health care financing initiated by the government mid-2007. Methods The research is based on the nationally representative Health Care Utilization and Expenditure survey conducted during May-June 2007, prior to preparing for new phase of implementation for the health care financing reforms. Households' catastrophic health expenditures were estimated according to the methodology proposed by WHO – Ke Xu 1. A logistic regression (logit model was used to predict probability of catastrophic health expenditure occurrence. Results In Georgia between 2000 and 2007 access to care for poor has improved slightly and the share of households facing catastrophic health expenditures have seemingly increased from 2.8% in 1999 to 11.7% in 2007. However, this variance may be associated with the methodological differences of the respective surveys from which the analysis were derived. The high level of the catastrophic health expenditure may be associated with the low share of prepayment in national health expenditure, adequate availability of services and a high level of poverty in the country. Major factors determining the financial catastrophe related to ill health were hospitalization, household members with chronic illness and poverty status of the household. The FFC for Georgia appears to have improved since 2004. Conclusion Reducing the prevalence of catastrophic health expenditure is a policy objective of the government, which can be achieved by focusing on increased financial protection offered to poor and expanding government financed benefits for poor and chronically ill by including and expanding inpatient coverage and adding drug benefits. This

  6. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

    OpenAIRE

    Bakhtiar Piroozi; Ghobad Moradi; Bijan Nouri; Amjad Mohamadi Bolbanabad; Hossein Safari

    2016-01-01

    Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percenta...

  7. Catastrophic Health Expenditures for Households with Disabled Members: Evidence from the Korean Health Panel.

    Science.gov (United States)

    Lee, Jeong-Eun; Shin, Hyung-Ik; Do, Young Kyung; Yang, Eun Joo

    2016-03-01

    Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis. PMID:26955233

  8. Catastrophic Medical Expenditure Risk

    NARCIS (Netherlands)

    G. Flores (Gabriela); O.A. O'Donnell (Owen)

    2012-01-01

    textabstractMedical expenditure risk can pose a major threat to living standards. We derive decomposable measures of catastrophic medical expenditure risk from reference-dependent utility with loss aversion. We propose a quantile regression based method of estimating risk exposure from cross-section

  9. Catastrophic Health Care Expenditure among Older People with Chronic Diseases in 15 European Countries

    Science.gov (United States)

    Arsenijevic, Jelena; Pavlova, Milena; Rechel, Bernd; Groot, Wim

    2016-01-01

    Introduction It is well-known that the prevalence of chronic diseases is high among older people, especially those who are poor. Moreover, chronic diseases can result in catastrophic health expenditure. The relationship between chronic diseases and their financial burden on households is thus double-sided, as financial difficulties can give rise to, and result from, chronic diseases. Our aim was to examine the levels of catastrophic health expenditure imposed by private out-of-pocket payments among older people diagnosed with diabetes mellitus, cardiovascular diseases and cancer in 15 European countries. Methods The SHARE dataset for individuals aged 50+ and their households, collected in 2010–2012 was used. The total number of participants included in this study was N = 51,661. The sample consisted of 43.8% male and 56.2% female participants. The average age was 67 years. We applied an instrumental variable approach for binary instrumented variables known as a treatment-effect model. Results We found that being diagnosed with diabetes mellitus and cardiovascular diseases was associated with catastrophic health expenditure among older people even in comparatively wealthy countries with developed risk-pooling mechanisms. When compared to the Netherlands (the country with the lowest share of out-of-pocket payments as a percentage of total health expenditure in our study), older people diagnosed with diabetes mellitus in Portugal, Poland, Denmark, Italy, Switzerland, Belgium, the Czech Republic and Hungary were more likely to experience catastrophic health expenditure. Similar results were observed for diagnosed cardiovascular diseases. In contrast, cancer was not associated with catastrophic health expenditure. Discussion Our study shows that older people with diagnosed chronic diseases face catastrophic health expenditure even in some of the wealthiest countries in Europe. The effect differs across chronic diseases and countries. This may be due to different socio

  10. Stories from Around the Globe: Financing Catastrophic Health Expenditures in Selected Countries

    OpenAIRE

    Dela Cruz, Anna Mae D.; Nuevo, Christian Edward L.; Haw, Nel Jason L.; Tang, Vincent Anthony S.

    2014-01-01

    This study reviews literature on financing catastrophic health expenditures in selected countries to describe and synthesize the strategies of relatively successful health financing schemes. It begins with a review of basic concepts and definitions to set the stage for later discussions. This is followed by a country selection process, where countries were selected based on their income level, health outcomes, coverage outcomes, cost effectiveness, and the availability of information on their...

  11. The Risk and Duration of Catastrophic Health Care Expenditures

    OpenAIRE

    Feenberg, Daniel; Skinner, Jonathan

    1992-01-01

    Catastrophic medical expenses are an important economic risk facing the elderly. Little is known about the persistence of such out-of-pocket medical costs. We measure the time-series property of medical costs using information on medical deductions from a panel of tax returns. During the period of analysis, 1968-73, taxpayers could deduct medical expenses above 3 percent of income. We correct for the resulting censoring bias using multivariate Tobit estimated with a variant of the smoothed si...

  12. Catastrophic medical expenditure risk.

    Science.gov (United States)

    Flores, Gabriela; O'Donnell, Owen

    2016-03-01

    We propose a measure of household exposure to particularly onerous medical expenses. The measure can be decomposed into the probability that medical expenditure exceeds a threshold, the loss due to predictably low consumption of other goods if it does and the further loss arising from the volatility of medical expenses above the threshold. Depending on the choice of threshold, the measure is consistent with a model of reference-dependent utility with loss aversion. Unlike the risk premium, the measure is only sensitive to particularly high expenses, and can identify households that expect to incur such expenses and would benefit from subsidised, but not actuarially fair, insurance. An empirical illustration using data from seven Asian countries demonstrates the importance of taking account of informal insurance and reveals clear differences in catastrophic medical expenditure risk across and within countries. In general, risk is higher among poorer, rural and chronically ill populations. PMID:26812650

  13. The effect of new cooperative medical scheme on health outcomes and alleviating catastrophic health expenditure in China: a systematic review.

    Directory of Open Access Journals (Sweden)

    Xiaoyun Liang

    Full Text Available BACKGROUND: In 2002, the Chinese government launched a new rural health financing policy to provide health insurance (New Cooperative Medical Scheme, NCMS for its rural population. NCMS, jointly financed by governments and individual households, aims to protect households from impoverishment due to catastrophic health expenditure. In 2011, NCMS covered more than 96% of the rural population. We have systematically searched and reviewed available evidence to estimate the effects of NCMS on health outcomes and on alleviating catastrophic health expenditure. METHODS: PubMed, Web of Science with Conference Proceedings, ProQuest Digital Dissertations, CMCI, CNKI, and VIP were searched. We also obtained literature from colleague communications. Quasi-experimental studies regarding the effect of NCMS on health outcomes and catastrophic health expenditure were included. Two independent reviewers screened the literature, extracted the data, and assessed the study quality. RESULTS: Fifteen studies out of the 6123 studies in the literature fulfilled criteria and were included in this review. Twelve studies identified the relationship between NCMS and health outcomes, among which six studies measured sickness or injury in the past four weeks, four measured sickness or injury in the past two weeks, and five measured self-reported health status. Four studies focused on the relationship between NCMS and alleviating catastrophic health expenditure. However, the results from these studies were in conflict: individual studies indicated that NCMS had positive, negative, or no effect on health outcomes and/or the incidence of catastrophic health payments, respectively. CONCLUSIONS: We still have no clear evidence that NCMS improves the health outcomes and decreases the alleviating catastrophic health expenditure of the China's rural population. In addition, the heterogeneity among individual studies reminds us that provider payment method reforms, benefit package

  14. 灾难性医疗支出研究%Study on Catastrophic Health Expenditure

    Institute of Scientific and Technical Information of China (English)

    褚福灵

    2016-01-01

    Catastrophic heath expenditure occurs when the total out-of-pocket health payments are ≥40%of the household’s capacity to pay(non-living expenses). Studies have showed that the highest rate of catastrophic payments was 13%% in the world, and there were about 5% of poverty caused by serious illness. We should calculate the rate of catastrophic payment and poverty due to illness by using normative methods, and adopt comprehensive measures to prevent the occurrence of catastrophic health expenditure.%家庭的医疗费用支出等于或超过家庭支付能力(非生存支出)的40%时,该家庭即发生了灾难性医疗支出。世界范围内,家庭灾难性医疗支出发生率最高为13%,因病致贫发生率最高为5%。应采用规范的方法测算灾难性医疗支出发生率与因病致贫率,并采取综合措施防范灾难性医疗风险的发生。

  15. Health service use, out-of-pocket payments and catastrophic health expenditure among older people in India

    DEFF Research Database (Denmark)

    Brinda, Ethel Mary; Kowal, Paul; Attermann, Jørn;

    2015-01-01

    BACKGROUND: Healthcare financing through out-of-pocket payments and inequities in healthcare utilisation are common in low and middle income countries (LMICs). Given the dearth of pertinent studies on these issues among older people in LMICs, we investigated the determinants of health service use......, out-of-pocket and catastrophic health expenditures among older people in one LMIC, India. METHODS: We accessed data from a nationally representative, multistage sample of 2414 people aged 65 years and older from the WHO's Study on global Ageing and adult health in India. Sociodemographic...... regression models were used to assess the determinants of out-of-pocket and catastrophic health expenditures. RESULTS: Out-of-pocket health expenditures were higher among participants with disability and lower income. Diabetes, hypertension, chronic pulmonary disease, heart disease and tuberculosis increased...

  16. Indian community health insurance schemes provide partial protection against catastrophic health expenditure

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    Ranson Kent

    2007-03-01

    Full Text Available Abstract Background More than 72% of health expenditure in India is financed by individual households at the time of illness through out-of-pocket payments. This is a highly regressive way of financing health care and sometimes leads to impoverishment. Health insurance is recommended as a measure to protect households from such catastrophic health expenditure (CHE. We studied two Indian community health insurance (CHI schemes, ACCORD and SEWA, to determine whether insured households are protected from CHE. Methods ACCORD provides health insurance cover for the indigenous population, living in Gudalur, Tamil Nadu. SEWA provides insurance cover for self employed women in the state of Gujarat. Both cover hospitalisation expenses, but only upto a maximum limit of US$23 and US$45, respectively. We reviewed the insurance claims registers in both schemes and identified patients who were hospitalised during the period 01/04/2003 to 31/03/2004. Details of their diagnoses, places and costs of treatment and self-reported annual incomes were obtained. There is no single definition of CHE and none of these have been validated. For this research, we used the following definition; "annual hospital expenditure greater than 10% of annual income," to identify those who experienced CHE. Results There were a total of 683 and 3152 hospital admissions at ACCORD and SEWA, respectively. In the absence of the CHI scheme, all of the patients at ACCORD and SEWA would have had to pay OOP for their hospitalisation. With the CHI scheme, 67% and 34% of patients did not have to make any out-of-pocket (OOP payment for their hospital expenses at ACCORD and SEWA, respectively. Both CHI schemes halved the number of households that would have experienced CHE by covering hospital costs. However, despite this, 4% and 23% of households with admissions still experienced CHE at ACCORD and SEWA, respectively. This was related to the following conditions: low annual income, benefit

  17. National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure?

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    Olayinka Stephen Ilesanmi

    2014-05-01

    Full Text Available Background The major objective of the National Health Insurance Scheme (NHIS in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. Methods The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. Results The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars and the range was 7,000–680,000 naira (46.7–4,533 US dollars in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars and the range was 10-17,700 naira (0.1–118 US dollars in 2012. In all, 67 (9.4% households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9% and CHE occurred in 42 (6.6% households. CHE occurred in 14 (10.9% of the households in the lowest quintile compared to 3 (2.5% in the highest wealth quintile (P= 0.004. The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI: 4.7 (1.3–16.8, P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE.

  18. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

    Science.gov (United States)

    Piroozi, Bakhtiar; Moradi, Ghobad; Nouri, Bijan; Mohamadi Bolbanabad, Amjad; Safari, Hossein

    2016-01-01

    Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results: The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion: The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform

  19. Maternity or catastrophe: a study of household expenditure on maternal health care in India

    OpenAIRE

    2013-01-01

    Using data from 60th round of the National Sample Survey, this study attempts to measure the incidence and intensity of ‘catastrophic’ maternal health care expenditure and examines its socio-economic correlates in urban and rural areas separately. Additionally, it measures the effect of maternal health care expenditure on poverty incidence and examines the factors associated with such impoverishment due to maternal health care payments. We found that maternal health care expenditure in urban ...

  20. Household economic impact of an emerging disease in terms of catastrophic out-of-pocket health care expenditure and loss of productivity: investigation of an outbreak of chikungunya in Orissa, India catastrophic out-of-pocket health care expenditure and loss of productivity: investigation of an outbreak of chikungunya in Orissa, India

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    Saji Saraswathy Gopalan

    2009-02-01

    Full Text Available Background & objectives: To examine the household economic impact of an outbreak of chikungunya in terms of out-of-pocket health care expenditure and income foregone due to loss of productive time in Orissa, India.Methods: Structured interviews were conducted on 150 respondents, bread winners from the affected households of a village with maximum number of reported cases in the state, during August 2007. We looked at the economic profile, treatment history, and patient-side cost of care, loss of productivity and consequent income loss.Results: The median out-of-pocket health care expenditure was US$ 84, of which the proportion of cost of diagnosis was the highest (US$ 77. One hundred and forty nine respondents incurred cost of care more than 10% of their monthly household income (catastrophic health expenditure. The median catastrophic health care expenditure was 37%. The respondents depended more on private health care providers (49% and 31% of them accessed care from both public and private health care providers. The median work days lost was 35 with a consequent loss of income of US$ 75.Interpretation & conclusion: Outbreak of an emerging disease creates unforeseen catastrophic health care expenditure and reinforcing the poverty ill-health nexus. The priorities of tackling emerging diseases should include; discretionary public health spending, financial protection against the cost of illness and productivity with special emphasis on people living on daily wages with less financial reserves, and further research on therapeutic measures to reduce the duration of suffering and consequent economic loss.

  1. National Health Expenditure Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — National Health Expenditure Accounts are comprised of the following, National Health Expenditures - Historical and Projected, Age Estimates, State Health...

  2. Catastrophic health expenditure: a comparative analysis of empty-nest and non-empty-nest households with seniors in Shandong, China

    Science.gov (United States)

    Yang, Tingting; Chu, Jie; Zhou, Chengchao; Medina, Alexis; Li, Cuicui; Jiang, Shan; Zheng, Wengui; Sun, Liyuan; Liu, Jing

    2016-01-01

    Objective The aim of this study was to compare the catastrophic health expenditure (CHE) prevalence and its determinants between empty-nest and non-empty-nest elderly households. Setting Shandong province of China. Participants A total of 2761 elderly households are included in the analysis. Results CHE incidence among elderly households was 44.9%. The CHE incidence of empty-nest singles (59.3%, p=0.000, OR=3.19) and empty-nest couples (52.9%, p=0.000, OR=2.45) are both statistically higher than that of non-empty-nest elderly households (31.4%). An inverse association was observed between CHE incidence and income level in all elderly household types. Factors including 1 or more household elderly members with non-communicable chronic diseases in the past 6 months, 1 or more elderly household members being hospitalised in the past year and lower household income, are significant risk factors for CHE in all 3 household types (p<0.05). Health insurance status was found to be a significant determinant of CHE among empty-nest singles and non-empty-nest households (p<0.05). Conclusions CHE incidence among elderly households is high in China. Empty-nest households are at higher risk for CHE than non-empty-nest households. Based on these findings, we suggest that special insurance be developed to broaden the coverage of health services and heighten the reimbursement rate for empty-nest elderly in the existing health insurance schemes. Financial and social protection interventions are also essential for identified at-risk subgroups among different types of elderly households. PMID:27381206

  3. National Health Expenditures - Historical

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Expenditure Accounts (NHEA) are the official estimates of total health care spending in the United States. Historical spending measures annual...

  4. Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China

    Institute of Scientific and Technical Information of China (English)

    Chengchao Zhou; Qian Long; Jiaying Chen; Li Xiang; Qiang Li; Shenglan Tang; Fei Huang

    2016-01-01

    Background:Tuberculosis (TB) often causes catastrophic economic effects on both the individual suffering the disease and their households.A number of studies have analyzed patient and household expenditure on TB care,but there does not appear to be any that have assessed the incidence,intensity and determinants of catastrophic health expenditure (CHE) relating to TB care in China.That will be the objective of this paper.Methods:The data used for this study were derived from the baseline survey of the China Government-Gates Foundation TB Phase Ⅱ program.Our analysis included 747 TB cases.Catastrophic health expenditure for TB care was estimated using two approaches,with households defined as experiencing CHE if their annual expenditure on TB care:(a) exceeded 10 % of total household income;and (b) exceeded 40 % of their non-food expenditure (capacity to pay).Chi-square tests were used to identify associated factors and logistic regression analysis to identify the determinants of CHE.Results:The incidence of CHE was 66.8 % using the household income measure and 54.7 % using non-food expenditure (capacity to pay).An inverse association was observed between CHE rates and household income level.Significant determinants of CHE were:age,household size,employment status,health insurance status,patient income as a percentage of total household income,hospitalization and status as a minimum living security household.Factors including gender,marital status and type of TB case had no significant associations with CHE.Conclusions:Catastrophic health expenditure incidence from TB care is high in China.An integrated policy expanding the free treatment package and ensuring universal coverage,especially the height of UHC for TB patients,is needed.Financial and social protection interventions are essential for identified at-risk groups.

  5. Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea.

    Science.gov (United States)

    Kim, Sujin; Kwon, Soonman

    2015-08-01

    To increase financial protection for catastrophic illness, South Korean government expanded the National Health Insurance (NHI) benefit coverage for cancer patients in September 2005. This paper investigated whether the policy has reduced inequality in catastrophic payments, defined as annual out-of-pocket (OOP) health payments exceeding 10% annual income, across different income groups. This study used the NHI claims data from 2002 to 2004 and 2006 to 2010. Triple difference estimator was employed to compare cancer patients as a treatment group with those with liver and cardio-cerebrovascular diseases as control groups and the low-income with the high-income groups. While catastrophic payments decreased in cancer patients compared with those of two diseases, they appeared to decrease more in the high-income than the low-income group. Considering that increased health care utilization and poor economic capacity may lead to a smaller reduction in catastrophic payments for the low-income than the high-income patients, the government needs to consider additional policy measures to increase financial protection for the poor. PMID:26123883

  6. Household catastrophic healthcare expenditure and impoverishment due to rotavirus gastroenteritis requiring hospitalization in Malaysia.

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    Tharani Loganathan

    Full Text Available While healthcare costs for rotavirus gastroenteritis requiring hospitalization may be burdensome on households in Malaysia, exploration on the distribution and catastrophic impact of these expenses on households are lacking.We assessed the economic burden, levels and distribution of catastrophic healthcare expenditure, the poverty impact on households and inequities related to healthcare payments for acute gastroenteritis requiring hospitalization in Malaysia.A two-year prospective, hospital-based study was conducted from 2008 to 2010 in an urban (Kuala Lumpur and rural (Kuala Terengganu setting in Malaysia. All children under the age of 5 years admitted for acute gastroenteritis were included. Patients were screened for rotavirus and information on healthcare expenditure was obtained.Of the 658 stool samples collected at both centers, 248 (38% were positive for rotavirus. Direct and indirect costs incurred were significantly higher in Kuala Lumpur compared with Kuala Terengganu (US$222 Vs. US$45; p<0.001. The mean direct and indirect costs for rotavirus gastroenteritis consisted 20% of monthly household income in Kuala Lumpur, as compared with only 5% in Kuala Terengganu. Direct medical costs paid out-of-pocket caused 141 (33% households in Kuala Lumpur to experience catastrophic expenditure and 11 (3% households to incur poverty. However in Kuala Terengganu, only one household (0.5% experienced catastrophic healthcare expenditure and none were impoverished. The lowest income quintile in Kuala Lumpur was more likely to experience catastrophic payments compared to the highest quintile (87% vs 8%. The concentration index for out-of-pocket healthcare payments was closer to zero at Kuala Lumpur (0.03 than at Kuala Terengganu (0.24.While urban households were wealthier, healthcare expenditure due to gastroenteritis had more catastrophic and poverty impact on the urban poor. Universal rotavirus vaccination would reduce both disease burden and health

  7. "Steeping" Of Health Expenditure Profiles

    OpenAIRE

    Buchner, Florian; Wasem, Jürgen

    2004-01-01

    If health care expenditure for the elderly grows faster than for younger people, the expenditure profiles become “steeper” – we call that “steeping”. Three instruments for measuring “steeping” are presented: (1) trend of the relation between per capita expenditure of the old and the young; (2) comparing the linear slopes of per capita expenditure in age groups; (3) trend in parameters of nonlinear modelling of expenditure profiles. Using data of the largest German private health insurer over ...

  8. Women, catastrophe and mental health.

    Science.gov (United States)

    Raphael, Beverley; Taylor, Mel; McAndrew, Virginia

    2008-01-01

    This paper examines the concept of catastrophic experience, its relationship to the range of acute and prolonged stressors to which women may be exposed and the broad impacts on their mental health and well-being. It identifies catastrophe in terms of multiple accumulated stresses including death, loss, victimization, demoralization, shame, stigmatization, helplessness and identity. Catastrophic experiences include personal violence in domestic circumstances of intimate partner abuse, sexual assault and child physical and sexual abuse. Women's experiences of loss through the violent deaths of children and loved ones may also have such enduring impacts. Terrorism victimizes men and women in this way, with the enduring impacts for women in terms of threat of ongoing attacks as well as acute effects and their aftermath. The catastrophes of war, conflict, genocide, sexual exploitation and refugee status differentially affect large numbers of women, directly and through their concerns for the care of their children and loved ones. Ultimate catastrophes such as Hiroshima and the Holocaust are discussed but with recognition of the very large numbers of women currently experiencing catastrophe in ongoing ways that may be silent and unrecognized. This is significant for clinical care and population impacts, and in the losses for women across such contexts. PMID:18058439

  9. National Health Expenditures - State (Provider)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Expenditure Accounts (NHEA) are the official estimates of total health care spending in the United States. Personal health care (PHC)...

  10. National Health Expenditures - State (Residence)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Expenditure Accounts (NHEA) are the official estimates of total health care spending in the United States. Personal health care (PHC)...

  11. Household economic impact of an emerging disease in terms of catastrophic out-of-pocket health care expenditure and loss of productivity: investigation of an outbreak of chikungunya in Orissa, India catastrophic out-of-pocket health care expenditure and loss of productivity: investigation of an outbreak of chikungunya in Orissa, India

    OpenAIRE

    Saji Saraswathy Gopalan; Ashis Das

    2009-01-01

    Background & objectives: To examine the household economic impact of an outbreak of chikungunya in terms of out-of-pocket health care expenditure and income foregone due to loss of productive time in Orissa, India.Methods: Structured interviews were conducted on 150 respondents, bread winners from the affected households of a village with maximum number of reported cases in the state, during August 2007. We looked at the economic profile, treatment history, and patient-side cost of care, los...

  12. Health-related financial catastrophe, inequality and chronic illness in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Md Mizanur Rahman

    Full Text Available BACKGROUND: Bangladesh has a high proportion of households incurring catastrophic health expenditure, and very limited risk sharing mechanisms. Identifying determinants of out-of-pocket (OOP payments and catastrophic health expenditure may reveal opportunities to reduce costs and protect households from financial risk. OBJECTIVE: This study investigates the determinants of high healthcare expenditure and healthcare- related financial catastrophe. METHODS: A cross-sectional household survey was conducted in Rajshahi city, Bangladesh, in 2011. Catastrophic health expenditure was estimated separately based on capacity to pay and proportion of non-food expenditure. Determinants of OOP payments and financial catastrophe were estimated using double hurdle and Poisson regression models respectively. RESULTS: On average households spent 11% of their total budgets on health, half the residents spent 7% of the monthly per capita consumption expenditure for one illness, and nearly 9% of households faced financial catastrophe. The poorest households spent less on health but had a four times higher risk of catastrophe than the richest households. The risk of financial catastrophe and the level of OOP payments were higher for users of inpatient, outpatient public and private facilities respectively compared to using self-medication or traditional healers. Other determinants of OOP payments and catastrophic expenses were economic status, presence of chronic illness in the household, and illness among children and adults. CONCLUSION: Households that received inpatient or outpatient private care experienced the highest burden of health expenditure. The poorest members of the community also face large, often catastrophic expenses. Chronic illness management is crucial to reducing the total burden of disease in a household and its associated increased risk of level of OOP payments and catastrophic expenses. Households can only be protected from these situations by

  13. Catastrophic healthcare expenditure during economic recession in the field of cardiovascular disease.

    Science.gov (United States)

    Fanourgiakis, John; Kanoupakis, Emmanuel

    2014-02-01

    Economic crisis drives many governments into drastic spending cuts in order to minimize their healthcare costs, resulting in an increase of out-of-pocket payment. This causes mainly the most vulnerable social groups, not only in poor countries, to lose their access to quality care and their ability to pay, and leads them in to catastrophic healthcare expenditures. Questions about whether health spending can be catastrophic rise across nations where there is an income reduction, unemployment and serious or chronic illness. Cardiovascular disease is the number one cause of death today. The first cost-of-illness study, which estimated the costs of cardiovascular disease in the EU in 2003, found them to be €169 billion a year, while the most recent, in 2009, estimated them at nearly €196 billion a year. Financial protection measures must be taken by governments in order to protect their citizens, particularly the most vulnerable ones. PMID:24308449

  14. Household Catastrophic Healthcare Expenditure and Impoverishment Due to Rotavirus Gastroenteritis Requiring Hospitalization in Malaysia

    OpenAIRE

    Loganathan, T; Lee, WS; Lee, KF; Jit, M.; Ng, CW

    2015-01-01

    Background While healthcare costs for rotavirus gastroenteritis requiring hospitalization may be burdensome on households in Malaysia, exploration on the distribution and catastrophic impact of these expenses on households are lacking. Objectives We assessed the economic burden, levels and distribution of catastrophic healthcare expenditure, the poverty impact on households and inequities related to healthcare payments for acute gastroenteritis requiring hospitalization in Malaysia. Methods A...

  15. Health Care Expenditure of Rural Households in Pondicherry, India

    Directory of Open Access Journals (Sweden)

    Poornima Varadarajan

    2013-11-01

    Full Text Available Background: Shortcomings in healthcare delivery has led people to spend a substantial proportion of their incomes on medical treatment. World Health Organization (2005 estimates reveal that every year 25 million households are forced into poverty by illness and the struggle to pay for healthcare. Thus we planned to calculate the health care expenditure of rural households and to assess the households incurring catastrophic health expenditure. Methods: A cross-sectional study was conducted in the service area of Sri Manakula Vinayagar Medical College and Hospital from May to August 2011. A total of 100 households from the 4 adjoining villages of our Institute were selected for operational and logistic feasibility. The household’s capacity to pay, out of pocket expenditure and catastrophic health expenditure were calculated. Data collection was done using a pretested questionnaire by the principal investigator and the analysis was done using SPSS (version 16. Results: The average income in the highest income quintile was Rs 51,885 but the quintile ratio was 14.98. The median subsistence expenditure was Rs 4,520. About 18% of households got impoverished paying for health care. About 81% of households were incurring out of pocket expenditure and 66% were facing catastrophic health expenses of 40%.Conclusion There was very high out of pocket spending and a high prevalence of catastrophic expenditure noted. Providing quality care at affordable cost and appropriate risk pooling mechanism are warranted to protect households from such economic threats.

  16. Equity in Health Care Expenditure in Nigeria

    Directory of Open Access Journals (Sweden)

    Olanrewaju Olaniyan

    2013-07-01

    Full Text Available Equity isone of the basic principles of health systems and features explicitly in theNigerian health financing policy. Despite acclaimed commitment to theimplementation of this policy through various pro-poor health programmes andinterventions, the level of inequity in health status and access to basichealth care interventions remain high. This paper examines the equity of healthcare expenditure by individuals in Nigeria. The paper evaluated equity in out-of-pocketspending( OOP for the country and separately for the six geopolitical zones ofthe country.The methodological framework rests onKakwani Progressivity Indices (KPIs, ReynoldSmolensky indices andconcentration indices (CIs using data from the 2004 Nigerian National LivingStandard Survey( NLSS collected by the National Bureau of Statistics. .The results reveal that health financing isregressive with the incidence disproportionately rest on poor households withabout 70% of the total expenditure on health is through out-of-pocket paymentsby households. Poor households are prone to bear most of the expenses in theevent of any health shock. The catastrophic consequences thus push some intopoverty, and aggravate the poverty of others.The paper therefore suggests that thecountry’s health financingsystems must be designed not only to allow people to access services when theyare needed, but must also protect household, from financial catastrophe, byreducing OOP spending through risk pooling and prepayment schemes within thehealth system.Keywords:                            Equity, Health careexpenditure, Kakwani progressivity index, Nigeria.

  17. Household catastrophic health expenditures: a comparative analysis of twelve Latin American and Caribbean Countries Gastos catastróficos en salud de los hogares: un análisis comparativo de doce países en América Latina y el Caribe

    Directory of Open Access Journals (Sweden)

    Felicia Marie Knaul

    2011-01-01

    Full Text Available OBJECTIVE: Compare patterns of catastrophic health expenditures in 12 countries in Latin America and the Caribbean. MATERIAL AND METHODS: Prevalence of catastrophic expenses was estimated uniformly at the household level using household surveys. Two types of prevalence indicators were used based on out-of-pocket health expense: a relative to an international poverty line, and b relative to the household's ability to pay net of their food basket. Ratios of catastrophic expenditures were estimated across subgroups defined by economic and social variables. RESULTS: The percent of households with catastrophic health expenditures ranged from 1 to 25% in the twelve countries. In general, rural residence, lowest quintile of income, presence of older adults, and lack of health insurance in the household are associated with higher propensity of catastrophic health expenditures. However, there is vast heterogeneity by country. CONCLUSIONS: Cross national studies may serve to examine how health systems contribute to the social protection of Latin American households.OBJETIVO: Comparar los patrones de gastos catastróficos en salud en 12 países de América Latina y el Caribe. MATERIAL Y MÉTODOS: Se estimó la prevalencia de gastos catastróficos de manera uniforme para doce países usando encuestas de hogares. Se emplearon dos tipos de indicadores para medir la prevalencia basados en el gasto de bolsillo en salud: a en relación con una línea de pobreza internacional; y b en relación con la capacidad de pago del hogar en términos de su propia canasta alimentaria. Se estimaron razones para comparar el nivel de gastos catastróficos entre subgrupos poblacionales definidos por variables económicas y sociales. RESULTADOS: El porcentaje de hogares con gastos catastróficos variaron de 1 a 25% en los 12 países. En general, la residencia rural, el bajo nivel de ingresos, la presencia de adultos mayores, y la carencia de aseguramiento en salud de los hogares

  18. The Effects of Intellectual Property Rights on Access to Medicines and Catastrophic Expenditure.

    Science.gov (United States)

    Jung, Youn; Kwon, Soonman

    2015-01-01

    Since the introduction of Trade-Related Aspects of Intellectual Property Rights (TRIPS) in 1995, there has been considerable concern that poor access to essential medicines in developing countries would be exacerbated because strengthening intellectual property rights (IPR) leads to monopoly of pharmaceutical markets and delayed entry of lower-cost generic drugs. However, despite extensive research and disputes regarding this issue, there are few empirical studies on the topic. In this study, we investigated the effect of IPR on access to medicines and catastrophic expenditure for medicines, using data from World Health Surveys 2002-2003. The index of patent rights developed by Ginarte and Park (1997) was used to measure the IPR protection level of each country. Estimates were adjusted for individual and country characteristics. In the results of multilevel logistic regression analyses, higher level of IPR significantly increased the likelihood of nonaccess to prescribed medicines even after controlling for individual socioeconomic status and national characteristics associated with access to medicines. This study's finding on the negative impact of IPR on access to medicines calls for the implementation of more active policy at the supra-national level to improve access in low- and middle-income countries. PMID:26077858

  19. Incentives of Health Care Expenditure

    Directory of Open Access Journals (Sweden)

    Eero Siljander

    2012-12-01

    Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of

  20. Patterns of Health Expenditures and Financial Protections in Vietnam 1992-2012.

    Science.gov (United States)

    Hoang, Van Minh; Oh, Juhwan; Tran, Tuan Anh; Tran, Thi Giang Huong; Ha, Anh Duc; Luu, Ngoc Hoat; Nguyen, Thi Kim Phuong

    2015-11-01

    Health financing has been considered as an important building block of a health system and has a key role in promoting universal health coverage in the Vietnam. This paper aims to describe the pattern of health expenditure, including total health expenditure and composition of health expenditure, over the last two decades in Vietnam. The paper mainly uses the data from Vietnam National Health Account and Vietnam Living Standards Survey. We also included data from other relevant published literature, reports and statistics about health care expenditure in Vietnam. The per capita health expenditure in Vietnam increased from US$ 14 in 1995 to US$ 86 in 2012. The total health expenditure as a share of GDP also rose from 5.2% in 1995 to 6.9% in 2012. Public health expenditure as percentage of government expenditure rose from 7.4% in 1995 to nearly 10% in 2012. The coverage of health insurance went up from 10% in 1995 to 68.5% in 2012. However, health financing in Vietnam was depending on private expenditures (57.4% in 2012). As a result, the proportion of households with catastrophic expenditure in 2012 was 4.2%. The rate of impoverishment in 2012 was 2.5%. To ensure equity and efficient goal of health system, policy actions for containing the health care out-of-pocket payments and their poverty impacts are urgently needed in Vietnam. PMID:26617446

  1. Corruption and health expenditure in Italy

    OpenAIRE

    Lagravinese, Raffaele; Paradiso, Massimo

    2012-01-01

    The vulnerability of health sector to corruption lies in the complex interaction between the social environment and the institutional setting of health systems. We investigate this interaction in the case of Italy, speci�cally looking at the impact of corruption on health expenditure. In Italy corruption is a social phenomenon. Health sector has been often involved in corruption o¤ences and decentralized health expenditure is considerably out of control. We show that the impact of corrupti...

  2. Modeling Per Capita State Health Expenditure Variat...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Modeling Per Capita State Health Expenditure Variation State-Level Characteristics Matter, published in Volume 3, Issue 4, of the Medicare and Medicaid Research...

  3. Causal Relationship among Education Expenditure, Health Expenditure and GDP: A Case Study for Bangladesh

    OpenAIRE

    Md. Mostafizur Rahman

    2011-01-01

    This paper investigated the causal relationship among health expenditure, education expenditure and GDP for Bangladesh. First we present the extension form of the augmented Solow Growth model by including education expenditure and health expenditure as education and health capital. In our empirical study we used time series data for the period 1990 to 2009. From the ECM methodology we found that an including of health and education expenditure as an investment in health and education capital ...

  4. Health Expenditures, Services and Outcomes in Africa

    OpenAIRE

    David H. Peters; Kandola, Kami; Elemendorf, A. Edward; Chellaraj, Gnanaraj

    2010-01-01

    In the past thirty years, Sub-Saharan African countries have made remarkable improvements in health conditions and status. However, they still suffer from some of the worst health problems in the world, and AIDS is making conditions much worse than they will be otherwise. This study, health expenditures, services, and outcomes in Africa considers 48 countries of Sub-Saharan Africa and outl...

  5. Impacto del Seguro Popular en el gasto catastrófico y de bolsillo en el México rural y urbano, 2005-2008 Impact of “Seguro Popular” on catastrophic and out-of-pocket health expenditures in rural and urban Mexico, 2005-2008

    Directory of Open Access Journals (Sweden)

    Sandra G Sosa-Rubí

    2011-01-01

    Full Text Available OBJETIVO. Estimar el efecto del Seguro Popular (SP sobre la incidencia del gasto catastrófico en salud (GCS y sobre el gasto de bolsillo en salud (GBS en el mediano plazo. MATERIAL Y MÉTODOS. Con base en la Encuesta de Evaluación del Seguro Popular (2005-2008, se analizaron los resultados del efecto del SP en la cohorte rural para dos años de seguimiento (2006 y 2008 y en la cohorte urbana para un año (2008. RESULTADOS. A nivel conglomerado no se detectaron efectos del SP. A nivel hogar se encontró que el SP tiene un efecto protector en el GCS y en el GBS en consulta externa y hospitalización en zonas rurales; y efectos significativos en la reducción de GBS en consulta externa en zonas urbanas. CONCLUSIONES. El SP se muestra como un programa efectivo para proteger a los hogares contra gastos de bolsillo por motivos de salud en el mediano plazo.OBJECTIVE. To estimate the effect of "Seguro Popular" (SP on the incidence of catastrophic health expenditure (CHE and out-of-pocket (OOP health expenditure in the medium term. MATERIAL AND METHODS. We used the 'Encuesta de Evaluación del SP' -SP Survey Evaluation- (2005-2008. We analyzed the SP effect on the rural cohort during two years of follow-up (2006 and 2008 and in the urban cohort during one year of follow-up (2008. RESULTS. At the local level (regional clusters we did not find an effect of the SP. At the household level we found a protective effect of SP on CHE and the OOP health payments in outpatient and hospitalization in rural areas; and a significant effect on the reduction of OOP health payments in outpatient services in urban zones. CONCLUSIONS. SP seems to be an effective program to protect poor household against out-of-pocket health expenditures in the medium term.

  6. Retirement Age and Health Expenditures

    OpenAIRE

    CREMER, Helmuth; Lozachmeur, Jean-Marie; PESTIEAU, Pierre

    2004-01-01

    This Paper studies the design of pension benefits and contributions when an individual’s health status (disutility of continued activity) is endogenous and depends on consumption of health services. Health services can be subsidized (in a linear or non-linear way, depending on the information structure). Uniform public provision of health services is also considered. We show that as with exogenous health status, the second-best policy may induce early retirement for some types of individuals....

  7. GSP and Health Expenditure in Italian Regions

    OpenAIRE

    Cosimo Magazzino

    2011-01-01

    This paper investigates the nexus between health care households’ expenditure and GSP for Italian regionsduring 1980-2009, using time series and panel econometric techniques. After a brief introduction and asurvey of the economic literature on this issue, we discuss the data and briefly introduce t h e methodologies.Empirical results show the presence of a long-run relationship in fifteen regions. As regards the causality analysis,health-led growth hypothesis is supported in three regions, wh...

  8. Aging Risk and Health Care Expenditure in Korea

    OpenAIRE

    Sang-Ho Nam; Byongho Tchoe

    2010-01-01

    This paper analyzes the impact of population aging on health care expenditures in Korea. Examination of the age-expenditure profile reveals that health care resources are allocated more for the older cohort of population over time, suggesting significant growth of health care expenditures due to population aging. We contend, however, that population aging is considered as a parameter rather than an independent variable to explain rising health care expenditures. This paper shows that populati...

  9. GSP and Health Expenditure in Italian Regions

    Directory of Open Access Journals (Sweden)

    Cosimo Magazzino

    2011-11-01

    Full Text Available This paper investigates the nexus between health care households’ expenditure and GSP for Italian regionsduring 1980-2009, using time series and panel econometric techniques. After a brief introduction and asurvey of the economic literature on this issue, we discuss the data and briefly introduce t h e methodologies.Empirical results show the presence of a long-run relationship in fifteen regions. As regards the causality analysis,health-led growth hypothesis is supported in three regions, while the reverse causation appears in five cases. Theneutrality hypothesis seems to be confirmed in ten regions. Finally, a bi-directional causality flow (feedbackhypothesis has been found for two regions. Panel analysis shows that, if our sample is divided into three morehomogeneous macro-regions (North, Centre and South, a long-run relationship between health expenditure andaggregate income has been found in two areas. Furthermore, the income elasticity is below the unity, implyingthat health expenditure is not a luxury good.

  10. Household income and health care expenditures in Mexico.

    Science.gov (United States)

    Parker, S W; Wong, R

    1997-06-01

    The purpose of this paper is to examine the determinants of household health expenditures in Mexico. Our analysis involves the estimation of household monetary health care expenditures, using the economic and demographic characteristics of the household as covariates. We pay particular attention to the impact of household income on health expenditures, estimating the elasticity of health care expenditures with respect to income for different income groups and according to health insurance status. For the empirical analysis, we use the Mexican National Survey of Income and Expenditures of 1989. Our principle findings show that monetary health expenditures by Mexican households are sensitive to changes in household income levels and that the group which is most responsive to changes in income levels in the lower-income uninsured group. This suggests that in times of economic crisis, these households reduce cash expenditures on health care by proportionately more than higher-income and insured households. PMID:10168755

  11. Maternal and neonatal health expenditure in mumbai slums (India: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Joshi Wasundhara

    2011-03-01

    Full Text Available Abstract Background The cost of maternity care can be a barrier to access that may increase maternal and neonatal mortality risk. We analyzed spending on maternity care in urban slum communities in Mumbai to better understand the equity of spending and the impact of spending on household poverty. Methods We used expenditure data for maternal and neonatal care, collected during post-partum interviews. Interviews were conducted in 2005-2006, with a sample of 1200 slum residents in Mumbai (India. We analysed expenditure by socio-economic status (SES, calculating a Kakwani Index for a range of spending categories. We also calculated catastrophic health spending both with and without adjustment for coping strategies. This identified the level of catastrophic payments incurred by a household and the prevalence of catastrophic payments in this population. The analysis also gave an understanding of the protection from medical poverty afforded by coping strategies (for example saving and borrowing. Results A high proportion of respondents spent catastrophically on care. Lower SES was associated with a higher proportion of informal payments. Indirect health expenditure was found to be (weakly regressive as the poorest were more likely to use wage income to meet health expenses, while the less poor were more likely to use savings. Overall, the incidence of catastrophic maternity expenditure was 41%, or 15% when controlling for coping strategies. We found no significant difference in the incidence of catastrophic spending across wealth quintiles, nor could we conclude that total expenditure is regressive. Conclusions High expenditure as a proportion of household resources should alert policymakers to the burden of maternal spending in this context. Differences in informal payments, significantly regressive indirect spending and the use of savings versus wages to finance spending, all highlight the heavier burden borne by the most poor. If a policy objective

  12. Health Expenditure Trends in OECD Countries, 1970-1997

    OpenAIRE

    Huber, Manfred

    1999-01-01

    This article provides an overview of current trends in health expenditures in 29 OECD countries and recent revisions of OECD health accounts. U.S. health expenditures are compared with those of other OECD countries. The interactions of cost-containment measures with changes in the public-private mix of financing and in the composition of health care spending are discussed.

  13. Health Expenditure, education and Economic Growth in MENA Countries

    OpenAIRE

    Lacheheb, Miloud; Med Nor, Norashidah; Baloch, Imdadullah

    2014-01-01

    This study examines the relationship between health expenditure, education and economic growth in MENA countries using panel data estimation. Our results based on random effect estimation endorse a relationship between health expenditure, education and economic growth. Data were obtained from the World Bank Development Indicators for the period of 1995 to 2010 for 20 countries from Middle East and North Africa region. Importantly, our results reveal that health expenditure and education have ...

  14. Health expenditures in Latin America and the Caribbean.

    Science.gov (United States)

    Govindaraj, R; Chellaraj, G; Murray, C J

    1997-01-01

    This paper presents the results of a study commissioned by the Latin American and Caribbean Technical Department of the World Bank to document and analyze health expenditures in Latin America and the Caribbean. In 1990, the countries of this region spent US$ 69 billion on health, with an average per capita health expenditure of US$ 162. On average, the countries spent 6.2% of their GDP on health, with the expenditures divided about equally between the public and private sectors. In both the public and private sectors, per capita health expenditures were positively and significantly correlated with per capita income. However, this relationship holds only for the public sector, when health expenditures are measured as a proportion of GDP. While several poorer countries were dependent on external assistance, with increasing income, the countries relied more on public expenditures to finance health care. Based on the limited time series data, it is evident that there was a considerable variation among countries regarding the proportion spent on capital investments, primary health care, and drugs, but not on salaries. Looking ahead, with increasing economic development, the proportion of GDP spent on health, along with public health expenditure as a proportion of total health expenditure, is likely to increase rapidly, while aid dependency is likely to decline. PMID:9015869

  15. Effect of Health Information Technology Expenditure on Patient Level Cost

    OpenAIRE

    Lee, Jinhyung; Dowd, Bryan

    2013-01-01

    Objectives This study investigate the effect of health information technology (IT) expenditure on individual patient-level cost using California Office of Statewide Health Planning and Development (OSHPD) data obtained from 2000 to 2007. Methods We used a traditional cost function and applied hospital fixed effect and clustered error within hospitals. Results We found that a quadratic function of IT expenditure best fit the data. The quadratic function in IT expenditure predicts a decrease in...

  16. Measuring the relationship between income and NHEs (national health expenditures).

    Science.gov (United States)

    Moore, W J; Newman, R J; Fheili, M

    1992-01-01

    This article uses recently published time series data for the Organization for Economic Cooperation and Development countries to estimate income elasticities for health care expenditures. Several different models and alternative specifications are examined to determine the sensitivity and robustness of the estimated relationships. Income is the dominant-determinant of health care spending and longrun income elasticity for health care is significantly greater than unity. This implies that health care is a luxury good, and expenditures will tend to rise with the level of national income. There is little evidence that the degree of public finance reduces the level of health care expenditures. PMID:10124434

  17. The Chernobyl catastrophe: Consequences on human health

    Energy Technology Data Exchange (ETDEWEB)

    Yablokov, A.; Labunska, I.; Blokov, I.; Santillo, D.; Johnston, P.; Stringer, R.; Sadownichik, T. (eds.); Antipkin, Yu.G. [Institute of Paediatrics, Obstetrics and Gynaecology, Academy of Medical Sciences, Kiev (Ukraine); Arabskaya, L.P. [Institute of Paediatrics, Obstetrics and Gynaecology, Academy of Medical Sciences, Kiev (Ukraine); Bazyka, D.A. [Research Centre for Radiation Medicine, Academy of Medical Sciences, Kiev (Ukraine)] (and others)

    2006-04-15

    This new Greenpeace report estimates that the full consequences of the Chernobyl disaster could top a quarter of a million cancers cases and nearly 100,000 fatal cancers. It reports that the report involved 52 respected scientists and includes information never before published in English. It challenges the International Atomic Energy Agency Chernobyl Forum report, which predicted 4,000 additional deaths attributable to the accident as a gross simplification of the real breadth of human suffering. Their data, based on Belarus national cancer statistics, predicts approximately 270,000 cancers and 93,000 fatal cancer cases caused by Chernobyl. The report also concludes that on the basis of demographic data, during the last 15 years, 60,000 people have additionally died in Russia because of the Chernobyl accident, and estimates of the total death toll for the Ukraine and Belarus could reach another 140,000. The report also looks into the ongoing health impacts of Chernobyl and concludes that radiation from the disaster has had a devastating effect on survivors; damaging immune and endocrine systems, leading to accelerated ageing, cardiovascular and blood illnesses, psychological illnesses, chromosomal aberrations and an increase in foetal deformations.

  18. The Chernobyl catastrophe: Consequences on human health

    International Nuclear Information System (INIS)

    This new Greenpeace report estimates that the full consequences of the Chernobyl disaster could top a quarter of a million cancers cases and nearly 100,000 fatal cancers. It reports that the report involved 52 respected scientists and includes information never before published in English. It challenges the International Atomic Energy Agency Chernobyl Forum report, which predicted 4,000 additional deaths attributable to the accident as a gross simplification of the real breadth of human suffering. Their data, based on Belarus national cancer statistics, predicts approximately 270,000 cancers and 93,000 fatal cancer cases caused by Chernobyl. The report also concludes that on the basis of demographic data, during the last 15 years, 60,000 people have additionally died in Russia because of the Chernobyl accident, and estimates of the total death toll for the Ukraine and Belarus could reach another 140,000. The report also looks into the ongoing health impacts of Chernobyl and concludes that radiation from the disaster has had a devastating effect on survivors; damaging immune and endocrine systems, leading to accelerated ageing, cardiovascular and blood illnesses, psychological illnesses, chromosomal aberrations and an increase in foetal deformations

  19. A snapshot of catastrophic post-disaster health expenses post-Haiyan

    Directory of Open Access Journals (Sweden)

    Noel Espallardo

    2015-11-01

    Full Text Available Introduction: This paper provides a snapshot of the health-care costs, out-of-pocket expenditures and available safety nets post-Typhoon Haiyan. Methods: This descriptive study used a survey and document review to report direct and indirect health-care costs and existing financial protection mechanisms used by households in two municipalities in the Philippines at one week and at seven months post-Haiyan. Results: Reported out-of-pocket health-care expenses were high immediately after the disaster and increased after seven months. The mean reported out-of-pocket expenses were higher than the reported average household income (US$ 24 to US$ 59. Discussion: The existing local and national mechanisms for health financing were promising and should be strengthened to reduce out-of-pocket expenses and protect people from catastrophic expenditures. Longer-term mechanisms are needed to ensure financial protection, especially among the poorest, beyond three months when most free services and medicines have ended. Preparedness should include prior registration of households that would ensure protection when a disaster comes.

  20. Public health expenditure in Spain: is there partisan behaviour?

    OpenAIRE

    Clemente, Jesús; Lazaro, Angelina; Montanes, Antonio

    2016-01-01

    This study examines the disparities in the evolution of Spanish regional public health expenditures from 1991 to 2010. We find that the recent development of the Spanish regional public health system have led the regions to reflect a very heterogeneous pattern of behaviour. These differences depend on economic and demographic factors, but also on the ideology of the regional governments. The longer a region is governed by a right-wing party, the lower the public health expenditure. This resul...

  1. Health care expenditures and gross domestic product: the Turkish case.

    Science.gov (United States)

    Sülkü, Seher Nur; Caner, Asena

    2011-02-01

    Our study examines the long-term relationship among per capita gross domestic product (GDP), per capita health expenditures and population growth rate in Turkey during the period 1984-2006, employing the Johansen multivariate co-integration technique. Related previous studies on OECD countries have mostly excluded Turkey-itself an OECD country. The only study on Turkey examines the period 1984-1998. However, after 1998, major events and policy changes that had a substantial impact on income and health expenditures took place in Turkey, including a series of reforms to restructure the health and social security system. In contrast to earlier findings in the literature, we find that the income elasticity of total health expenditures is less than one, which indicates that health care is a necessity in Turkey during the period of analysis. According to our results, a 10% increase in per capita GDP is associated with an 8.7% increase in total per capita health expenditures, controlling for population growth. We find that the income elasticity of public health expenditures is less than one. But, in the case of private health care expenditures, the elasticity is greater than one, meaning that private health care is a luxury good in Turkey. PMID:20151170

  2. Radiological research activity 1998–2007: relationship to gross domestic product, health expenditure and public expenditure on education

    OpenAIRE

    Spitzmueller, David; Hodler, Juerg; Seifert, Burkhardt; Zanetti, Marco

    2010-01-01

    Objective The purpose of this study was to evaluate the relationship of the radiological research activity from 1998 to 2007 to the gross domestic product (GDP), health expenditure and public expenditure on education. Methods The population-adjusted research activity determined by the number of articles published, the cumulative impact factor (IF) and the cumulative IF per capita were correlated with per capita values of the GDP, health expenditure and public education expenditure. Linear reg...

  3. Dynamics of Health Expenditures in OECD Countries: Panel ARDL Approach

    OpenAIRE

    İbrahim Doğan; Nadide Sevil Tülüce; Aydan Doğan

    2014-01-01

    This study used a panel data set, which is including 15 OECD countries that have high income per capita for the time period of 1995-2011. Following causality and autoregressive distributed lag (ARDL), paper yields: 1) respectively the largest and the smallest impacts on health expenditures are caused by public spending and the influences of Age Dependency Ratio Young (ADRY); 2) income and Age Dependency Ratio Old (ADRO) on health expenditures are positive; 3) another strikin...

  4. The Determinants of Health Expenditure in Italian Regions

    OpenAIRE

    Cosimo Magazzino; Marco Mele

    2012-01-01

    The health care expenditure in Italian regions is examined, applying the model selection procedure and panel methodologies to identify the determinants of health expenditure at the state level. After a brief introduction and a survey of the economic literature on this issue, we discuss the data and briefly introduce the methodologies. Empirical results suggest that the real Gross State Product, the unemployment rate, the number of beds in community hospitals, the urbanization degree and the p...

  5. Economic impact of chikungunya epidemic: out-of-pocket health expenditures during the 2007 outbreak in Kerala, India.

    Science.gov (United States)

    Vijayakumar, K; George, B; Anish, T S; Rajasi, R S; Teena, M J; Sujina, C M

    2013-01-01

    The southern state of Kerala, India was seriously affected by a chikungunya epidemic in 2007. As this outbreak was the first of its kind, the morbidity incurred by the epidemic was a challenge to the state's public health system. A cross sectional survey was conducted in five districts of Kerala that were seriously affected by the epidemic, using a two-stage cluster sampling technique to select households, and the patients were identified using a syndromic case definition. We calculated the direct health expenditure of families and checked whether it exceed the margins of catastrophic health expenditure (CHE). The median (IQR) total out-of-pocket (OOP) health expenditure in the study population was USD7.4 (16.7). The OOP health expenditure did not show any significant association with increasing per-capita monthly income.The major share (47.4%) of the costs was utilized for buying medicines, but costs for transportation (17.2%), consultations (16.6%), and diagnoses (9.9%) also contributed significantly to the total OOP health expenditure. The OOP health expenditure was high in private sector facilities, especially in tertiary care hospitals. For more than 15% of the respondents, the OOP was more than double their average monthly family income. The chikungunya outbreak of 2007 had significantly contributed to the OOP expenditure of the affected community in Kerala.The OOP health expenditure incurred was high, irrespective of the level of income. Governments should attempt to ensure comprehensive financial protection by covering the costs of care, along with loss of productivity. PMID:23682438

  6. The Causal Relationship between Health and Education Expenditures in Malaysia

    Directory of Open Access Journals (Sweden)

    Chor Foon TANG

    2011-08-01

    Full Text Available A major macroeconomic policy in generating economic growth is to encourage investments on human capital such as health and education. This is because both health and education make significant contribution to increasing productivity of the labour force which ultimately exerts a positive effect on raising output levels. A question that arises is whether investments on health and education have a causal relationship and if so, what is the directional causality? The objective of this study is to examine the causal relationship between health and education expenditures in Malaysia. This study covered annual data from 1970 to 2007. Using Granger causality as well as Toda and Yamamoto MWALD causality approaches, this study suggests that education Granger-causes health expenditure in both the short run and long run. The findings of this study implied that the Malaysian society places preference on education expenditure rather than health. This preference is not unexpected as generally, an educated and knowledgeable society precedes a healthy one. Before a society has attained a relatively higher level of education, it is less aware of the importance of health. Thus, expenditure on education should lead expenditure on health.

  7. Health Sector:Public Expenditure Review 2010/11

    OpenAIRE

    Kikuli, Regina; Ally, Mariam

    2012-01-01

    The main objective of Health Sector Public Expenditure Review for fiscal year (FY) 2011 (PER FY11) was to assess the budgetary allocations and expenditures to inform stakeholders about progress made in key health financing milestones over the 2006/07–2011/12 period. Specifically, the Health Sector PER sets out to provide: A review of PER FY10 findings and actions taken by the sector in response to those findings, indicating unaccomplished/pending actions, and identifying follow-up actions fo...

  8. Determinants of Household Health Expenditure: Case of Urban Orissa

    OpenAIRE

    Bhabesh, Sen; Himanshu, Sekhar Rout

    2007-01-01

    Little attention has been given to the micro aspects of health research by the researchers, government, policy makers and development planners. In this connection, the objective of the paper is to increase awareness – not only among health researchers but also among policy makers and practitioners who use health research findings – about the influence of socioeconomic characteristics in terms of income and education on household health expenditures, as well as to encourage improved approache...

  9. Egypt Health Policy Note : Egypt Public Expenditure Review

    OpenAIRE

    World Bank

    2006-01-01

    The public expenditures review (PER) of the health sector was prepared in response to a request from the government of Egypt as part of a broader PER work that covers other sectors. This policy note is intended to inform government policymakers of the key findings from the PER and recommend strategies for improving the efficiency, equity, and sustainability of public financing in the health sector, with a special emphasis on expanding the coverage of social health insurance - a major plank in...

  10. Health Literacy Impact on National Healthcare Utilization and Expenditure

    Directory of Open Access Journals (Sweden)

    Rafia Rasu

    2015-11-01

    Full Text Available Background Health literacy presents an enormous challenge in the delivery of effective healthcare and quality outcomes. We evaluated the impact of low health literacy (LHL on healthcare utilization and healthcare expenditure. Methods Database analysis used Medical Expenditure Panel Survey (MEPS from 2005-2008 which provides nationally representative estimates of healthcare utilization and expenditure. Health literacy scores (HLSs were calculated based on a validated, predictive model and were scored according to the National Assessment of Adult Literacy (NAAL. HLS ranged from 0-500. Health literacy level (HLL and categorized in 2 groups: Below basic or basic (HLS <226 and above basic (HLS ≥226. Healthcare utilization expressed as a physician, nonphysician, or emergency room (ER visits and healthcare spending. Expenditures were adjusted to 2010 rates using the Consumer Price Index (CPI. A Pvalue of 0.05 or less was the criterion for statistical significance in all analyses. Multivariate regression models assessed the impact of the predicted HLLs on outpatient healthcare utilization and expenditures. All analyses were performed with SAS and STATA®11.0 statistical software. Results The study evaluated 22 599 samples representing 503 374 648 weighted individuals nationally from 2005-2008. The cohort had an average age of 49 years and included more females (57%. Caucasian were the predominant racial ethnic group (83% and 37% of the cohort were from the South region of the United States of America. The proportion of the cohort with basic or below basic health literacy was 22.4%. Annual predicted values of physician visits, nonphysician visits, and ER visits were 6.6, 4.8, and 0.2, respectively, for basic or below basic compared to 4.4, 2.6, and 0.1 for above basic. Predicted values of office and ER visits expenditures were $1284 and $151, respectively, for basic or below basic and $719 and $100 for above basic (P < .05. The extrapolated national

  11. Nuclear catastrophe in Japan. Health consequences resulting from Fukushima

    International Nuclear Information System (INIS)

    On 11 March 2011, a nuclear catastrophe occurred at the Fukushima Dai-ichi nuclear power plant in Japan in the wake of an earthquake and due to serious safety deficiencies. This resulted in a massive and prolonged release of radioactive fission and decay products. Approximately 20% of the radioactive substances released into the atmosphere have led to the contamination of the landmass of Japan with 17,000 becquerels per square meter of cesium-137 and a comparable quantity of cesium-134. The initial health consequences of the nuclear catastrophe are already now, after only two years, scientifically verifiable. Similar to the case of Chernobyl, a decline in the birth rate was documented nine months after the nuclear catastrophe. Throughout Japan, the total drop in number of births in December 2011 was 4362, with the Fukushima Prefecture registering a decline of 209 births. Japan also experienced a rise in infant mortality, with 75 more children dying in their first year of life than expected statistically. In the Fukushima Prefecture alone, some 55,592 children were diagnosed with thyroid gland nodules or cysts. In contrast to cysts and nodules found in adults, these findings in children must be classified as precancerous. There were also the first documented cases in Fukushima of thyroid cancer in children. The present document undertakes three assessments of the expected incidence of cancer resulting from external exposure to radiation. These are based on publications in scientific journals on soil contamination in 47 prefectures in Japan, the average total soil contamination, and, in the third case, on local dose rate measurements in the fall of 2012. Taking into consideration the shielding effect of buildings, the medical organization IPPNW has calculated the collective lifetime doses for individuals at 94,749 manSv, 206,516 manSv, and 118,171 manSv, respectively. In accordance with the risk factors set by the European Committee on Radiation Risk (ECRR) for death

  12. Children with special health care needs: Impact of health care expenditures on family financial burden

    OpenAIRE

    Lindley, Lisa C.; Mark, Barbara A.

    2010-01-01

    We investigated the relationship between health care expenditures for Special Health Care Needs (SHCN) children and family perception of financial burden. Using 2005/2006 National Survey of Children with Special Health Care Needs data, a multivariate logistic regression model was used to estimate the relationship between the SHCN child’s health care expenditure and perceived financial burden, while controlling for family and child characteristics. Our analysis suggests that health care expend...

  13. Canadian health expenditures: Where do we really stand internationally?

    OpenAIRE

    Deber, R; Swan, B

    1999-01-01

    There are different ways to measure how much Canada spends on health care and the quality of these measurements may vary. This paper examines Organization for Economic Cooperation and Development data for 3 common standards of measure: health expenditures as a proportion of gross domestic product (GDP), nominal spending per capita (US dollars) and spending per capita in purchasing power parities (PPP) equivalents. In 1994, the most recent year for which there were firm data. Canada spent 9.9%...

  14. Population Ageing and Government Health Expenditures in New Zealand, 1951-2051

    OpenAIRE

    John Bryant; Audrey Teasdale; Martin Tobias; Jit Cheung; Mhairi McHugh

    2004-01-01

    The paper uses a simulation model to assess the effects of population ageing on government health expenditures in New Zealand. Population ageing is defined to include disability trends and “distance to death”; government health expenditures are defined to include both acute and long-term care. The model results suggest that population ageing is associated with a large increase in expenditure share of people aged 65 and over, which rises from about 29% of total government health expenditure in...

  15. 30 years life with Chernobyl, 5 years life with Fukushima. Health consequences of the nuclear catastrophes of Chernobyl and Fukushima

    International Nuclear Information System (INIS)

    The IPPNW report on health consequences of the nuclear catastrophes of Chernobyl and Fukushima covers the following issues: Part.: 30 years life with Chernobyl: Summarized consequences of Chernobyl, the accident progression, basic data of the catastrophe, estimation of health hazards as a consequence of the severe accident of Chernobyl, health consequences for the liquidators, health consequences for the contaminated population, mutagenic and teratogenic effects. Part B: 5 years life with Fukushima: The start of the nuclear catastrophe, emissions and contamination, consequences of the nuclear catastrophe on human health, thyroid surveys in the prefecture Fukushima, consequences of the nuclear catastrophe on the ecosystem, outlook.

  16. Forecasting drug utilization and expenditure in a metropolitan health region

    OpenAIRE

    Korkmaz Seher; Kalin Mats; Wilking Nils; Persson Marie E; Wettermark Björn; Hjemdahl Paul; Godman Brian; Petzold Max; Gustafsson Lars L

    2010-01-01

    Abstract Background New pharmacological therapies are challenging the healthcare systems, and there is an increasing need to assess their therapeutic value in relation to existing alternatives as well as their potential budget impact. Consequently, new models to introduce drugs in healthcare are urgently needed. In the metropolitan health region of Stockholm, Sweden, a model has been developed including early warning (horizon scanning), forecasting of drug utilization and expenditure, critica...

  17. Determinants of Regional Variation in Health Expenditures in Germany.

    Science.gov (United States)

    Göpffarth, Dirk; Kopetsch, Thomas; Schmitz, Hendrik

    2016-07-01

    Health care expenditure in Germany shows clear regional differences. Such geographic variations are often seen as an indicator for inefficiency. With its homogeneous health care system, low co-payments and uniform prices, Germany is a particularly suited example to analyse regional variations. We use data for the year 2011 on expenditure, utilization of health services and state of health in Germany's statutory health insurance system. This data, which originate from a variety of administrative sources and cover about 90% of the population, are enriched with a wealth of socio-economic variables, data on pollutants, prices and individual preferences. State of health and demography explains 55% of the differences as measured by the standard deviation while all control variables account for a total of 72% of the differences at county level. With other measures of variation, we can account for an even greater proportion. A higher proportion of variation than usually supposed can thus be explained. Whilst this study cannot quantify inefficiencies, our results contradict the thesis that regional variations reflect inefficiency. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25962986

  18. Private finance and sustainable growth of national health expenditures.

    Science.gov (United States)

    Hilsenrath, Peter; Hill, James; Levey, Samuel

    2004-01-01

    This analysis explores the role of the private sector relative to all health spending among Organization for Economic Cooperation and Development (OECD) countries. Bi-variate regression was employed for 31 countries using current data. It was found that the share of GDP allocated to health varies among countries, ranging from 5 percent in Turkey to 14 percent in the United States. Variation in per capita income explains much of this difference but other factors are important too. One appears to be the role of the private sector in financing health expenditures. Our analysis concludes that concern about rising health sector costs should be placed in a larger context: rising health care costs may be justified if benefits are large enough and cover the opportunity costs of alternative uses of resources. PMID:15682949

  19. Forecasting drug utilization and expenditure in a metropolitan health region

    Directory of Open Access Journals (Sweden)

    Korkmaz Seher

    2010-05-01

    Full Text Available Abstract Background New pharmacological therapies are challenging the healthcare systems, and there is an increasing need to assess their therapeutic value in relation to existing alternatives as well as their potential budget impact. Consequently, new models to introduce drugs in healthcare are urgently needed. In the metropolitan health region of Stockholm, Sweden, a model has been developed including early warning (horizon scanning, forecasting of drug utilization and expenditure, critical drug evaluation as well as structured programs for the introduction and follow-up of new drugs. The aim of this paper is to present the forecasting model and the predicted growth in all therapeutic areas in 2010 and 2011. Methods Linear regression analysis was applied to aggregate sales data on hospital sales and dispensed drugs in ambulatory care, including both reimbursed expenditure and patient co-payment. The linear regression was applied on each pharmacological group based on four observations 2006-2009, and the crude predictions estimated for the coming two years 2010-2011. The crude predictions were then adjusted for factors likely to increase or decrease future utilization and expenditure, such as patent expiries, new drugs to be launched or new guidelines from national bodies or the regional Drug and Therapeutics Committee. The assessment included a close collaboration with clinical, clinical pharmacological and pharmaceutical experts from the regional Drug and Therapeutics Committee. Results The annual increase in total expenditure for prescription and hospital drugs was predicted to be 2.0% in 2010 and 4.0% in 2011. Expenditures will increase in most therapeutic areas, but most predominantly for antineoplastic and immune modulating agents as well as drugs for the nervous system, infectious diseases, and blood and blood-forming organs. Conclusions The utilisation and expenditure of drugs is difficult to forecast due to uncertainties about the rate

  20. Canadian health expenditures: where do we really stand internationally?

    Science.gov (United States)

    Deber, R; Swan, B

    1999-06-15

    There are different ways to measure how much Canada spends on health care and the quality of these measurements may vary. This paper examines Organization for Economic Cooperation and Development data for 3 common standards of measure: health expenditures as a proportion of gross domestic product (GDP), nominal spending per capita (US dollars) and spending per capita in purchasing power parities (PPP) equivalents. In 1994, the most recent year for which there were firm data. Canada spent 9.9% of its GDP on health care (rank 3 of 29), and $1999 PPPs per capita (rank 3). However, actual spending was only US$1824 per capita (rank 14). In the same year Japan spent 7% of GDP on health care (rank 22), $1478 in PPPs per capita (rank 16), but actually spent US$2614 per capita (rank 3). Although each measure is suitable for some policy purposes, Canadian spending remains modest by international standards. PMID:10410638

  1. The determinants of health expenditure in Malaysia: A time series analysis

    OpenAIRE

    Tang, Chor Foon

    2010-01-01

    The purpose of this study is to investigate the determinants of health expenditure in Malaysia within the time series framework from 1967 to 2007. This study employed the Johansen-Juselius cointegration test to examine the cointegration relationship. The results showed that health expenditure and its determinants are cointegrated. Consistent with economic theory, the TYDL and variance decomposition analysis reveals that the key explanatory variables in Malaysia’s health expenditure model are ...

  2. [The federal health expenditure on the uninsured population: Mexico 1980-1995].

    Science.gov (United States)

    Lara, A; Gómez-Dantés, O; Urdapilleta, O; Bravo, M L

    1997-01-01

    In the last fifteen years Mexico suffered several economic crisis which have negatively affected public expenditure in social welfare and, as a consequence, public expenditure in health. This paper discusses the relationship between the adjustment policies adopted to confront these crisis and public expenditure in health care for the non-insured population, as well as the regional distribution of this expenditure. In part one, the evolution of general public expenditure, public expenditure in social welfare, and public expenditure in health between 1980 and 1995 is described. In part two, the distribution of public health expenditure for the non-insured population among the five regions in which the country was divided by the National Health Survey II is discussed. The main conclusion of this paper is that, between 1980 and 1995, the public expenditure gaps that have existed for a long time in Mexico among regions remained unchanged. These gaps basically affect the southern states of the country, are not related to health needs, and may deepen in view of the new relative cuts in public expenditure in social welfare announced by the new administration. PMID:9254433

  3. Health Care Expenditure among People with Disabilities: Potential Role of Workplace Health Promotion and Implications for Rehabilitation Counseling

    Science.gov (United States)

    Karpur, Arun; Bruyere, Susanne M.

    2012-01-01

    Workplace health-promotion programs have the potential to reduce health care expenditures, especially among people with disabilities. Utilizing nationally representative survey data, the authors provide estimates for health care expenditures related to secondary conditions, obesity, and health behaviors among working-age people with disabilities.…

  4. Improved estimates of capital formation in the National Health Expenditure Accounts.

    Science.gov (United States)

    Sensenig, Arthur L; Donahoe, Gerald F

    2006-01-01

    The National Health Expenditure Accounts (NHEA) were revised with the release of the 2004 estimates. The largest revision was the incorporation of a more comprehensive measure of investment in medical sector capital. The revision raised total health expenditures' share of gross domestic product (GDP) from 15.4 to 15.8 percent in 2003. The improved measure encompasses investment in moveable equipment and software, as well as expenditures for the construction of structures used by the medical sector. PMID:17290665

  5. Explaining health care utilization for panic attacks using cusp catastrophe modeling.

    Science.gov (United States)

    Katerndahl, David

    2008-10-01

    Despite increased health care utilization, patients with panic disorder continue to report unmet needs. The objective was to compare the fit of linear and Cusp Catastrophe Modeling in explaining changes in utilization of emergency, general and mental health settings, and self-treatments for panic symptoms. This community-based study surveyed 97 subjects with panic attacks drawn from a sample of randomly-selected adults from randomly-selected households. The stressor (splitting) variable used was Phobic Anxiety while predisposing variables included Family Health Care Utilization, Perceived Life Threat and Need For Treatment, and Treatment Experience. Outcomes consisted of the number of sites and self-treatments used for panic symptoms when first seeking care and during the 2 months prior to survey. Use of mental health sites and self-treatments demonstrated superior modeling with cusp catastrophe approaches using treatment experience as the predisposing variable, accounting for 47% and 38% of variances respectively, improving the fit by over 20% compared to the best linear models in both cases. Cusp catastrophe modeling accounted for more variance than all linear models when describing use of mental health settings and self-treatments. Cusp catastrophe may explain bimodal distributions in behavior, delays in behavior change, and sudden shifts in behavior in stressful situations. PMID:18765074

  6. Parent-Reported Health Consequences and Relationship to Expenditures in Children with ADHD.

    Science.gov (United States)

    deJong, Neal A; Williams, Christianna S; Thomas, Kathleen C

    2016-04-01

    Objectives (1) To describe parents' report of special needs for children with ADHD on the Children with Special Health Care Needs (CSHCN) Screener; and (2) to assess the association between responses to Screener items and annual mental health and total health expenditures per child. Methods In pooled 2002-2011 Medical Expenditure Panel Survey (MEPS) data, we identify children ages 4-17 years with ADHD. We use OLS and two-part regressions to model the relationship between CSHCN Screener items and mental health and total health expenditures. Based on these models we estimate adjusted, average total health expenditures for children with ADHD-both with and without a co-morbid mental health condition-and different combinations of endorsed Screener items. This research was conducted in accordance with prevailing ethical principles. Results There were 3883 observations on 2591 children with ADHD. Without a co-morbid mental health condition, average total expenditures per year from adjusted, model-based estimates were $865 for those meeting no Screener items, $2664 for those meeting only the medication item, $3595 for those meeting the medication and counseling items, and $4203 for those meeting the medication, counseling, and use of more health services items. Children with a co-morbid mental health condition had greater total health expenditures for each combination of Screener items. The associations between Screener items and mental health expenditures were similar, but with a slightly lower marginal effect of the medication item (p population health management. PMID:26754346

  7. Should catastrophic risks be included in a regulated competitive health insurance market?

    NARCIS (Netherlands)

    W.P.M.M. van de Ven (Wynand); F.T. Schut (Erik)

    1994-01-01

    textabstractIn 1988 the Dutch government launched a proposal for a national health insurance based on regulated competition. The mandatory benefits package should be offered by competing insurers and should cover both non-catastrophic risks (like hospital care, physician services and drugs) and cata

  8. Returns on investment in public health: effect of public health expenditures on infant health, 1983-1990.

    Science.gov (United States)

    Becker, E R; Principe, K; Adams, E K; Teutsch, S M

    1998-01-01

    In this study, we developed a broad conceptual framework focusing on how public health expenditures impact the nation's health. We then applied this framework to infant health outcomes and, using an eight-year state panel database, empirically analyzed how state public health expenditures, ceteris paribus, impact a state's level of teenage births and the receipt of prenatal care. Two hypotheses were tested. Hypothesis 1 states that over time, public health expenditures and public health activities, ceteris paribus, significantly decrease births to mothers less than 20 years of age. Hypothesis 2 states that over time, public health expenditures and public health activities, ceteris paribus, significantly decrease the number of infants whose mothers received late or no prenatal care. We find support for both hypotheses but observe that the way public health expenditures are measured has an impact on the findings. Other important implications of the study are noted. To our knowledge, this is the first article that has taken an aggregate state perspective over time and applied it to specific measures of infant health. PMID:9718507

  9. Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico.

    Science.gov (United States)

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2006-11-18

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis. PMID:17113432

  10. [Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico].

    Science.gov (United States)

    Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar; Bryson-Cahn, Chloe; Barofsky, Jeremy; Maguire, Rachel; Miranda, Martha; Sesma, Sergio

    2007-01-01

    Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular de Salud (Popular Health Insurance). We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results of the Mexican experience suggest an important role for the organisation and financing of the health system in reducing impoverishment and protecting households during periods of individual and collective financial crisis. PMID:17469400

  11. Evidence on the determinants of Canadian provincial government health expenditures: 1965-1991.

    Science.gov (United States)

    Di Matteo, L; Di Matteo, R

    1998-04-01

    Real per capital provincial government expenditures on health care over the period 1965-1991 are examined using pooled time-series cross-section regression analysis: Key determinants of real per capita provincial government expenditures on health care over the period 1965-1991 are real provincial per capita income, the proportion of the provincial population over age 65 and real provincial per capita federal transfer revenues. Established program financing had a negative and significant impact on real per capita provincial government health expenditures in Newfoundland and Quebec. An income elasticity of 0.77 implies that health care is not a luxury good. PMID:10180916

  12. Refining estimates of public health spending as measured in national health expenditure accounts: the Canadian experience.

    Science.gov (United States)

    Ballinger, Geoff

    2007-01-01

    The recent focus on public health stemming from, among other things, severe acute respiratory syndrome and avian flu has created an imperative to refine health-spending estimates in the Canadian Health Accounts. This article presents the Canadian experience in attempting to address the challenges associated with developing the needed taxonomies for systematically capturing, measuring, and analyzing the national investment in the Canadian public health system. The first phase of this process was completed in 2005, which was a 2-year project to estimate public health spending based on a more classic definition by removing the administration component of the previously combined public health and administration category. Comparing the refined public health estimate with recent data from the Organization for Economic Cooperation and Development still positions Canada with the highest share of total health expenditure devoted to public health than any other country reporting. The article also provides an analysis of the comparability of public health estimates across jurisdictions within Canada as well as a discussion of the recommendations for ongoing improvement of public health spending estimates. The Canadian Institute for Health Information is an independent, not-for-profit organization that provides Canadians with essential statistics and analysis on the performance of the Canadian health system, the delivery of healthcare, and the health status of Canadians. The Canadian Institute for Health Information administers more than 20 databases and registries, including Canada's Health Accounts, which tracks historically 40 categories of health spending by 5 sources of finance for 13 provincial and territorial jurisdictions. Until 2005, expenditure on public health services in the Canadian Health Accounts included measures to prevent the spread of communicable disease, food and drug safety, health inspections, health promotion, community mental health programs, public

  13. Social class related inequalities in household health expenditure and economic burden: evidence from Kerala, south India

    Directory of Open Access Journals (Sweden)

    Narayana Delampady

    2011-01-01

    Full Text Available Abstract Background In the Indian context, a household's caste characteristics are most relevant for identifying its poverty and vulnerability status. Inadequate provision of public health care, the near-absence of health insurance and increasing dependence on the private health sector have impoverished the poor and the marginalised, especially the scheduled tribe population. This study examines caste-based inequalities in households' out-of-pocket health expenditure in the south Indian state of Kerala and provides evidence on the consequent financial burden inflicted upon households in different caste groups. Methods Using data from a 2003-2004 panel survey in Kottathara Panchayat that collected detailed information on health care consumption from 543 households, we analysed inequality in per capita out-of-pocket health expenditure across castes by considering households' health care needs and types of care utilised. We used multivariate regression to measure the caste-based inequality in health expenditure. To assess health expenditure burden, we analysed households incurring high health expenses and their sources of finance for meeting health expenses. Results The per capita health expenditures reported by four caste groups accord with their status in the caste hierarchy. This was confirmed by multivariate analysis after controlling for health care needs and influential confounders. Households with high health care needs are more disadvantaged in terms of spending on health care. Households with high health care needs are generally at higher risk of spending heavily on health care. Hospitalisation expenditure was found to have the most impoverishing impacts, especially on backward caste households. Conclusion Caste-based inequality in household health expenditure reflects unequal access to quality health care by different caste groups. Households with high health care needs and chronic health care needs are most affected by this inequality

  14. Aggregate health care expenditures and national income. Is health care a luxury good?

    Science.gov (United States)

    Parkin, D; McGuire, A; Yule, B

    1987-06-01

    It is well known that a strong relationship exists between national expenditures on health care and national income. This has been used to suggest that health care is a luxury good, and that factors such as the type of health care delivery system in a country are of little importance in determining expenditure levels. This paper argues that these implications rely upon the application of microeconomic analysis to macroeconomic data, and that this is not appropriate. As well as raising questions about the inferences drawn from previous studies, new empirical evidence is presented which casts some doubts on previous findings. International comparisons are based on Purchasing Power Parity rather than exchange rate conversions, underlining the importance of prices as well as quantities in the relationship, and leading to the conclusion that the aggregate data show health care to be, if anything, a necessity rather than a luxury good. PMID:10312163

  15. Methodological aspects of health evaluation of the population suffered after the Chernobyl catastrophe

    International Nuclear Information System (INIS)

    Ecological situation in Belarus and the necessity of liquidation of medical consequences of the Chernobyl NPP Catastrophe demand many years' dynamic observation after the health condition of large people's contingents. At present this problem is being solved by the clinical follow up of the population undergone irradiation due to the Chernobyl catastrophe which is the basis of medical-prevention measures, directed to low medical consequences of the Chernobyl catastrophe. All the information on population's health received during the clinical follow up is put to a special State Data Base which was started for a clinical follow op information support, carrying out scientific researches and receiving reliable data on medical- biological consequences of the Chernobyl catastrophe. At present there's a problem of correct evaluation of health changes of the population who need clinical follow up on all its levels. The problem of comparative analyses of stored data hasn't been solved yet. It's necessary to underline that illness data of the population suffered after the Chernobyl catastrophe received due to intensive clinical follow up can't be compared with illness data of the population in general received due to ordinary applies to hospitals. It would be methodologically incorrect. Besides all said above, including into the research all the classes and forms of illnesses according to IDC-9, IDC-10 (International Disease Classification 9,10) what in a great degree enlarges volume of the research and its expenses is irrational. While studying the Chernobyl catastrophe medical consequences one must include to the analysis classes and nosologic illness forms which level and dynamic changes connected in some extend to radiation irradiation. By doing this one can minimize the volume and the expenses in the research like this. In this situation it's necessary to state such population health indexes which level exposed to a distortion in the lowest degree in the result of

  16. Determinants and Equity Evaluation for Health Expenditure Among Patients with Rare Diseases in China

    Science.gov (United States)

    Xin, Xiao-Xiong; Zhao, Liang; Guan, Xiao-Dong; Shi, Lu-Wen

    2016-01-01

    Background: China has not established social security system for rare diseases. Rare diseases could easily impoverish patients and their families. Little research has studied the equity and accessibility of health services for patients with rare diseases in China. This study aimed to explore the factors that influence health expenditure of rare diseases and evaluate its equity. Methods: Questionnaire survey about living conditions and cost burden of patients with rare diseases was conducted. Individual and family information, health expenditure and reimbursement in 2014 of 982 patients were collected. The impact of medical insurance, individual sociodemographic characteristics, family characteristics, and healthcare need on total and out-of-pocket (OOP) health expenditures was analyzed through the generalized linear model. Equity of health expenditure was evaluated by both concentration index and Lorenz curve. Results: Of all the surveyed patients, 11.41% had no medical insurance and 92.10% spent money to seek medical treatment in 2014. It was suggested female (P = 0.048), over 50 years of age (P = 0.062), high-income group (P = 0.021), hospitalization (P = 0.000), and reimbursement ratio (RR) (P = 0.000) were positively correlated with total health expenditure. Diseases not needing long-term treatment (P = 0.000) was negatively correlated with total health expenditure. Over 50 years of age (P = 0.065), high-income group (P = 0.018), hospitalization (P = 0.000) and having Urban Employee Basic Medical Insurance (UEBMI) (P = 0.022) were positively correlated with OOP health expenditure. Patient or the head of the household having received higher education (P = 0.044 and P = 0.081) and reimbursement ratio (P = 0.078) were negatively correlated with OOP health expenditure. The equity evaluation found concentration indexes of health expenditure before and after reimbursement were 0.0550 and 0.0539, respectively. Conclusions: OOP health expenditure of patients with UEBMI

  17. Using Quantile Regression to Examine Health Care Expenditures during the Great Recession

    OpenAIRE

    J. Chen; Vargas-Bustamante, A; Mortensen, K.; Thomas, SB

    2013-01-01

    Objective To examine the association between the Great Recession of 2007-2009 and health care expenditures along the health care spending distribution, with a focus on racial/ethnic disparities. Data Sources/Study Setting Secondary data analyses of the Medical Expenditure Panel Survey (2005-2006 and 2008-2009). Study Design Quantile multivariate regressions are employed to measure the different associations between the economic recession of 2007-2009 and health care spending. Race/ethnicity a...

  18. Iranian Households’ Payments on Food and Health Out-of-Pocket Expenditures: Evidence of Inequality

    Directory of Open Access Journals (Sweden)

    Hesam GHIASVAND

    2015-10-01

    Full Text Available Background: Inequality in households’ payments on food and health expenditures presents the accessibility and utili-zation patterns between them. This study investigated the Iranian rural and urban households’ inequality in payments on food and Out-of-Pocket health expenditures from 1998 to 2012.Methods: This descriptive study was conducted through the analysis of Iranian Statistics Centre data on Iranian households’ income and expenditures. The Gini Coefficients, Concentration and Kakwani indices have been calculat-ed for Iranian rural and urban households’ Out-of-Pocket health and food expenditures.Results: The means of Iranian rural and urban total consumption expenditures inequality were 0.48 and 0.48, respec-tively. The means of concentration index of food expenditures for rural and urban regions were 0.35 and 0.34, respec-tively. The means of Out-of-Pocket payments for health services for rural and urban regions were 0.51 and 0.5, re-spectively. Finally the means of Kakwani index of Out-of-Pocket health payments in rural and urban households were -0.005 and -0.018, respectively.Conclusion: There are relative high levels of inequality in Iranian households’ payments on food and Out-of-Pocket health expenditures.

  19. Estimating the Relationship between Economic Growth and Health Expenditures in ECO Countries Using Panel Cointegration Approach.

    Science.gov (United States)

    Hatam, Nahid; Tourani, Sogand; Homaie Rad, Enayatollah; Bastani, Peivand

    2016-02-01

    Increasing knowledge of people about health leads to raising the share of health expenditures in government budget continuously; although governors do not like this rise because of budget limitations. This study aimed to find the association between health expenditures and economic growth in ECO countries. We added health capital in Solow model and used the panel cointegration approach to show the importance of health expenditures in economic growth. For estimating the model, first we used Pesaran cross-sectional dependency test, after that we used Pesaran CADF unit root test, and then we used Westerlund panel cointegration test to show if there is a long-term association between variables or not. After that, we used chaw test, Breusch-Pagan test and Hausman test to find the form of the model. Finally, we used OLS estimator for panel data. Findings showed that there is a positive, strong association between health expenditures and economic growth in ECO countries. If governments increase investing in health, the total production of the country will be increased, so health expenditures are considered as an investing good. The effects of health expenditures in developing countries must be higher than those in developed countries. Such studies can help policy makers to make long-term decisions. PMID:26997596

  20. Voluntary Health Insurance expenditure in low- and middle-income countries: Exploring trends during 1995–2012 and policy implications for progress towards universal health coverage

    OpenAIRE

    Pettigrew, LM; Mathauer, I

    2016-01-01

    Background Most low- and middle-income countries (LMIC) rely significantly on private health expenditure in the form of out-of-pocket payments (OOP) and voluntary health insurance (VHI). This paper assesses VHI expenditure trends in LMIC and explores possible explanations. This illuminates challenges deriving from changes in VHI expenditure as countries aim to progress equitably towards universal health coverage (UHC). Methods Health expenditure data was retrieved from the WHO Global Health E...

  1. The effect of telehealth systems and satisfaction with health expenditure among patients with metabolic syndrome.

    Science.gov (United States)

    Uei, Shu-Lin; Tsai, Chung-Hung; Kuo, Yu-Ming

    2016-04-29

    Telehealth cost analysis has become a crucial issue for governments in recent years. In this study, we examined cases of metabolic syndrome in Hualien County, Taiwan. This research adopted the framework proposed by Marchand to establish a study process. In addition, descriptive statistics, a t test, analysis of variance, and regression analysis were employed to analyze 100 questionnaires. The results of the t$ test revealed significant differences in medical health expenditure, number of clinical visits for medical treatment, average amount of time spent commuting to clinics, amount of time spent undergoing medical treatment, and average number of people accompanying patients to medical care facilities or assisting with other tasks in the past one month, indicating that offering telehealth care services can reduce health expenditure. The statistical analysis results revealed that customer satisfaction has a positive effect on reducing health expenditure. Therefore, this study proves that telehealth care systems can effectively reduce health expenditure and directly improve customer satisfaction with medical treatment. PMID:27163314

  2. Health Care Expenditures in OECD Countries : A Panel Unit Root and Cointegration Analysis

    OpenAIRE

    Dreger, Christian; Reimers, Hans-Eggert

    2005-01-01

    This paper investigates the link between health care expenditures and GDP for a sample of 21 OECD countries using recent developed panel cointegration techniques. In contrast to previous studies, the analysis accounts for the fact that health care expenditures are not only determined by income. The other driving force is medical progress, which is proxied by different variables, like life expectancy, infant mortality and the share of the elderly. In the extended models, a cointegration relati...

  3. Investigating the Effect of Government Health Expenditure on HDI in Iran

    OpenAIRE

    Mohammad Javad Razmi; Ezatollah Abbasian; Sahar Mohammadi

    2012-01-01

    Human development is used as one of the most important indices to measure the level of countries development in resent decades. This study examines the effect of government health expenditure on human development index (HDI) by using the ordinary least squares method (OLS) over the period 1990-2009 in Iran. The results show a positive and significant elationship between government health expenditure and human development index. Also, Granger Causality Test indicates that there is no bilateral...

  4. Investigation for integration of the German Public Health Service in catastrophe and disaster prevention programs in Germany

    International Nuclear Information System (INIS)

    This research project aimed at investigating the integration of the GPHS into the plans for civil defence and protection as well as catastrophe prevention of the Federal Republic of Germany. Following a comprehensive analysis of the current situation, potential proposals for an improved integrative approach will be presented. In view of the lack of topics relevant for medical care in disaster medicine in educational curricula and training programs for medical students and postgraduate board programs for public health physicians, a working group of the Civil Protection Board of the German Federal Ministry of the Interior already complained in their 'Report on execution of legal rules for protection and rescue of human life as well as restitution of public health after disaster' in 1999, that the integration of the GPHS into catastrophe and disaster prevention programs has insufficiently been solved. On a point-by-point approach, our project analysed the following issues: - Legislative acts for integration of the German Public Health Service into medical care in catastrophes and disasters to protect the civilian population of Germany and their implementation and execution. - Administrative rules and directives on state and district levels that show relationship to integration of the German Public Health Service into preparedness programs for catastrophe prevention and management and their implementation and execution. - Education and postgraduate training options for physicians and non-physician employees of the German Public health Service to prepare for medical care in catastrophes and disasters. - State of knowledge and experience of the German Public Health Service personnel in emergency and disaster medicine. - Evaluation of the German administrative catastrophe prevention authorities with regard to their integration of the German Public Health Service into preparedness programs for catastrophe prevention and management. - Development of a concept to remedy the

  5. Final report:Health sector Public Expenditure Review (PER) update Financial Year (FY) 05

    OpenAIRE

    Ministry of Health,Tanzania, (MHT)

    2008-01-01

    In contrast to recent years, the health sector Public Expenditure Review update for FY05 is presented largely as an internal sectoral document for reviewing trends in budget and expenditure rather than as a detailed input to the budget process due to its delayed timing and a change in the focus of the overall government poverty reduction strategy with the development of the MKUKUTA (the Kiswahili acronym for the National Strategy for Growth and Poverty Reduction, the second Poverty Reduction ...

  6. Differences between sources of government expenditure in education and health, Tanzania

    OpenAIRE

    Lugo, Maria Ana

    2011-01-01

    Reliable data on government expenditure in priority sectors, such as health and education, is a key ingredient into the analysis of public policy effectiveness. This brief note has two primary goals: (i) to document the increasing divergence over time between various official Tanzanian data sources on spending in these two sectors, and (ii) to outline possible explanations for this divergence and highlight its consequences for social expenditure analysis.

  7. Trends in Scale and Structure of Korea's Health Expenditure over Last Three Decades (1980-2009): Financing, Functions and Providers

    OpenAIRE

    Jeong, Hyoung-Sun; Shin, Jeong-Woo

    2012-01-01

    This paper introduces statistics related to the size and composition of Korea's total health expenditure. The figures produced were tailored to the OECD's system of health accounts. Korea's total health expenditure in 2009 was estimated at 73.7 trillion won (US$ 57.7 billion). The annual per capita health expenditure was equivalent to US$ PPP 1,879. Korea's total health expenditure as a share of gross domestic product was 6.9% in 2009, far below the OECD average of 9.5%. Korea's public financ...

  8. Household expenditure for dental care in low and middle income countries.

    Directory of Open Access Journals (Sweden)

    Mohd Masood

    Full Text Available This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries who participated in the WHO World Health Survey (WHS were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries.

  9. Household expenditure for dental care in low and middle income countries.

    Science.gov (United States)

    Masood, Mohd; Sheiham, Aubrey; Bernabé, Eduardo

    2015-01-01

    This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries) who participated in the WHO World Health Survey (WHS) were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE) in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries. PMID:25923691

  10. The Determinants of Health Expenditures in Tunisia: An ARDL Bounds Testing Approach

    OpenAIRE

    Sami Chaabouni; Chokri Abednnadher

    2014-01-01

    This article examines the determinants of health expenditures in Tunisia during the period 1961-2008, using the Autoregressive Distributed Lag (ARDL) approach by Pesaran et al. (2001). The results of the bounds test show that there is a stable long-run relationship between per capita health expenditure, GDP, population ageing, medical density and environmental quality. In fact, on the one hand there are the short-run and long-run results which reveal that health care is a necessity, not a lux...

  11. Evaluating the redistributive impact of public health expenditure using an insurance value approach.

    Science.gov (United States)

    Spadaro, Amedeo; Mangiavacchi, Lucia; Moral-Arce, Ignacio; Adiego-Estella, Marta; Blanco-Moreno, Angela

    2013-10-01

    This article analyses the redistributive impact of public health expenditure in Spain using an insurance value approach to compute individual and household's value of health services non-cash benefit. We model the intensity of use of different health care services using a count data framework on a nationally representative health care survey and then predict probabilities on the 2006 Spanish EU-SILC sample. This allows us to extend disposable income with the expected monetary value of public health services and to compare it with strictly cash income. Since non-cash income due to public health services is associated with health needs, we use needs-adjusted equivalence scales to perform distributional analysis and poverty/inequality comparisons. The results show that public health expenditure in Spain acts progressively on income distribution, and that health in-kind benefits, once considered as part of disposable income, can be extremely effective in reducing poverty and inequality. PMID:22948513

  12. Comparison of the Effects of Public and Private Health Expenditures on the Health Status: a Panel Data Analysis in Eastern Mediterranean Countries

    Directory of Open Access Journals (Sweden)

    Enayatollah Homaie Rad

    2013-01-01

    Full Text Available BackgroundHealth expenditures are divided in two parts of public and private health expenditures. Public health expenditures contain social security spending, taxing to private and public sectors, and foreign resources like loans and subventions. On the other hand, private health expenditures contain out of pocket expenditures and private insurances. Each of these has different effects on the health status. The present study aims to compare the effects of these expenditures on health in Eastern Mediterranean Region (EMR. MethodsIn this study, infant mortality rate was considered as an indicator of health status. We estimated the model using the panel data of EMR countries between 1995 and 2010. First, we used Pesaran CD test followed by Pesaran’s CADF unit root test. After the confirmation of having unit root, we used Westerlund panel cointegration test and found that the model was cointegrated and then after using Hausman and Breusch-Pagan tests, we estimated the model using the random effects. ResultsThe results showed that the public health expenditures had a strong negative relationship with infant mortality rate. However, a positive relationship was found between the private health expenditures and infant mortality rate (IMR. The relationship for public health expenditures was significant, but for private health expenditures was not. ConclusionThe study findings showed that the public health expenditures in the EMR countries improved health outcome, while the private health expenditures did not have any significant relationship with health status, so often increasing the public health expenditures leads to reduce IMR. But this relationship was not significant because of contradictory effects for poor and wealthy peoples.

  13. What drives health care expenditure?--Baumol's model of 'unbalanced growth' revisited.

    Science.gov (United States)

    Hartwig, Jochen

    2008-05-01

    The share of health care expenditure in GDP rises rapidly in virtually all OECD countries, causing increasing concern among politicians and the general public. Yet, economists have to date failed to reach an agreement on what the main determinants of this development are. This paper revisits Baumol's [Baumol, W.J., 1967. Macroeconomics of unbalanced growth: the anatomy of urban crisis. American Economic Review 57 (3), 415-426] model of 'unbalanced growth', showing that the latter offers a ready explanation for the observed inexorable rise in health care expenditure. The main implication of Baumol's model in this context is that health care expenditure is driven by wage increases in excess of productivity growth. This hypothesis is tested empirically using data from a panel of 19 OECD countries. Our tests yield robust evidence in favor of Baumol's theory. PMID:18164773

  14. Managed care, deficit financing, and aggregate health care expenditure in the United States: a cointegration analysis.

    Science.gov (United States)

    Murthy, N R; Okunade, A A

    2000-09-01

    We applied a battery of cointegration tests comprising those of Johansen and Juselius [19], Phillips and Hansen [35], and Engle and Granger [6], to model aggregate health care expenditure using 1960-96 US data. The existence of a stable long-run economic relationship or cointegration is confirmed, in the United States, between aggregate health care expenditure and real GDP, population age distribution, managed care enrollment, number of practicing physicians, and government deficits. The evidence of cointegration among these variables, chosen on the theoretical basis of prior studies, implies that while they are individually non-stationary in levels, together they are highly correlated and move, in the long run to form an economic equilibrium relationship of US aggregate health care expenditure. More specifically, and for the first time in this line of inquiry, (i) managed care enrollment is found to be negatively associated with the level of health care spending, (ii) supply disinduced demand effects of physicians tend to moderate health expenditure, and (iii) government deficit financing is positively related to health care spending. The observed sign and magnitude of the income coefficient are consistent with health care being a luxury good. PMID:11105414

  15. Aromatherapy in complex health improvement of children, suffered from the Chernobyl catastrophe

    International Nuclear Information System (INIS)

    Aromatherapy is an effective and safe method widely used last decade for functional disorders treatment. We used this method for health improvement of children, suffered from Chernobyl catastrophe with autonomic system dysfunction. In complex rehabilitation measures we used collar-neck zone massage with Lemon oil (54 children), Aromastress orally (31) and Electro Essence oral receiving (82). As the result normalization of vegetative state (p=0,02) and vegetative reactivity (p=0,03) as well as neurological symptoms reduction (p=0,0001) registered. In children, taking Aromastress, electrocardiography violations disappeared more frequently (p=0,02). Electro Essence promoted deterioration of cumulated in organism radioactivity (p<0,0001). Thus aromatherapy is an effective method in complex health improvement of children, residing in radioactively contaminated regions. (Authors)

  16. Health care expenditure decisions in the presence of devolution and equalisation grants.

    Science.gov (United States)

    Levaggi, Rosella; Menoncin, Francesco

    2014-12-01

    In a model where health care provision, its regional distribution and the equalisation grant are the result of a utilitarian bargaining between a (relatively) rich region and a poor one, a First Best solution can be reached only if the two Regions have the same bargaining power. From a policy point of view, our model may explain the observed cross-national differences in the redistributive power of health care expenditure and it suggests that to equalise resources across Regions an income based equalisation grant may be preferred because it causes less distortions than an expenditure based one. PMID:25024039

  17. Tests of stationarity and cointegration of health care expenditure and gross domestic product: an application to Turkey.

    Science.gov (United States)

    Kiymaz, Halil; Akbulut, Yasemin; Demir, Ahmet

    2006-12-01

    This study examines the long-run relationship among the per capita private, public, and total health care expenditure and per capita gross domestic product and population growth of Turkey. We find some evidence of multivariate cointegrating relationships among the health care expenditure and gross domestic product, and population growth. We further find a bivariate cointegrating relationship between private health care expenditure and per capita gross domestic product. Accordingly, a 10% increase in gross domestic product would translate into a 21.9% increase in total health care expenditure while controlling population growth. The income elasticity of health expenditure is found to be greater than 1, implying that health care is a luxury good in Turkey. Finally we note that there exists one-way causality running from per capita gross domestic product to various definitions of health care expenses. PMID:17109146

  18. Health expenditure comparison of extended-release metoprolol succinate and immediate-release metoprolol tartarate

    Directory of Open Access Journals (Sweden)

    Vaidya V

    2012-02-01

    Full Text Available Varun Vaidya, Pranav PatelCollege of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USABackground: Metoprolol, a selective beta-1 blocker, is available in two different salt forms in the market – metoprolol succinate (MS and metoprolol tartarate (MT. Both the formulations are Food and Drug Administration approved for the treatment of hypertension. Several studies have shown similar efficacies between the two salts; however, they differ in their pharmacokinetic properties and are therefore priced differently. The primary objective of this study was to compare the overall health care expenditures of hypertensive patients on MT and MS to see if the price difference in the two preparations is offset by savings in overall expenditure.Methods: Two cohorts of patients using MT and MS were selected from the 2008 Medical Expenditure Panel Survey. Propensity score matching technique was used to balance the cohorts on various parameters such as demographic information, insurance status, and comorbidity score. Patients using MT were matched to patients using MS on the logit of propensity score using calipers of width equal to 0.2 of the standard deviation of the logit of the propensity score. Multiple regression analysis was carried out to examine the association between health expenditure and type of metoprolol salt, adjusting for other covariates.Results: A total of 742 patients were found to use metoprolol (MT-388, MS-354. After propensity score matching, a total of 582 patients were left in the sample for final analysis (291 patients in each cohort. The average annual health care expenditure was slightly higher in the MT cohort; however, after adjusting for covariates in a multivariate analysis, the difference was found to be statistically insignificant (P = 0.23.Conclusion: Both the products of metoprolol were found to have similar average annual total health care expenditure; however, MS once a day has higher out

  19. Health care expenditure and decentralization: a national and international empirical analysis for OECD countries

    OpenAIRE

    Mosca, Ilaria; Filippini, Massimo; Meneguzzo, Marco; Crivelli, Luca

    2006-01-01

    The consistent rise in health care expenditure in these last years has attracted a lot of attention by academics, policy makers, and politicians. The quota of GDP spent on health has become considerably high in many OECD countries and pundits searched for possible solutions to increase the efficiency of the health care sector and to contain waste. Decentralization has been perceived as a solution to be pursued in order to achieve better economic performance thanks to the closeness of the gove...

  20. The burden of maternal health care expenditure in India: multilevel analysis of national data

    OpenAIRE

    Leone, Tiziana; James, K S; Padmadas, Sabu S

    2013-01-01

    To quantify the economic burden of maternal health care services on Indian households and examine the levels of expenditure incurred in public and private health care institutions at the national, state and community levels. Cross-sectional population data from the 2004 National Sample Survey Organisation were used, which considered 9,643 households for the analysis where at least one woman received maternal health care services during the year preceding the survey. Multilevel linear regressi...

  1. Tax Financed Government Health Expenditure and Growth with Capital Deepening Externality

    OpenAIRE

    Kei Hosoya

    2003-01-01

    This paper develops a two-sector endogenous growth model with health capital and examines the impact tax financed health expenditure has on long-run growth. In this model, health capital is accumulated through government spending as a flow channel and a capital deepening externality as a stock channel. When arguing about the problem of growth maximizing flat tax, the latter channel plays a significant role for determining tax rate.

  2. Low birth weight and health expenditures from birth to late adolescence

    OpenAIRE

    Hummer, Michael; Lehner, Thomas; Gerald J. Pruckner

    2012-01-01

    Using administrative panel data of health insurants, we estimate the effects of low birth weight on health service utilization among children and young adults between birth and 21 years old. To account for time-invariant heterogeneity of mothers, we use sibling fixed- effects estimation. We find that low birth weight strongly increases subsequent health expenditures and that the effect is particularly pronounced in the first year of life. Starting in compulsory schooling, we observe a shift i...

  3. The determinants of Chinese provincial government health expenditures: evidence from 2002-2006 data.

    Science.gov (United States)

    Pan, Jay; Liu, Gordon G

    2012-07-01

    There is great divergence in provincial government health expenditures in China. Real per capita provincial government health expenditures (GHE) over the period 2002-2006 are examined using panel regression analysis. Key determinants of real per capita provincial GHE are real provincial per capita general budget revenue, real provincial per capita transfers from the central government, the proportion of provincial population under age 15, urban employee basic health insurance coverage, and proportion of urban population. Roughly equal and relatively low elasticities of budget revenue and transfers imply that the GHE is a necessity rather than a luxury good, and transfers have yet to become efficient instruments for the fair allocation of health resources by policy makers. Moreover, severe acute respiratory syndrome outbreak has increased the GHE, but we find no statistical evidence that provincial GHE have fluctuated according to the public health status. PMID:21560182

  4. The Pattern of Govemment Health Expenditure in China

    Institute of Scientific and Technical Information of China (English)

    Yang Ling; Liu Yuanli

    2012-01-01

    For a while since the inception of economic system re- form programs in 1980s, China's government investment in health was weakened. This resulted in healthcare provider's increasing re- liance on user charges for their income, poorer access to healthcare for the vulnerable population groups, and increasing socioeconomic disparities in health and healthcare. To address these problems, China initiated a series of health sector reforms since late 1990s. Our comprehensive review study has found that indeed Chinese government spending on health has been increasing in recent years, especially since 2009, when the new Healthcare Reform Plan was announced. Still, China needs to both further strengthen government investment in health and address the structural imbal- ances in government health financing, in order to make the overall Chinese health system more equitable and more efficient.

  5. Health care expenditure and life expectancy in Australia: how well do we perform?

    Science.gov (United States)

    Taylor, R; Salkeld, G

    1996-06-01

    The Australian health care system consists of mixed public and private financing underpinned by Medicare, a universal government-run insurance scheme paid through taxation (and levy) on income. Australia has improved its ranking for life expectancy (at birth) since 1960, and in 1990 ranked ninth and seventh of 24 countries for females and males respectively; this is ahead of the United States and United Kingdom, and approximately equal to Canada. Australian hospital bed supply and utilisation are average, after deletion of day-only cases. The proportion of gross domestic product (GDP) spent on health, in relation to GDP per capita (adjusted for purchasing power), in Australia in 1990 was average, and the prices for health care from 1975 to 1990 did not increase when adjusted for inflation. Although 68 per cent of health expenditure emanates from public sources in Australia, this is lower than in the majority of European countries and Canada. Some countries are doing poorly (such as the United States, with lower than average life expectancy and higher than predicted health expenditure) and some countries are doing well (with higher than average life expectancy and lower than predicted health expenditure; for example, Japan). Australia has higher than average life expectancy and only slightly higher than predicted health expenditure per capita. Although the Australian system could be improved, there are no indications that radical changes are required. The relatively high life expectancy in Australia can be attributed to favourable social and economic conditions, successful public health programs, and the availability of universal quality health care. PMID:8768411

  6. The Causal Relationship between Health and Education Expenditures in Malaysia

    OpenAIRE

    Chor Foon TANG; Yew Wah LAI

    2011-01-01

    A major macroeconomic policy in generating economic growth is to encourage investments on human capital such as health and education. This is because both health and education make significant contribution to increasing productivity of the labour force which ultimately exerts a positive effect on raising output levels. A question that arises is whether investments on health and education have a causal relationship and if so, what is the directional causality? The objective o...

  7. Household Expenditure for Dental Care in Low and Middle Income Countries

    OpenAIRE

    M. Masood; Sheiham, A; Bernabé, E.

    2015-01-01

    This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries) who participated in the WHO World Health Survey (WHS) were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or highe...

  8. A Performance Analysis of Public Expenditure on Maternal Health in Mexico

    Science.gov (United States)

    Servan-Mori, Edson; Avila-Burgos, Leticia; Nigenda, Gustavo; Lozano, Rafael

    2016-01-01

    We explore the relationship between public expenditure, coverage of adequate ANC (including timing, frequent and content), and the maternal mortality ratio -adjusted by coverage of adequate ANC- observed in Mexico in 2012 at the State level. Additionally, we examine the inequalities and concentration of public expenditure between populations with and without Social Security. Results suggest that in the 2003–2011 period, the public expenditure gap between women with and without Social Security decreased 74%, however, the distribution is less equitable among women without Social Security, across the States. Despite high levels of coverage on each dimension of ANC explored, coverage of adequate ANC was lower among Social Security than non-Social Security women. This variability results in differences up to 1.5 times in State-adjusted maternal mortality rate at the same level of expense and maternal mortality rate, respectively. The increase in the economic resources is only a necessary condition for achieving improved health outcomes. Providing adequate health services and achieving efficient, effective and transparent use of resources in health, are critical elements for health systems performance. The attainment of universal effective coverage of maternal health and reducing maternal mortality in Mexico, requires the adjustment of policy innovations including the rules of allocation and execution of health resources. Health policies should be designed on a more holistic view promoting a balance between accessibility, effective implementation and rigorous stewardship. PMID:27043819

  9. Health care expenditure for hospital-based delivery care in Lao PDR

    Directory of Open Access Journals (Sweden)

    Douangvichit Daovieng

    2012-01-01

    Full Text Available Abstract Background Delivery by a skilled birth attendant (SBA in a hospital is advocated to improve maternal health; however, hospital expenses for delivery care services are a concern for women and their families, particularly for women who pay out-of-pocket. Although health insurance is now implemented in Lao PDR, it is not universal throughout the country. The objectives of this study are to estimate the total health care expenses for vaginal delivery and caesarean section, to determine the association between health insurance and family income with health care expenditure and assess the effect of health insurance from the perspectives of the women and the skilled birth attendants (SBAs in Lao PDR. Methods A cross-sectional study was carried out in two provincial hospitals in Lao PDR, from June to October 2010. Face to face interviews of 581 women who gave birth in hospital and 27 SBAs was carried out. Both medical and non-medical expenses were considered. A linear regression model was used to assess influencing factors on health care expenditure and trends of medical and non-medical expenditure by monthly family income stratified by mode of delivery were assessed. Results Of 581 women, 25% had health care insurance. Health care expenses for delivery care services were significantly higher for caesarean section (270 USD than for vaginal delivery (59 USD. After adjusting for the effect of hospital, family income was significantly associated with all types of expenditure in caesarean section, while it was associated with non-medical and total expenditures in vaginal delivery. Both delivering women and health providers thought that health insurance increased the utilisation of delivery care. Conclusions Substantially higher delivery care expenses were incurred for caesarean section compared to vaginal delivery. Three-fourths of the women who were not insured needed to be responsible for their own health care payment. Women who had higher family

  10. Drivers of health care expenditure: Does Baumol's cost disease loom large?

    OpenAIRE

    Colombier, Carsten

    2012-01-01

    According to Baumol (1993) health care epitomises Baumol's cost disease. Sectors that suffer from Baumol's cost disease are characterised by slow productivity growth due to a high labour coefficient. As a result, unit costs of these sectors rise inexorably if the respective wages increase with productivity growth of the progressive industries such as manufacturing. Thus, according to Baumol (1993) the secular rise in health-care expenditure has been unavoidable. This present paper demonstrate...

  11. Is Health Care Expenditure Really a Luxury Good? Re-assessment and New Evidence Based on OECD Data

    OpenAIRE

    Vincenzo Atella; Giorgia Marini

    2007-01-01

    The aim of the paper is to present new evidence on the relationship between income and health expenditure allowing for (i) substitution and complementary relationships between private and public health expenditure, (ii) presence of structural breaks in the dependent variables, and (iii) presence of heterogeneous institutional setting (country-specific health systems). Our results show that income elasticity is quite sensitive to the inclusion of technology variables and to health system heter...

  12. A multilevel analysis on the determinants of regional health care expenditure: a note.

    Science.gov (United States)

    López-Casasnovas, Guillem; Saez, Marc

    2007-03-01

    Health care in most countries is a rather "local good" for which the fiscal decentralization theory applies and heterogeneity is the result. In order to address the issue of multijurisdictional health care in estimating income elasticity, we constructed a unique sample using data for 110 regions in eight Organisation for Economic Co-operation and Development (OECD) countries in 1997. We estimated this sample data with a multilevel hierarchical model. In doing this, we tried to identify two sources of random variation: within- and between-country variation. The basic purpose was to find out whether the different relationships between health care spending and the explanatory variables are country specific. We concluded that to take into account the degree of fiscal decentralization within countries in estimating income elasticity of health expenditure proves to be important. Two plausible reasons lie behind this: (a) where there is decentralization to the regions, policies aimed at emulating diversity tend to increase national health care expenditure and (b) without fiscal decentralization, central monitoring of finance tends to reduce regional diversity and therefore decrease national health expenditure. The results of our estimation do seem to validate both these points. PMID:17186198

  13. On the international stability of health care expenditure functions: are government and private functions similar?

    Science.gov (United States)

    Clemente, Jesús; Marcuello, Carmen; Montañés, Antonio; Pueyo, Fernando

    2004-05-01

    This paper studies the stability of health care expenditure functions in a sample of OECD countries. We adopt the cointegration approach and the results show that there is a long-term relationship between total health care expenditure (HCE) and gross domestic product (GDP). However, the existence of cointegration is only shown when we admit the presence of some changes in the elasticities of the model. Our results also provide evidence against the existence of a unique relationship between health and GDP for the sample. Thus, we can conclude that the differences in health systems may cause differences in the aggregate functions. Additionally, we examine aggregate health functions for government (GHCE) and private expenditures (PHCE), again finding evidence of different patterns of behaviour. Finally, we open a discussion on the character of health as a necessary or luxury good. In this context, we find differences between the government and the private function. In order to illustrate these findings, we propose a theoretical model as an example of the influence of political decisions on income elasticity. PMID:15120472

  14. Sex and age differences in health expenditure in Northern Italy

    OpenAIRE

    Simone Ghislandi; Pier Giorgio Crosignani; Eva Negri; Carlo La Vecchia; Carlo Zocchetti

    2014-01-01

    BACKGROUND: Little is known about the health care spending distribution across the age and sex gradient in European systems. The aim of the present study is to examine gender and age differences in health care utilization in Lombardy, Italy.METHODS: We analysed administrative data for the year 2010 in Lombardy (the largest Italian region, with about 10 million inhabitant) including spending for inpatient and outpatient services and pharmaceuticals. Data were aggregated across age and sex.RESU...

  15. Budgetary Expenditure on Health and Human Development in India

    OpenAIRE

    Brijesh C. Purohit

    2012-01-01

    This study aims at analyzing the differentials across rich and poor states and across rich and poorer strata and rural urban segments of 19 major Indian states. The study indicates that besides individual health financing policies of the respective state governments, there are significant disparities even between rural and urban strata and rich and poorer sections of the society. These are indicated by high inequality coefficients and an emerging pattern of life style second generation health...

  16. The Weight of Health Expenditures on Household Income in Cameroon

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    Joseph Parfait OWOUNDI

    2014-02-01

    Full Text Available  African leaders pledged at the Abuja conference in 2001, to mobilize more financial resources to allocate at least 15% of their national budgets to the health sector to achieve the Millennium Development Goals (MDGs, seem to have difficulty meeting this commitment because of weakness and fragmentation of health systems. These commitments were renewed in Gaborone, Botswana in 2005 and in Ouagadougou, Burkina Faso in 2006. Indeed, donor funding is still a large part of public health spending on the continent. In some countries, 50% or more of their budgets come from foreign or private assistance. In about half the countries, the private health financing is equal to or exceeds largely public funding, up to 70% in some states like Sudan, Côte d'Ivoire, Cameroon, Chad, Liberia and Uganda. Only five countries (Rwanda, Malawi, Zambia, Burkina Faso, and Togo have so far respected the promise made to the Abuja conference. In Cameroon, where 51% of the population lives on less than two dollars per day, the average propensity of the total medical consumption is very high. Indeed, 32% of households spend less than half of income on health, while 16% of households spend more than half of the income and 52% spend more than the total income. This corresponds to a weight of 68% in health care spending.  

  17. THE EVALUATION OF THE FAMILY MEDICINE PRACTICE EFFECTS ON HEALTH CARE EXPENDITURES IN TURKEY

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    Sinan AYTEKİN

    2012-06-01

    Full Text Available Family Medicine is an important practice in terms of producing preventive medicine sensation in individuals and following health care system. The pilot application was launched in Düzce/Türkiye in 2005. The purpose of the study is to examine whether there is a differences between the application numbers to the hospitals and health expenditures before and after the prevalence of the family medicine practice.Statistical data about health care and insurance are assembled for 2009 and 2010 based on Medula data published by Social Security Institution. Then, the number of prescriptions, prescribed amounts, the number of consultsto hospitals and the amount of invoice of consults to hospitals were compared for these years. First of all, the Shapiro-Wilk test was applied to the data. Normally distributed data were analyzed with paired t-test.Non-normal distributed data were analyzed with the Wilcoxon Signed sign test. As a result of the analysis, the difference between health care expenditures and the number of consultation to hospitals provedto be statistically significant before and after the prevalence of the family medicine practice. Reasons for these differences were examined with the help of the tables. After commissioning of patient referral application, health care expenditures are considered to decrease and to reach the real level.

  18. Gender inequality, health expenditure and maternal mortality in sub-Saharan Africa: A secondary data analysis

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    Frank Chirowa

    2013-01-01

    Full Text Available Background: This article provided an analysis of gender inequality, health expenditure and its relationship to maternal mortality.Objective: The objective of this article was to explore gender inequality and its relationship with health expenditure and maternal mortality in sub-Saharan Africa (SSA. A unique analysis was used to correlate the Gender Inequality Index (GII, Health Expenditure and Maternal Mortality Ratio (MMR. The GII captured inequalities across three dimensions – Reproductive health, Women empowerment and Labour force participation between men and women. The GII is a composite index introduced by the UNDP in 2010 and corrects for the disadavanatges of the other gender indices. Although the GII incorporates MMR in its calculation, it should not be taken as a substitute for, but rather as complementary to, the MMR.Method: An exploratory and descriptive design to a secondary documentary review using quantitative data and qualitative information was used. The article referred to sub-Saharan Africa, but seven countries were purposively selected for an in-depth analysis based on the availability of data. The countries selected were Angola, Botswana, Malawi, Mozambique,South Africa, Zambia and Zimbabwe.Results: Countries with high gender inequality captured by the gender inequality index were associated with high maternal mortality ratios as compared with countries with lower gender inequality, whilst countries that spend less on health were associated with higher maternal deaths than countries that spend more.Conclusion: A potential relationship exists between gender inequality, health expenditure, and maternal mortality. Gender inequalities are systematic and occur at the macro, societal and household levels.

  19. Can mothers rely on the Brazilian health system for their deliveries? An assessment of use of the public system and out-of-pocket expenditure in the 2004 Pelotas Birth Cohort Study, Brazil

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    Bertoldi Andréa D

    2008-03-01

    Full Text Available Abstract Background In a country where comprehensive free health care is provided via a public health system (SUS, an unexpected high frequency of catastrophic out-of-pocket expenditure has been described. We studied how deliveries were financed among mothers of a birth cohort and whether they were an important source of household out-of-pocket expenditure. Methods All deliveries occurring in the city of Pelotas, Brazil, during 2004, were recruited for a birth cohort study. All mothers were interviewed just after birth and three months later. Comprehensive data on the pregnancy, delivery, birth conditions and newborn health were collected, along with detailed information on expenses related to the delivery. Results The majority of the deliveries (81% were financed by the public health system, a proportion that increased to more than 95% among the 40% poorest mothers. Less than 1% of these mothers reported some out-of-pocket expenditure. Even among those mothers covered by a private health plan, nearly 50% of births were financed by the SUS. Among the 20% richest, a third of the deliveries were paid by the SUS, 50% by private health plans and 17% by direct payment. Conclusion The public health system offered services in quantity and quality enough to attract even beneficiaries of private health plans and spared mothers from the poorest strata of the population of practically any expense.

  20. To what extent does recurrent government health expenditure in Uganda reflect its policy priorities?

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    Nabyonga-Orem Juliet

    2010-10-01

    Full Text Available Abstract Background The National Health Policy 2000 - 2009 and Health sector strategic plans I & II emphasized that Primary Health Care (PHC would be the main strategy for national development and would be operationalized through provision of the minimum health care package. Commitment was to spend an increasing proportion of the health budget for the provision of the basic minimum package of health services which was interpreted to mean increasing spending at health centre level. This analysis was undertaken to gain a better understanding of changes in the way recurrent funding is allocated in the health sector in Uganda and to what extent it has been in line with agreed policy priorities. Methods Government recurrent wage and non-wage expenditures - based on annual releases by the Uganda Ministry of Finance, Planning and Economic Development were compiled for the period 1997/1998 to financial year 2007/2008. Additional data was obtained from a series of Ministry of Health annual health sector reports as well as other reports. Data was verified by key government officials in Ministry of Finance, Planning and Economic Development and Ministry of Health. Analysis of expenditures was done at sector level, by the different levels in the health care system and the different levels of care. Results There was a pronounced increase in the amount of funds released for recurrent expenditure over the review period fueled mainly by increases in the wage component. PHC services showed the greatest increase, increasing more than 70 times in ten years. At hospital level, expenditures remained fairly constant for the last 10 years with a slight reduction in the wage component. Conclusion The policy aspiration of increasing spending on PHC was attained but key aspects that would facilitate its realization were not addressed. At any given level of funding for the health sector, there is need to work out an optimal balance in investment in the different inputs to

  1. Nuclear catastrophe in Japan. Health consequences resulting from Fukushima; Atomkatastrophe in Japan. Gesundheitliche Folgen von Fukushima

    Energy Technology Data Exchange (ETDEWEB)

    Paulitz, Henrik; Eisenberg, Winfrid; Thiel, Reinhold

    2013-03-06

    On 11 March 2011, a nuclear catastrophe occurred at the Fukushima Dai-ichi nuclear power plant in Japan in the wake of an earthquake and due to serious safety deficiencies. This resulted in a massive and prolonged release of radioactive fission and decay products. Approximately 20% of the radioactive substances released into the atmosphere have led to the contamination of the landmass of Japan with 17,000 becquerels per square meter of cesium-137 and a comparable quantity of cesium-134. The initial health consequences of the nuclear catastrophe are already now, after only two years, scientifically verifiable. Similar to the case of Chernobyl, a decline in the birth rate was documented nine months after the nuclear catastrophe. Throughout Japan, the total drop in number of births in December 2011 was 4362, with the Fukushima Prefecture registering a decline of 209 births. Japan also experienced a rise in infant mortality, with 75 more children dying in their first year of life than expected statistically. In the Fukushima Prefecture alone, some 55,592 children were diagnosed with thyroid gland nodules or cysts. In contrast to cysts and nodules found in adults, these findings in children must be classified as precancerous. There were also the first documented cases in Fukushima of thyroid cancer in children. The present document undertakes three assessments of the expected incidence of cancer resulting from external exposure to radiation. These are based on publications in scientific journals on soil contamination in 47 prefectures in Japan, the average total soil contamination, and, in the third case, on local dose rate measurements in the fall of 2012. Taking into consideration the shielding effect of buildings, the medical organization IPPNW has calculated the collective lifetime doses for individuals at 94,749 manSv, 206,516 manSv, and 118,171 manSv, respectively. In accordance with the risk factors set by the European Committee on Radiation Risk (ECRR) for death

  2. The Association Between Self-Rated Mental Health Status and Total Health Care Expenditure: A Cross-Sectional Analysis of a Nationally Representative Sample.

    Science.gov (United States)

    Nguyen, Muoi T; Chan, Winnie Y; Keeler, Courtney

    2015-09-01

    Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data.This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6).Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ tests and a 2-part model (logistics regression and generalized linear model regression for the first and second stages, respectively).Although predictive of any health expenditure, SRMH alone was not highly predictive of the dollar value of that health expenditure conditional on any spending. By comparison, the K6 measure was significantly and positively associated with the probability of any health expenditure as well as the dollar value of that spending. Taken together, both the K6 and SRMH measures suggest a positive relationship between poor mental health and the probability of any health expenditure and total expenditure conditional on any spending, even when adjusting for other confounding factors such as race/ethnicity, sex, age, educational attainment, insurance status, and some regional characteristics.Our results suggest that psychological distress and SRMH may represent potential pathways linking poor mental health to increased health care expenditure. Further research exploring the nuances of these relationships may aid researchers, practitioners, and policy makers in addressing issues of inflated health care expenditure in populations at risk for poor mental health. PMID:26334899

  3. "Factor Decomposition of Inter-prefectural Health Care Expenditure Disparities in Japan"

    OpenAIRE

    Masayoshi Hayashi; Akiko Oyama

    2014-01-01

    Despite frequent discussions on regional variations in health care expenditure (HCE), few studies account for the sources of such regional disparities. This study bridges this gap in the literature by taking the following two steps. First, we explore the determinants of regional HCE in Japan, covering a data period that expands the scope of previous studies (i.e., the 2000s). Second, we decompose the variations in regional HCE into contributions explained by the HCE determinants examined in t...

  4. Modifiable health risk factors and medical expenditures - The case of Taiwan.

    Science.gov (United States)

    Lin, Tsui-Fang

    2008-12-01

    To contain escalating healthcare spending has become a great challenge for many countries around the world. Among all factors influencing medical costs, extensive studies have shown that adoption of healthy lifestyles such as not smoking, moderate drinking, eating healthy food, and exercising regularly can contribute to good health and lower the odds of having diseases that result in higher medical spending. The goal of this paper is to explore the relationship between modifiable risk factors and healthcare costs in Taiwan. A two-part model is employed to estimate the association between modifiable risk factors and medical expenditures. A logit model is used in the first stage of estimation and a generalized linear model is used in the second stage of estimation. Linking the 2001 National Health Interview Survey (NHIS) and the claims data in the National Health Insurance Research Database (NHIRD) in Taiwan, I find some significant associations between several lifestyle variables and medical expenditures. Former smokers are found to have higher probability of using medical care and incur higher medical expenses. People with exercise habits are less likely to use inpatient care services, and they incur lower inpatient expenses. Therefore, healthcare policies promoting non-smoking and physical activities should be used in Taiwan to curb rising expenditures and to achieve better care for people with chronic diseases. PMID:18950919

  5. Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures.

    Science.gov (United States)

    Liang, Li-Lin; Mirelman, Andrew J

    2014-08-01

    A consensus exists that rising income levels and technological development are among key drivers of total health spending. Determinants of public sector health expenditure, by contrast, are less well understood. This study examines a complex relationship across government health expenditure (GHE), sociopolitical risks, and international aid, while taking into account the impacts of national income, debt and tax financing and aging populations on health spending. We apply a fixed-effects two-stage least squares regression method to a panel dataset comprising 120 countries for the years 1995 through 2010. Our results show that democratic accountability has a diminishing positive correlation with GHE, and that levels of GHE are higher when government is more stable. Corruption is associated with less GHE in developing countries, but with higher GHE in developed countries. We also find that development assistance for health (DAH) is fungible with domestically financed government health expenditure (DGHE). For an average country, a 1% increase in DAH to government is associated with a 0.03-0.04% decrease in DGHE. Furthermore, the degree of fungibility of DAH to government is higher in countries where corruption or ethnic tensions are widespread. However, DAH to non-governmental organizations is not fungible with DGHE. PMID:24929917

  6. UK and Twenty Comparable Countries GDP-Expenditure-on-Health 1980-2013: The Historic and Continued Low Priority of UK Health-Related Expenditure

    Science.gov (United States)

    Harding, Andrew J.E.; Pritchard, Colin

    2016-01-01

    It is well-established that for a considerable period the United Kingdom has spent proportionally less of its gross domestic product (GDP) on health-related services than almost any other comparable country. Average European spending on health (as a % of GDP) in the period 1980 to 2013 has been 19% higher than the United Kingdom, indicating that comparable countries give far greater fiscal priority to its health services, irrespective of its actual fiscal value or configuration. While the UK National Health Service (NHS) is a comparatively lean healthcare system, it is often regarded to be at a ‘crisis’ point on account of low levels of funding. Indeed, many state that currently the NHS has a sizeable funding gap, in part due to its recently reduced GDP devoted to health but mainly the challenges around increases in longevity, expectation and new medical costs. The right level of health funding is a political value judgement. As the data in this paper outline, if the UK ‘afforded’ the same proportional level of funding as the mean average European country, total expenditure would currently increase by one-fifth.

  7. Is metacognition a causal moderator of the relationship between catastrophic misinterpretation and health anxiety? A prospective study.

    Science.gov (United States)

    Bailey, Robin; Wells, Adrian

    2016-03-01

    Psychological theories have identified a range of variables contributing to health anxiety, including, dysfunctional illness beliefs, catastrophic misinterpretation, somatosensory amplification and neuroticism. More recently, metacognitive beliefs have been proposed as important in health anxiety. This study aimed to test the potential causal role of metacognitive beliefs in health anxiety. A prospective design was employed and participants (n = 105) completed a battery of questionnaire at two time points (6 months apart). Results demonstrated that cognitive, personality and metacognitive variables were bi-variate prospective correlates of health anxiety. Hierarchical regression analysis revealed that only metacognitive beliefs emerged as independent and significant prospective predictors of health anxiety. Moderation analysis demonstrated that metacognitive beliefs prospectively moderated the relationship between catastrophic misinterpretation and health anxiety. Follow-up regression analysis incorporating the interaction term (metacognition × misinterpretation) showed that the term explained additional variance in health anxiety. The results confirm that metacognition is a predictor of health anxiety and it is more substantive than misinterpretations of symptoms, somatosensory amplification, neuroticism, and illness beliefs. These results may have major implications for current cognitive models and for the treatment of health anxiety. PMID:26851713

  8. "The Effects of Hypertension and Obesity on Total Health Care Expenditures of Diabetes Patients in the United States"

    OpenAIRE

    Simon Condliffe; Charles Link; Micheal F. Pollack; Shreekant Parasuraman

    2012-01-01

    We identify a representative sample of U.S. diabetes patients with comorbid hypertension and evaluate health care expenditures in this population across BMI strata. The underlying hypothesis is that the presence of comorbid obesity and hypertension poses an additional burden on patients with diabetes, thus impacting their overall resource utilization. That is, hypertension and obesity in combination have a greater adverse impact on health care expenditures than individually. More than one-thi...

  9. Psychiatric inpatient expenditures and public health insurance programmes: analysis of a national database covering the entire South Korean population

    OpenAIRE

    Chung Woojin

    2010-01-01

    Abstract Background Medical spending on psychiatric hospitalization has been reported to impose a tremendous socio-economic burden on many developed countries with public health insurance programmes. However, there has been no in-depth study of the factors affecting psychiatric inpatient medical expenditures and differentiated these factors across different types of public health insurance programmes. In view of this, this study attempted to explore factors affecting medical expenditures for ...

  10. Diabetes, minor depression and health care utilization and expenditures: a retrospective database study

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    McCollum Marianne

    2007-04-01

    Full Text Available Abstract Background To estimate the prevalence of minor depression among US adults with diabetes, health care resource utilization, and expenditures by people with diabetes with and without minor depression. Methods Among adult 2003 Medical Expenditure Panel Survey respondents, diabetes was identified by diagnosis code and self-report. Depression was identified by diagnosis code plus ≥ one antidepressant prescription. Odds of having depression was estimated in people with diabetes and the general population, adjusted for sociodemographic variables (e.g., age, sex, race/ethnicity. Multivariate regressions evaluated factors associated with utilization and log-transformed expenditures for ambulatory care, hospitalizations, emergency visits, and prescriptions. Results In 2003, 1932 respondents had diabetes, 435/1932 had diabetes and minor depression. Adults with diabetes were more likely than the general population to have depression (adjusted OR 1.81, 95% CI 1.56, 2.09. People with diabetes with versus without comorbid depression were more likely to be women, have lower incomes and health status, and more diabetes complications (all p Conclusion People with diabetes are twice as likely to have depression as the general population. Screening for and treatment of depression is warranted, as is additional research into a causal relationship between diabetes and depression.

  11. Psychiatric inpatient expenditures and public health insurance programmes: analysis of a national database covering the entire South Korean population

    Directory of Open Access Journals (Sweden)

    Chung Woojin

    2010-09-01

    Full Text Available Abstract Background Medical spending on psychiatric hospitalization has been reported to impose a tremendous socio-economic burden on many developed countries with public health insurance programmes. However, there has been no in-depth study of the factors affecting psychiatric inpatient medical expenditures and differentiated these factors across different types of public health insurance programmes. In view of this, this study attempted to explore factors affecting medical expenditures for psychiatric inpatients between two public health insurance programmes covering the entire South Korean population: National Health Insurance (NHI and National Medical Care Aid (AID. Methods This retrospective, cross-sectional study used a nationwide, population-based reimbursement claims dataset consisting of 1,131,346 claims of all 160,465 citizens institutionalized due to psychiatric diagnosis between January 2005 and June 2006 in South Korea. To adjust for possible correlation of patients characteristics within the same medical institution and a non-linearity structure, a Box-Cox transformed, multilevel regression analysis was performed. Results Compared with inpatients 19 years old or younger, the medical expenditures of inpatients between 50 and 64 years old were 10% higher among NHI beneficiaries but 40% higher among AID beneficiaries. Males showed higher medical expenditures than did females. Expenditures on inpatients with schizophrenia as compared to expenditures on those with neurotic disorders were 120% higher among NHI beneficiaries but 83% higher among AID beneficiaries. Expenditures on inpatients of psychiatric hospitals were greater on average than expenditures on inpatients of general hospitals. Among AID beneficiaries, institutions owned by private groups treated inpatients with 32% higher costs than did government institutions. Among NHI beneficiaries, inpatients medical expenditures were positively associated with the proportion of

  12. Gender Difference in Health-Care Expenditure: Evidence from India Human Development Survey

    Science.gov (United States)

    Saikia, Nandita; Moradhvaj; Bora, Jayanta Kumar

    2016-01-01

    Background While the gender disparity in health and mortality in various stages of life in India is well documented, there is limited evidence on female disadvantage in health-care expenditure (HCE). Aims Examine the gender difference in HCE in short-term and major morbidity in India, and understand the role of factors underlying the difference. Data and Methods Using two rounds of nationally representative panel data—the India Human Development Survey (IHDS) 2004–2005 and 2011–2012 (IHDS I & II)—we calculate morbidity prevalence rate and mean HCE by gender, and examine the adjusted effect of gender on major morbidity-related HCE by using a two-part regression model. Further, we performed Oaxaca-Blinder decomposition of the gender gap in HCE in major morbidity to understand the contribution of demographic and socio-economic factors. Results Health-care expenditure on females was systematically lower than on males across all demographic and socio-economic groups. Multivariate analysis confirms that female HCE is significantly lower than male HCE even after controlling demographic and socio-economic factors (β = -0.148, p = 0.000, CI:-0.206–0.091). For both short-term and major morbidity, a female disadvantage on HCE increased from IHDS I to IHDS II. For instance, the male–female gap in major morbidity related expenditure increased from INR 1298 to INR 4172. A decomposition analysis of gender gap in HCE demonstrates that about 48% of the gap is attributable to differences in demographic and socio-economic factors (endowment effect), whereas 50% of the gap is due to the differential effect of the determinants (coefficient effect). Interpretation Indians spend less on female health care than on male health care. Most of the gender gap in HCE is not due to differential distribution of factors affecting HCE. PMID:27391322

  13. 30 years life with Chernobyl, 5 years life with Fukushima. Health consequences of the nuclear catastrophes of Chernobyl and Fukushima; 30 Jahre Leben mit Tschernobyl, 5 Jahre Leben mit Fukushima. Gesundheitliche Folgen der Atomkatastrophen von Tschernobyl und Fukushima

    Energy Technology Data Exchange (ETDEWEB)

    Claussen, Angelika; Rosen, Alex

    2016-02-15

    The IPPNW report on health consequences of the nuclear catastrophes of Chernobyl and Fukushima covers the following issues: Part.: 30 years life with Chernobyl: Summarized consequences of Chernobyl, the accident progression, basic data of the catastrophe, estimation of health hazards as a consequence of the severe accident of Chernobyl, health consequences for the liquidators, health consequences for the contaminated population, mutagenic and teratogenic effects. Part B: 5 years life with Fukushima: The start of the nuclear catastrophe, emissions and contamination, consequences of the nuclear catastrophe on human health, thyroid surveys in the prefecture Fukushima, consequences of the nuclear catastrophe on the ecosystem, outlook.

  14. Health Expenditure Concentration and Characteristics of High-Cost Enrollees in CHIP.

    Science.gov (United States)

    Sen, Bisakha; Blackburn, Justin; Aswani, Monica S; Morrisey, Michael A; Becker, David J; Kilgore, Meredith L; Caldwell, Cathy; Sellers, Chris; Menachemi, Nir

    2016-01-01

    Devising effective cost-containment strategies in public insurance programs requires understanding the distribution of health care spending and characteristics of high-cost enrollees. The aim was to characterize high-cost enrollees in a state's public insurance program and determine whether expenditure inequality changes over time, or with changes in cost-sharing policies or program eligibility. We use 1999-2011 claims and enrollment data from the Alabama Children's Health Insurance Program, ALL Kids. All children enrolled in ALL Kids were included in our study, including multiple years of enrollment (N = 1,031,600 enrollee-months). We examine the distribution of costs over time, whether this distribution changes after increases in cost sharing and expanded eligibility, patient characteristics that predict high-cost status, and examine health services used by high-cost children to identify what is preventable. The top 10% (1%) of enrollees account for about 65.5% (24.7%) of total program costs. Inpatient and outpatient costs are the largest components of costs incurred by high-cost utilizers. Non-urgent emergency department costs are a relatively small portion. Average expenditure increases over time, particularly after expanded eligibility, and the share of costs incurred by the top 10% and 1% increases slightly. Multivariable logistic regression results indicate that infants and older teens, Caucasian children, and those with chronic conditions are more likely to be high-cost utilizers. Increased cost sharing does not reduce cost concentration or average expenditure among high-cost utilizers. These findings suggest that identifying and targeting potentially preventable costs among high-cost utilizers are called for to help reduce costs in public insurance programs. PMID:27166411

  15. More Health Expenditure, Better Economic Performance? Empirical Evidence From OECD Countries.

    Science.gov (United States)

    Wang, Fuhmei

    2015-01-01

    Recent economic downturns have led many countries to reduce health spending dramatically, with the World Health Organization raising concerns over the effects of this, in particular among the poor and vulnerable. With the provision of appropriate health care, the population of a country could have better health, thus strengthening the nation's human capital, which could contribute to economic growth through improved productivity. How much should countries spend on health care? This study aims to estimate the optimal health care expenditure in a growing economy. Applying the experiences of countries from the Organization for Economic Co-Operation and Development (OECD) over the period 1990 to 2009, this research introduces the method of system generalized method of moments (GMM) to derive the design of the estimators of the focal variables. Empirical evidence indicates that when the ratio of health spending to gross domestic product (GDP) is less than the optimal level of 7.55%, increases in health spending effectively lead to better economic performance. Above this, more spending does not equate to better care. The real level of health spending in OECD countries is 5.48% of GDP, with a 1.87% economic growth rate. The question which is posed by this study is a pertinent one, especially in the current context of financially constrained health systems around the world. The analytical results of this work will allow policymakers to better allocate scarce resources to achieve their macroeconomic goals. PMID:26310501

  16. Medical technology as a key driver of rising health expenditure: disentangling the relationship

    Directory of Open Access Journals (Sweden)

    Sorenson C

    2013-05-01

    Full Text Available Corinna Sorenson,1,2 Michael Drummond,2,3 Beena Bhuiyan Khan1 1LSE Health, London School of Economics and Political Science, London, UK; 2European Health Technology Institute for Socioeconomic Research, Brussels, Belgium; 3Centre for Health Economics, University of York, York, UK Abstract: Health care spending has risen steadily in most countries, becoming a concern for decision-makers worldwide. Commentators often point to new medical technology as the key driver for burgeoning expenditures. This paper critically appraises this conjecture, based on an analysis of the existing literature, with the aim of offering a more detailed and considered analysis of this relationship. Several databases were searched to identify relevant literature. Various categories of studies (eg, multivariate and cost-effectiveness analyses were included to cover different perspectives, methodological approaches, and issues regarding the link between medical technology and costs. Selected articles were reviewed and relevant information was extracted into a standardized template and analyzed for key cross-cutting themes, ie, impact of technology on costs, factors influencing this relationship, and methodological challenges in measuring such linkages. A total of 86 studies were reviewed. The analysis suggests that the relationship between medical technology and spending is complex and often conflicting. Findings were frequently contingent on varying factors, such as the availability of other interventions, patient population, and the methodological approach employed. Moreover, the impact of technology on costs differed across technologies, in that some (eg, cancer drugs, invasive medical devices had significant financial implications, while others were cost-neutral or cost-saving. In light of these issues, we argue that decision-makers and other commentators should extend their focus beyond costs solely to include consideration of whether medical technology results in

  17. The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures

    Science.gov (United States)

    Rahman, Momotazur; Galarraga, Omar; Zinn, Jacqueline S.; Grabowski, David C.; Mor, Vincent

    2016-01-01

    Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes. PMID:26223431

  18. Financing health care expenditure in the OECD countries: Evidence from a heterogeneous, cross-sectional dependent panel

    Directory of Open Access Journals (Sweden)

    de Mello-Sampayo Felipa

    2014-01-01

    Full Text Available This paper analyses the relationship between health expenditure and the way it is financed in a panel of 30 OECD countries observed annually from 1990 to 2009. The nonstationarity and cointegration properties between health care spending and its sources of funding, income, and non-income variables are studied. This is performed in a panel data context controlling for both cross section dependence and unobserved heterogeneity. The findings suggest that when health care expenditure is mainly financed by government it becomes independent of an individual’s income, controlling for dependency rates for old and young age structure and technological progress.

  19. Patient-Centered Medical Home Features and Health Care Expenditures of Medicare Beneficiaries with Chronic Disease Dyads.

    Science.gov (United States)

    Philpot, Lindsey M; Stockbridge, Erica L; Padrón, Norma A; Pagán, José A

    2016-06-01

    Three out of 4 Medicare beneficiaries have multiple chronic conditions, and managing the care of this growing population can be complex and costly because of care coordination challenges. This study assesses how different elements of the patient-centered medical home (PCMH) model may impact the health care expenditures of Medicare beneficiaries with the most prevalent chronic disease dyads (ie, co-occurring high cholesterol and high blood pressure, high cholesterol and heart disease, high cholesterol and diabetes, high cholesterol and arthritis, heart disease and high blood pressure). Data from the 2007-2011 Medical Expenditure Panel Survey suggest that increased access to PCMH features may differentially impact the distribution of health care expenditures across health care service categories depending on the combination of chronic conditions experienced by each beneficiary. For example, having no difficulty contacting a provider after regular hours was associated with significantly lower outpatient expenditures for beneficiaries with high cholesterol and diabetes (n = 635; P = 0.038), but it was associated with significantly higher inpatient expenditures for beneficiaries with high blood pressure and high cholesterol (n = 1599; P = 0.015), and no significant differences in expenditures in any category for beneficiaries with high blood pressure and heart disease (n = 1018; P > 0.05 for all categories). However, average total health care expenditures are largely unaffected by implementing the PCMH features considered. Understanding how the needs of Medicare beneficiaries with multiple chronic conditions can be met through the adoption of the PCMH model is important not only to be able to provide high-quality care but also to control costs. (Population Health Management 2016;19:206-211). PMID:26440215

  20. National health expenditure projections: modest annual growth until coverage expands and economic growth accelerates.

    Science.gov (United States)

    Keehan, Sean P; Cuckler, Gigi A; Sisko, Andrea M; Madison, Andrew J; Smith, Sheila D; Lizonitz, Joseph M; Poisal, John A; Wolfe, Christian J

    2012-07-01

    For 2011-13, US health spending is projected to grow at 4.0 percent, on average--slightly above the historically low growth rate of 3.8 percent in 2009. Preliminary data suggest that growth in consumers' use of health services remained slow in 2011, and this pattern is expected to continue this year and next. In 2014, health spending growth is expected to accelerate to 7.4 percent as the major coverage expansions from the Affordable Care Act begin. For 2011 through 2021, national health spending is projected to grow at an average rate of 5.7 percent annually, which would be 0.9 percentage point faster than the expected annual increase in the gross domestic product during this period. By 2021, federal, state, and local government health care spending is projected to be nearly 50 percent of national health expenditures, up from 46 percent in 2011, with federal spending accounting for about two-thirds of the total government share. Rising government spending on health care is expected to be driven by faster growth in Medicare enrollment, expanded Medicaid coverage, and the introduction of premium and cost-sharing subsidies for health insurance exchange plans. PMID:22692089

  1. Health Care Expenditure and GDP in African Countries: Evidence from Semiparametric Estimation with Panel Data

    Directory of Open Access Journals (Sweden)

    Zhike Lv

    2014-01-01

    Full Text Available A large body of literature studies on the relationship between health care expenditure (HCE and GDP have been analyzed using data intensively from developed countries, but little is known for other regions. This paper considers a semiparametric panel data analysis for the study of the relationship between per capita HCE and per capita GDP for 42 African countries over the period 1995–2009. We found that infant mortality rate per 1,000 live births has a negative effect on per capita HCE, while the proportion of the population aged 65 is statistically insignificant in African countries. Furthermore, we found that the income elasticity is not constant but varies with income level, and health care is a necessity rather than a luxury for African countries.

  2. Longitudinal Relationships between Caloric Expenditure and Gray Matter in the Cardiovascular Health Study

    Science.gov (United States)

    Raji, Cyrus A.; Merrill, David A.; Eyre, Harris; Mallam, Sravya; Torosyan, Nare; Erickson, Kirk I.; Lopez, Oscar L.; Becker, James T.; Carmichael, Owen T.; Gach, H. Michael; Thompson, Paul M.; Longstreth, W.T.; Kuller, Lewis H.

    2016-01-01

    Background: Physical activity (PA) can be neuroprotective and reduce the risk for Alzheimer’s disease (AD). In assessing physical activity, caloric expenditure is a proxy marker reflecting the sum total of multiple physical activity types conducted by an individual. Objective:To assess caloric expenditure, as a proxy marker of PA, as a predictive measure of gray matter (GM) volumes in the normal and cognitively impaired elderly persons. Methods: All subjects in this study were recruited from the Institutional Review Board approved Cardiovascular Health Study (CHS), a multisite population-based longitudinal study in persons aged 65 and older. We analyzed a sub-sample of CHS participants 876 subjects (mean age 78.3, 57.5% F, 42.5% M) who had i) energy output assessed as kilocalories (kcal) per week using the standardized Minnesota Leisure-Time Activities questionnaire, ii) cognitive assessments for clinical classification of normal cognition, mild cognitive impairment (MCI), and AD, and iii) volumetric MR imaging of the brain. Voxel-based morphometry modeled the relationship between kcal/week and GM volumes while accounting for standard covariates including head size, age, sex, white matter hyperintensity lesions, MCI or AD status, and site. Multiple comparisons were controlled using a False Discovery Rate of 5 percent. Results: Higher energy output, from a variety of physical activity types, was associated with larger GM volumes in frontal, temporal, and parietal lobes, as well as hippocampus, thalamus, and basal ganglia. High levels of caloric expenditure moderated neurodegeneration-associated volume loss in the precuneus, posterior cingulate, and cerebellar vermis. Conclusion:Increasing energy output from a variety of physical activities is related to larger gray matter volumes in the elderly, regardless of cognitive status. PMID:26967227

  3. Comparisons of annual health care utilization, drug consumption, and medical expenditure between the elderly and general population in Taiwan

    OpenAIRE

    Wan-Hsuan Lu, MS; Wei-Ju Lee, MD, MS; Liang-Kung Chen, MD, PhD; Fei-Yuan Hsiao, PhD

    2016-01-01

    Background/Purpose: The aim of this study was to present an overview of health care utilization (outpatient, inpatient, and emergency visits), total medical expenditure, and drug consumption between the elderly and general population under Taiwan's National Health Insurance program. Methods: We conducted a cross-sectional analysis using the 2010 Taiwan's Longitudinal Health Insurance Database. Our analysis included 999,418 beneficiaries with eligible records under the National Health Insur...

  4. Determinants of Medical and Health Care Expenditure Growth for Urban Residents in China: A Systematic Review Article.

    Directory of Open Access Journals (Sweden)

    Xiaolong Zhu

    2014-12-01

    Full Text Available In recent years, medical and health care consumption has risen, making health risk an important determinant of household spending and welfare. We aimed to examine the determinants of medical and health care expenditure to help policy-makers in the improvement of China's health care system, benefiting the country, society and every household. This paper employs panel data from China's provinces from 2001 to 2011 with all possible economic variations and studies the determinants of medical and healthcare expenditure for urban residents. CPI (consumer price index of medical services and the resident consumption level of urban residents have positive influence on medical and health care expenditures for urban residents, while the local medical budget, the number of health institutions, the incidence of infectious diseases, the year-end population and the savings of urban residents will not have effect on medical and health care expenditure for urban residents. This paper proposed three relevant policy suggestions for Chinese governments based on the findings of the research.

  5. Climate catastrophes

    Science.gov (United States)

    Budyko, Mikhail

    1999-05-01

    Climate catastrophes, which many times occurred in the geological past, caused the extinction of large or small populations of animals and plants. Changes in the terrestrial and marine biota caused by the catastrophic climate changes undoubtedly resulted in considerable fluctuations in global carbon cycle and atmospheric gas composition. Primarily, carbon dioxide and other greenhouse gas contents were affected. The study of these catastrophes allows a conclusion that climate system is very sensitive to relatively small changes in climate-forcing factors (transparency of the atmosphere, changes in large glaciations, etc.). It is important to take this conclusion into account while estimating the possible consequences of now occurring anthropogenic warming caused by the increase in greenhouse gas concentration in the atmosphere.

  6. Machines that Go 'Ping': Medical Technology and Health Expenditures in OECD Countries.

    Science.gov (United States)

    Willemé, Peter; Dumont, Michel

    2015-08-01

    Technology is believed to be a major determinant of increasing health spending. The main difficulty to quantify its effect is to find suitable proxies to measure medical technological innovation. This paper's main contribution is the use of data on approved medical devices and drugs to proxy for medical technology. The effects of these variables on total real per capita health spending are estimated using a panel model for 18 Organisation for Economic Co-operation and Development (OECD) countries covering the period 1981-2012. The results confirm the substantial cost-increasing effect of medical technology, which accounts for almost 50% of the explained historical growth of spending. Despite the overall net positive effect of technology, the effect of two subgroups of approvals on expenditure is significantly negative. These subgroups can be thought of as representing 'incremental medical innovation', whereas the positive effects are related to radically innovative pharmaceutical products and devices. A separate time series model was estimated for the USA because the FDA approval data in fact only apply to the USA, while they serve as proxies for the other OECD countries. Our empirical model includes an indicator of obesity, and estimations confirm the substantial contribution of this lifestyle variable to health spending growth in the countries studied. PMID:25070599

  7. Resounding Catastrophe

    DEFF Research Database (Denmark)

    Kristensen, Thomas Bjørnsten

    2012-01-01

    The article discusses specific aesthetic strategies for articulating and describing the catastrophic event of 9/11 by focusing on its auditory aspects. This is done through a reading of the American media- and sound artist Stephen Vitiello’s work and novelist Don DeLillo’s Falling Man....

  8. Financing Health Care Expenditure in the OECD Countries: Evidence from a Heterogeneous, Cross-Sectional Dependent Panel

    OpenAIRE

    de Mello-Sampayo Felipa; de Sousa-Vale Sofia

    2014-01-01

    This paper analyses the relationship between health expenditure and the way it is financed in a panel of 30 OECD countries observed annually from 1990 to 2009. The nonstationarity and cointegration properties between health care spending and its sources of funding, income, and non-income variables are studied. This is performed in a panel data context controlling for both cross section dependence and unobserved heterogeneity. The findings suggest that when ...

  9. Health care utilization and expenditures among Medicaid beneficiaries with neuropathic pain following spinal cord injury

    Directory of Open Access Journals (Sweden)

    Margolis JM

    2014-07-01

    Full Text Available Jay M Margolis,1 Paul Juneau,1 Alesia Sadosky,2 Joseph C Cappelleri,3 Thomas N Bryce,4 Edward C Nieshoff5 1Truven Health Analytics, Bethesda, MD, USA; 2Pfizer Inc., New York, NY, USA; 3Pfizer Inc., Groton, CT, USA; 4Department of Rehabilitation Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA; 5Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, MI, USA Background: The study aimed to evaluate health care resource utilization (HRU and costs for neuropathic pain (NeP secondary to spinal cord injury (SCI among Medicaid beneficiaries. Methods: The retrospective longitudinal cohort study used Medicaid beneficiary claims with SCI and evidence of NeP (SCI-NeP cohort matched with a cohort without NeP (SCI-only cohort. Patients had continuous Medicaid eligibility 6 months pre- and 12 months postindex, defined by either a diagnosis of central NeP (ICD-9-CM code 338.0x or a pharmacy claim for an NeP-related antiepileptic or antidepressant drug within 12 months following first SCI diagnosis. Demographics, clinical characteristics, HRU, and expenditures were compared between cohorts. Results: Propensity score-matched cohorts each consisted of 546 patients. Postindex percentages of patients with physician office visits, emergency department visits, SCI- and pain-related procedures, and outpatient prescription utilization were all significantly higher for SCI-NeP (P<0.001. Using regression models to account for covariates, adjusted mean expenditures were US$47,518 for SCI-NeP and US$30,150 for SCI only, yielding incremental costs of US$17,369 (95% confidence interval US$9,753 to US$26,555 for SCI-NeP. Factors significantly associated with increased cost included SCI type, trauma-related SCI, and comorbidity burden. Conclusion: Significantly higher HRU and total costs were incurred by Medicaid patients with NeP secondary to SCI compared with matched SCI-only patients. Keywords: spinal

  10. Medicare: Comparison of Catastrophic Health Insurance Proposals--An Update. Briefing Report to the Chairman, Select Committee on Aging, House of Representatives.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Div. of Human Resources.

    This document updates a recent report by the General Accounting Office (GAO) which compared Medicare catastrophic health insurance proposals. The update includes H.R. 2470, as passed by the House of Representatives and S. 1127, as reported by the Senate Committee on Finance. An introduction explains the roles of Medicare, Medicaid, the Veterans…

  11. Spatio-temporal dependencies between hospital beds, physicians and health expenditure using visual variables and data classification in statistical table

    Science.gov (United States)

    Medyńska-Gulij, Beata; Cybulski, Paweł

    2016-06-01

    This paper analyses the use of table visual variables of statistical data of hospital beds as an important tool for revealing spatio-temporal dependencies. It is argued that some of conclusions from the data about public health and public expenditure on health have a spatio-temporal reference. Different from previous studies, this article adopts combination of cartographic pragmatics and spatial visualization with previous conclusions made in public health literature. While the significant conclusions about health care and economic factors has been highlighted in research papers, this article is the first to apply visual analysis to statistical table together with maps which is called previsualisation.

  12. Spatio-temporal dependencies between hospital beds, physicians and health expenditure using visual variables and data classification in statistical table

    Directory of Open Access Journals (Sweden)

    Medyńska-Gulij Beata

    2016-06-01

    Full Text Available This paper analyses the use of table visual variables of statistical data of hospital beds as an important tool for revealing spatio-temporal dependencies. It is argued that some of conclusions from the data about public health and public expenditure on health have a spatio-temporal reference. Different from previous studies, this article adopts combination of cartographic pragmatics and spatial visualization with previous conclusions made in public health literature. While the significant conclusions about health care and economic factors has been highlighted in research papers, this article is the first to apply visual analysis to statistical table together with maps which is called previsualisation.

  13. Private expenditure and the role of private health insurance in Greece: status quo and future trends.

    Science.gov (United States)

    Siskou, Olga; Kaitelidou, Daphne; Economou, Charalampos; Kostagiolas, Peter; Liaropoulos, Lycourgos

    2009-10-01

    The health care system in Greece is financed in almost equal proportions by public and private sources. Private expenditure, consists mostly of out-of-pocket and under-the-table payments. Such payments strongly suggest dissatisfaction with the public system, due to under financing during the last 25 years. This gap has been filled rapidly by the private sector. From this point of view, one might suggest that the flourishing development of private provision may lead in turn to a corresponding growth in private health insurance (PHI). This paper aims to examine the role of PHI in Greece, to identify the factors influencing its development, and to make some suggestions about future policies and trends. In the decade of 1985-1995 PHI show increasing activity, reflecting the intention of some citizens to seek health insurance solutions in the form of supplementary cover in order to ensure faster access, better quality of services, and increased consumer choice. The benefits include programs covering hospital expenses, cash benefits, outpatient care expenses, disability income insurance, as well as limited managed care programs. However, despite recent interest, PHI coverage remains low in Greece compared to other EU countries. Economic, social and cultural factors such as low average household income, high unemployment, obligatory and full coverage by social insurance, lead to reluctance to pay for second-tier insurance. Instead, there is a preference to pay a doctor or hospital directly even in the form of under-the-table payments (which are remarkably high in Greece), when the need arises. There are also factors endogenous to the PHI industry, related to market policies, low organisational capacity, cream skimming, and the absence of insurance products meeting consumer requirements, which explain the relatively low state of development of PHI in Greece. PMID:19593628

  14. Catastrophe medicine; Medecine de catastrophe

    Energy Technology Data Exchange (ETDEWEB)

    Lebreton, A. [Service Technique de l`Energie Electrique et des Grands Barrages (STEEGB), (France)

    1996-12-31

    The `Catastrophe Medicine` congress which took place in Amiens (France) in December 5 to 7 1996 was devoted to the assessment and management of risks and hazards in natural and artificial systems. The methods of risk evaluation and prevision were discussed in the context of dams accidents with the analysis of experience feedbacks and lessons gained from the organisation of emergency plans. Three round table conferences were devoted to the importance of psychological aspects during such major crises. (J.S.)

  15. Impacts of Cost Containment Strategies on Pharmaceutical Expenditures of the National Health Insurance in Taiwan, 1996-2003

    OpenAIRE

    Yue-Chune Lee; Ming-Chin Yang; Yu-Tung Huang; Chien-Hsiang Liu; Sun-Bing Chen

    2006-01-01

    Introduction: Pharmaceutical expenditure (PE) of the National Health Insurance (NHI) programme in Taiwan grew from 62.2 billion Taiwan new dollars ($NT) in 1996 to $NT94.5 billion in 2003.The government has been introducing many strategies to control PE since the inception of NHI including price adjustment based on the prices of international products or existing products (inter-brands comparison), or market price and volume survey; delegation of financial responsibility to regional bureaux; ...

  16. Health Expenditures in Greece: A Multiple Least Squares Regression and Cointegration Analysis Using Bootstrap Simulation in EVIEWS

    OpenAIRE

    Giovanis, Eleftherios

    2009-01-01

    This paper examines the factors that are contributing at the most explained and efficient way to health expenditures in Greece. Two methods are applied. Multiple regressions and vector error correction models are estimated, as also unit root tests applied to define in which order variables are stationary. Because the available data are yearly and capture a small period from 1985-2006, so the sample is small, a bootstrap simulation is applied, to improve the estimations.

  17. AN ANALYSIS OF IMPACT OF PUBLIC EXPENDITURE ON EDUCATION AND HEALTH IN INDIA

    OpenAIRE

    Joginder and Rakesh

    2015-01-01

    The relationship between economic growth and public spending is an important subject of analysis and debate (Mitchell, 2005). One central question is whether or not government expenditure increases the long run steady state growth of the economy. Some scholars are of the opinion that public expenditure, notably on physical infrastructure & human capital can enhance the economic growth. But particularly Amartya Sen has emphasised that when a country invest more in human capital that is in h...

  18. Below the Glass Floor : Analytical Review of Expenditure by Provincial Administrations on Rural Health from Health Function Grants and Provincial Internal Revenue

    OpenAIRE

    World Bank

    2013-01-01

    Below the glass floor is a report that explores the impact of recent increases in operational function grant funding to provinces to support rural health service delivery. It seeks to identify what expenditure provinces have made to support and enable key front line service delivery activities such as; facility operations, patrols, medical supply distribution, emergency patient transfer, r...

  19. Seizing Catastrophes

    DEFF Research Database (Denmark)

    Kublitz, Anja

    2013-01-01

    Based on fieldwork among Palestinians in Denmark the article investigates the Palestinian temporality of Nakba that is equivalent to a time of security in the sense that it is concerned with existential threats and emergency action. The Arabic term Nakba literally means catastrophe and is in...... Palestinian national discourse used to designate the Arab-Israeli war of 1948, when more than half of the Palestinian population were expelled from their homeland – a reverse national myth about how Palestine failed to come into being. Yet, according to Palestinians in Denmark, the Nakba cannot be relegated...

  20. Household Financial Contribution to the Health System in Shiraz, Iran in 2012

    Directory of Open Access Journals (Sweden)

    Zahra Kavosi

    2014-10-01

    Full Text Available Background One common challenge to social systems is achieving equity in financial contributions and preventing financial loss. Because of the large and unpredictable nature of some costs, achieving this goal in the health system presents important and unique problems. The present study investigated the Household Financial Contributions (HFCs to the health system. Methods The study investigated 800 households in Shiraz. The study sample size was selected using stratified sampling and cluster sampling in the urban and rural regions, respectively. The data was collected using the household section of the World Health Survey (WHS questionnaire. Catastrophic health expenditures were calculated based on the ability of the household to pay and the reasons for the catastrophic health expenditures by a household were specified using logistic regression. Results The results showed that the fairness financial contribution index was 0.6 and that 14.2% of households were faced with catastrophic health expenditures. Logistic regression analysis revealed that household economic status, the basic and supplementary insurance status of the head of the household, existence of individuals in the household who require chronic medical care, use of dental and hospital care, rural location of residences, frequency of use of outpatient services, and Out-of-Pocket (OOP payment for physician visits were effective factors for determining the likelihood of experiencing catastrophic health expenditure. Conclusion It appears that the current method of health financing in Iran does not adequately protect households against catastrophic health expenditure. Consequently, it is essential to reform healthcare financing.

  1. Incremental health expenditure and lost days of normal activity for individuals with mental disorders: results from the São Paulo Megacity Study

    OpenAIRE

    Chiavegatto Filho, Alexandre Dias Porto; Wang, Yuan-Pang; Campino, Antonio Carlos Coelho; Malik, Ana Maria; Viana, Maria Carmen; Andrade, Laura Helena

    2015-01-01

    Background With the recent increase in the prevalence of mental disorders in developing countries, there is a growing interest in the study of its consequences. We examined the association of depression, anxiety and any mental disorders with incremental health expenditure, i.e. the linear increase in health expenditure associated with mental disorders, and lost days of normal activity. Methods We analyzed the results from a representative sample survey of residents of the Metropolitan Region ...

  2. Commercial porters of eastern Nepal: health status, physical work capacity, and energy expenditure.

    Science.gov (United States)

    Malville, N J; Byrnes, W C; Lim, H A; Basnyat, R

    2001-01-01

    The purpose of the study was to compare full-time hill porters in eastern Nepal with part-time casual porters engaged primarily in subsistence farming. The 50 porters selected for this study in Kenja (elevation 1,664 m) were young adult males of Tibeto-Nepali origin. Following standardized interviews, anthropometry, and routine physical examinations, the porters were tested in a field laboratory for physiological parameters associated with aerobic performance. Exercise testing, using a step test and indirect calorimetry, included a submaximal assessment of economy and a maximal-effort graded exercise test. Energy expenditure was measured in the field during actual tumpline load carriage. No statistically significant differences were found between full-time and part-time porters with respect to age, anthropometric characteristics, health, nutritional status, or aerobic power. Mean VO2 peak was 2.38 +/- 0.27 L/min (47.1 +/- 5.3 ml/kg/min). Load-carrying economy did not differ significantly between porter groups. The relationship between VO2 and load was linear over the range of 10-30 kg with a slope of 9 +/- 4 ml O2/min per kg of load. During the field test of actual work performance, porters expended, on average, 348 +/- 68 kcal/hr in carrying loads on the level and 408 +/- 60 kcal/hr in carrying loads uphill. Most porters stopped every 2 min, on average, to rest their loads briefly on T-headed resting sticks (tokmas). The technique of self-paced, intermittent exercise together with the modest increase in energy demands for carrying increasingly heavier loads allows these individuals to regulate work intensity and carry extremely heavy loads without creating persistent medical problems. PMID:11466966

  3. Radiation situation and health statistics of the people in the Tula region of Russia after the Chernobyl catastrophe

    International Nuclear Information System (INIS)

    Long-term programs are necessary in order to minimize the medical consequences and to increase the efficiency of medical assistance to those who have undergone radiation action as a result of the Chernobyl catastrophe. It is also necessary to evaluate objectively the state of health of the sufferers, to obtain scientifically grounded conclusions on effects of 'low' radiation doses on human organism, and to estimate the genetic consequences for future generations. These programs must foresee the implementation of various activities, including: 1. Provision of further monitoring of persons attributed to the groups of risk, especially: those whose thyroid was irradiated when they were children and adolescents; children born by mothers whose thyroid was irradiated in their children-adolescent age; children whose thyroid was irradiated in pre-natal period; pregnant women; liquidators of 1986-1987 and their children born after 1986. 2. Provision of medical-prophylactic institutions on the polluted territories (of district and regional levels) and clinics of research centers with modern medico-diagnostic equipment, as well as regular supply of necessary reagents and medicines to hospitals and clinics. 3. Development of system of rehabilitation medical activities and sanatorium bases for the Chernobyl sufferers, especially for children. 4. Supply of food products with radioprotective properties; fresh vegetables, fruits etc., especially for children in the polluted territories. 5. Scientific study of radiation action combined with action of other carcinogens including chemical pollutants. (J.P.N.)

  4. Health care is an individual necessity and a national luxury: applying multilevel decision models to the analysis of health care expenditures.

    Science.gov (United States)

    Getzen, T E

    2000-03-01

    Health care is neither "a necessity" or "a luxury"; it is "both" since the income elasticity varies with the level of analysis. With insurance, individual income elasticities are typically near zero, while national health expenditure elasticities are commonly greater than 1.0. The debate over whether health care is or is not a luxury good arises primarily from the failure to specify levels of analysis clearly so as to distinguish variation within groups from variation between groups. Apparently, contradictory empirical results are shown to be consistent with a simple nested multilevel model of health care spending. PMID:10947579

  5. Components of growth in current public-expenditure on education and health

    OpenAIRE

    Ohagan, J; Kelly, M.

    1984-01-01

    Abstract: This paper examines the growth in the GDP share of current public expenditure on national, vocational and university education in Ireland between 1961 and 1979 in terms of four factors: transfer changes, demographic changes, enrolment changes, and movements in relative "costs". The change in the relative cost of hospital care between 1966 and 1979 is also estimated.

  6. Coherent catastrophism

    Science.gov (United States)

    Asher, D. J.; Clube, S. V. M.; Napier, W. M.; Steel, D. I.

    We review the theoretical and observational evidence that, on timescales relevant to mankind, the prime collision hazard is posed by temporally correlated impacts (coherent catastrophism, Δt ˜ 10 2-10 4 yr) rather than random ones (stochastic catastrophism, Δt ˜ 10 5-10 8 yr). The mechanism whereby coherent incursions into and through the terrestrial atmosphere occur is described as being the result of giant cometary bodies arriving in orbits with perihelia in the inner solar system. Hierarchical fragmentation of such large (100 km-plus) bodies — due to thermal stresses near perihelion, collisions in the asteroid belt, or passages through the Jovian Roche radius — results in numerous ˜kilometre-sized objects being left in short-period orbits, and appearing in telescopic searches as Apollo-type asteroids. Many more smaller objects, in the 10-100 metre size range and only recently observed, by the Spacewatch team, are expected to be in replenished clusters in particular orbits as a result of continuing disintegrations of large, differentiated, cometary objects. Gravitational perturbations by Jupiter bring these clusters around to have a node at 1 AU in a cyclic fashion, leading to impacts at certain times of year every few years during active periods lasting a few centuries, such periods being separated by intervals of a few millennia. Furthermore, fragmentations within the hierarchy result in significant bombardment commensurabilities ( Δt ˜ 10-10 2 yr) during active periods occurring at random intervals ( Δt ˜ 10 2-10 3 yr). It appears that the Earth has been subject to such impacts since the break-up of such a comet ˜2×10 4 years ago; currently we are not passing through a high-risk epoch, although some phenomena originating in the products of this break-up have been observed in the 20th century. This most recent hierarchical disintegration, associated with four well-known meteor showers and termed the Taurid Complex, is now recognized as resulting

  7. Effect of Restricting Access to Health Care on Health Expenditures among Asylum-Seekers and Refugees: A Quasi-Experimental Study in Germany, 1994-2013.

    Directory of Open Access Journals (Sweden)

    Kayvan Bozorgmehr

    Full Text Available Access to health care for asylum-seekers and refugees (AS&R in Germany is initially restricted before regular access is granted, allegedly leading to delayed care and increasing costs of care. We analyse the effects of (a restricted access; and (b two major policy reforms (1997, 2007 on incident health expenditures for AS&R in 1994-2013.We used annual, nation-wide, aggregate data of the German Federal Statistics Office (1994-2013 to compare incident health expenditures among AS&R with restricted access (exposed to AS&R with regular access (unexposed. We calculated incidence rate differences (∆IRt and rate ratios (IRRt, as well as attributable fractions among the exposed (AFe and the total population (AFp. The effects of between-group differences in need, and of policy reforms, on differences in per capita expenditures were assessed in (segmented linear regression models. The exposed and unexposed groups comprised 4.16 and 1.53 million person-years. Per capita expenditures (1994-2013 were higher in the group with restricted access in absolute (∆IRt = 375.80 Euros [375.77; 375.89] and relative terms (IRR = 1.39. The AFe was 28.07% and the AFp 22.21%. Between-group differences in mean age and in the type of accommodation were the main independent predictors of between-group expenditure differences. Need variables explained 50-75% of the variation in between-group differences over time. The 1997 policy reform significantly increased ∆IRt adjusted for secular trends and between-group differences in age (by 600.0 Euros [212.6; 986.2] and sex (by 867.0 Euros [390.9; 1342.5]. The 2007 policy reform had no such effect.The cost of excluding AS&R from health care appears ultimately higher than granting regular access to care. Excess expenditures attributable to the restriction were substantial and could not be completely explained by differences in need. An evidence-informed discourse on access to health care for AS&R in Germany is needed; it

  8. Reverse Catastrophe

    Directory of Open Access Journals (Sweden)

    Przemysław Czapliński

    2015-01-01

    Full Text Available The principal notion of the article–a “backward catastrophe”– stands for a catastrophe which occurs unseen until it becomes recognized and which broadens its destructive activity until it has been recognized. This concept in the article has been referred to the Shoah. The main thesis is that the recognition of the actual influence of the Holocaust began in Polish culture in the mid-1980s (largely it started with the film by Claude Lanzmann Shoah and the essay by Jan Błoński Biedni Polacy patrzą na getto [“The Poor Poles Look at the Ghetto”], that is when the question: “What happened to the Jews”, assumes the form: “Did the things that happened to the Jews, also happened to the Poles?”. Cognitive and ethical reorientation leads to the revealing of the hidden consequences of the Holocaust reaching as far as the present day and undermining the foundations of collective identity. In order to understand this situation (and adopt potentially preventive actions Polish society should be recognized as a postcatastrophic one.

  9. Catastrophic volcanism

    Science.gov (United States)

    Lipman, Peter W.

    1988-01-01

    Since primitive times, catastrophes due to volcanic activity have been vivid in the mind of man, who knew that his activities in many parts of the world were threatened by lava flows, mudflows, and ash falls. Within the present century, increasingly complex interactions between volcanism and the environment, on scales not previously experienced historically, have been detected or suspected from geologic observations. These include enormous hot pyroclastic flows associated with collapse at source calderas and fed by eruption columns that reached the stratosphere, relations between huge flood basalt eruptions at hotspots and the rifting of continents, devastating laterally-directed volcanic blasts and pyroclastic surges, great volcanic-generated tsunamis, climate modification from volcanic release of ash and sulfur aerosols into the upper atmosphere, modification of ocean circulation by volcanic constructs and attendent climatic implications, global pulsations in intensity of volcanic activity, and perhaps triggering of some intense terrestrial volcanism by planetary impacts. Complex feedback between volcanic activity and additional seemingly unrelated terrestrial processes likely remains unrecognized. Only recently has it become possible to begin to evaluate the degree to which such large-scale volcanic processes may have been important in triggering or modulating the tempo of faunal extinctions and other evolutionary events. In this overview, such processes are examined from the viewpoint of a field volcanologist, rather than as a previous participant in controversies concerning the interrelations between extinctions, impacts, and volcanism.

  10. Government Expenditures on Education, Health, and Infrastructure : A Naive Look at Levels, Outcomes, and Efficiency

    OpenAIRE

    Estache, A.; Gonzalez, M; L. Trujillo

    2007-01-01

    All interested parties seem to agree that it is important to be able to monitor public sector performance at the sectoral level, but most current work based on multi-country databases does not lend itself to country-specific conclusions. This is due to a large extent to major data limitations both on sectoral expenditures and on sectoral outcomes. This paper discusses the related issues an...

  11. Reference-Based Pricing Schemes: Effect on Pharmaceutical Expenditure, Resource Utilisation and Health Outcomes

    OpenAIRE

    Ioannides-Demos, Lisa L.; Ibrahim, Joseph E.; McNeil, John J.

    2002-01-01

    Pharmaceutical expenditure is rising more rapidly than the general inflation rate in most advanced countries. One strategy that has been introduced to control pharmaceutical costs is reference-based pricing (RBP). Its potential is restricted to those specific segments of the drug market where several drugs (and/or their generic forms) exist without substantial evidence that any particular agent is superior. Three broad approaches have been adopted. These involve the aggregation of drugs into ...

  12. Catastrophes control problem

    International Nuclear Information System (INIS)

    The problem of catastrophe control is discussed. Catastrophe control aims to withdraw responsible engineering constructions out of the catastrophe. The mathematical framework of catastrophes control systems is constructed. It determines the principles of systems filling by the concrete physical contents and, simultaneously, permits to employ modern control methods for the synthesis of optimal withdrawal strategy for protected objects

  13. Impact of Medication-Assisted Treatment for Opioid Addiction on Medicaid Expenditures and Health Services Utilization Rates in Vermont.

    Science.gov (United States)

    Mohlman, Mary Kate; Tanzman, Beth; Finison, Karl; Pinette, Melanie; Jones, Craig

    2016-08-01

    In the face of increasing rates of overdose deaths, escalating health care costs, and the tremendous social costs of opioid addiction, policy makers are asked to address the questions of whether and how to expand access to treatment services. In response to an upward trend in opioid abuse and adverse outcomes, Vermont is investing in statewide expansion of a medication-assisted therapy program delivered in a network of community practices and specialized treatment centers (Hub & Spoke Program). This study was conducted to test the rationale for these investments and to establish a pre-Hub & Spoke baseline for evaluating the additive impact of the program. Using a serial cross-sectional design from 2008 to 2013 to evaluate medical claims for Vermont Medicaid beneficiaries with opioid dependence or addiction (6158 in the intervention group, 2494 in the control group), this study assesses the treatment and medical service expenditures for those receiving medication-assisted treatment compared to those receiving substance abuse treatment without medication. Results suggest that medication-assisted therapy is associated with reduced general health care expenditures and utilization, such as inpatient hospital admissions and outpatient emergency department visits, for Medicaid beneficiaries with opioid addiction. For state Medicaid leaders facing similar decisions on approaches to opioid addiction, these results provide early support for expanding medication-assisted treatment services rather than relying only on psychosocial, abstinence, or detoxification interventions. PMID:27296656

  14. Insurance Protection for Catastrophic Health Expenses for Individuals under Age 65. Hearings before the Subcommittee on Health of the Committee on Ways and Means. House of Representatives, One Hundredth Congress, First Session.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Committee on Ways and Means.

    The hearing reported in this document sought to obtain information concerning the nature and extent of the problem of Americans who do not have financial access to necessary health services and are at risk for catastrophic expenses, and to examine possible solutions to the problem. Witnesses included representatives from American Airlines, the…

  15. Health care use and costs for children with attention-deficit/hyperactivity disorder - National estimates front the Medical Expenditure Panel Survey

    NARCIS (Netherlands)

    Chan, E; Zhan, CL; Homer, CJ

    2002-01-01

    Context: Although attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent chronic condition of childhood, little is known about patterns of health care use and associated expenditures. Objective: To compare health care use and costs among children with ADHD, children with asthma, and t

  16. An Empirical Analysis of Rural-Urban Differences in Out-Of-Pocket Health Expenditures in a Low-Income Society of China

    Science.gov (United States)

    Wang, Lidan; Wang, Anjue; Zhou, Detong; FitzGerald, Gerry; Ye, Dongqing; Jiang, Qicheng

    2016-01-01

    Objective The paper examines whether out-of-pocket health care expenditure also has regional discrepancies, comparing to the equity between urban and rural areas, and across households. Method Sampled data were derived from Urban Household Survey and Rural Household Survey data for 2011/2012 for Anhui Province, and 11049 households were included in this study. The study compared differences in out-of-pocket expenditure on health care between regions (urban vs. rural areas) and years (2011 vs. 2012) using two-sample t-test, and also investigated the degree of inequality using Lorenz and concentration curves. Result Approximately 5% and 8% of total household consumption expenditure was spent on health care for urban and rural populations, respectively. In 2012, the wealthiest 20% of urban and rural population contributed 49.7% and 55.8% of urban and rural total health expenditure respectively, while the poorest 20% took only 4.7% and 4.4%. The concentration curve for out-of-pocket expenditure in 2012 fell below the corresponding concentration curve for 2011 for both urban and rural areas, and the difference between curves for rural areas was greater than that for urban areas. Conclusion A substantial and increasing gap in health care expenditures existed between urban and rural areas in Anhui. The health care financing inequality merits ample attention, with need for policymaking to focus on improving the accessibility to essential health care services, particularly for rural and poor residents. This study may provide useful information on low income areas of China. PMID:27223811

  17. Protein kinase A induces UCP1 expression in specific adipose depots to increase energy expenditure and improve metabolic health.

    Science.gov (United States)

    Dickson, Lorna M; Gandhi, Shriya; Layden, Brian T; Cohen, Ronald N; Wicksteed, Barton

    2016-07-01

    Adipose tissue PKA has roles in adipogenesis, lipolysis, and mitochondrial function. PKA transduces the cAMP signal downstream of G protein-coupled receptors, which are being explored for therapeutic manipulation to reduce obesity and improve metabolic health. This study aimed to determine the overall physiological consequences of PKA activation in adipose tissue. Mice expressing an activated PKA catalytic subunit in adipose tissue (Adipoq-caPKA mice) showed increased PKA activity in subcutaneous, epididymal, and mesenteric white adipose tissue (WAT) depots and brown adipose tissue (BAT) compared with controls. Adipoq-caPKA mice weaned onto a high-fat diet (HFD) or switched to the HFD at 26 wk of age were protected from diet-induced weight gain. Metabolic health was improved, with enhanced insulin sensitivity, glucose tolerance, and β-cell function. Adipose tissue health was improved, with smaller adipocyte size and reduced macrophage engulfment of adipocytes. Using metabolic cages, we found that Adipoq-caPKA mice were shown to have increased energy expenditure, but no difference to littermate controls in physical activity or food consumption. Immunoblotting of adipose tissue showed increased expression of uncoupling protein-1 (UCP1) in BAT and dramatic UCP1 induction in subcutaneous WAT, but no induction in the visceral depots. Feeding a HFD increased PKA activity in epididymal WAT of wild-type mice compared with chow, but did not change PKA activity in subcutaneous WAT or BAT. This was associated with changes in PKA regulatory subunit expression. This study shows that adipose tissue PKA activity is sufficient to increase energy expenditure and indicates that PKA is a beneficial target in metabolic health. PMID:27097660

  18. Reference-based pricing schemes: effect on pharmaceutical expenditure, resource utilisation and health outcomes.

    Science.gov (United States)

    Ioannides-Demos, Lisa L; Ibrahim, Joseph E; McNeil, John J

    2002-01-01

    Pharmaceutical expenditure is rising more rapidly than the general inflation rate in most advanced countries. One strategy that has been introduced to control pharmaceutical costs is reference-based pricing (RBP). Its potential is restricted to those specific segments of the drug market where several drugs (and/or their generic forms) exist without substantial evidence that any particular agent is superior. Three broad approaches have been adopted. These involve the aggregation of drugs into generic groups, related drug groups (e.g. ACE inhibitors) or drugs grouped by therapeutic indication (e.g. antihypertensives). For each drug group, a single reimbursement level or reference price is set. Drugs above the reference price require part or total payment by the patient. The experience with RBP ranges from over 10 years in Germany (involving all levels of RBP) to the more recent implementation of RBP for related drug groups in Australia. This review summarises the current state of knowledge on RBP from the published experiences in the countries where RBP has been adopted. The published systematic reviews of RBP from the countries that have implemented it suggest that RBP has been successful at temporarily capping drug prices for the RBP drug groups and achieving short term cost savings. However, other factors influencing total pharmaceutical expenditure have often occurred simultaneously and make it difficult to isolate specific effects of RBP. Further investigation is required before any valid conclusions can be drawn about the net effect of RBP on healthcare costs. RBP has withstood the initial legal challenges of pharmaceutical companies and the criticisms of some clinicians. Where the reference price is based on the lowest priced drug(s) in the group, RBP appears to be one of the few strategies likely to be effective at encouraging doctors to use the least expensive agents as first-line therapy and utilise more expensive agents in those who experience side effects

  19. Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE

    OpenAIRE

    Kumar, Kaushalendra; Singh, Ashish; Kumar, Santosh; Ram, Faujdar; Singh, Abhishek; Ram, Usha; Negin, Joel; Kowal, Paul R.

    2015-01-01

    Background and Objectives The provision of affordable health care is generally considered a fundamental goal of a welfare state. In addition to its role in maintaining and improving the health status of individuals and households, it impacts the economic prosperity of a society through its positive effects on labor productivity. Given this context, this paper assesses socioeconomic-differentials in the impact of out-of-pocket-health-expenditure (OOPHE) on impoverishment in China and India, tw...

  20. Patterns of Health Care Expenditures, Utilization and Demand for Medical Care in Sample Philippine Households

    OpenAIRE

    Bautista, Cristina M.

    1995-01-01

    Due to tight fiscal budget, health care planners have started to explore alternative financing mechanisms. These alternatives can be effectively implemented given thorough understanding of mechanisms that direct household demand for health care. This paper investigates the factors of households’ health seeking behavior to determine the implications for health care financing reforms. In addition, it looks into the responsiveness of households to changes in prices and income. Insights of househ...

  1. Measuring overfitting in nonlinear models: a new method and an application to health expenditures.

    Science.gov (United States)

    Bilger, Marcel; Manning, Willard G

    2015-01-01

    When fitting an econometric model, it is well known that we pick up part of the idiosyncratic characteristics of the data along with the systematic relationship between dependent and explanatory variables. This phenomenon is known as overfitting and generally occurs when a model is excessively complex relative to the amount of data available. Overfitting is a major threat to regression analysis in terms of both inference and prediction. We start by showing that the Copas measure becomes confounded by shrinkage or expansion arising from in-sample bias when applied to the untransformed scale of nonlinear models, which is typically the scale of interest when assessing behaviors or analyzing policies. We then propose a new measure of overfitting that is both expressed on the scale of interest and immune to this problem. We also show how to measure the respective contributions of in-sample bias and overfitting to the overall predictive bias when applying an estimated model to new data. We finally illustrate the properties of our new measure through both a simulation study and a real-data illustration based on inpatient healthcare expenditure data, which shows that the distinctions can be important. PMID:24123628

  2. The Pediatric Home Care/Expenditure Classification Model (P/ECM): A Home Care Case-Mix Model for Children Facing Special Health Care Challenges

    OpenAIRE

    Phillips, Charles D

    2015-01-01

    Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large sta...

  3. Expenditures in the health care system in Brazil: the participation of states and the Federal District in financing the health care system from 2002 to 2013

    Directory of Open Access Journals (Sweden)

    Renata Maria de Deus Costa

    2015-04-01

    Full Text Available OBJECTIVE: To analyze the public expenditures of states on health care and the participation of states and the Federal District in financing the Unified Health System, better known by the acronym SUS. To develop the research, two targets were used: “to rescue expenses per government source (federal, state and municipal during the period from 2002 to 2013” and “to rescue resource transfers from the federal SUS to the states and also to municipalities”. METHODS: This research is bibliographic, documentary and descriptive and used a quantitative approach. Data were extracted from the Information System Public Health Budget, and additional data were collected from the public managers of states, municipalities and the Federal District during the period from 2002 to 2013. Federal data from the Undersecretary of Planning and Budget (originally extracted from the Integrated System of Financial Administration of the Federal Government and available on the Budget Public Health System webpage were also collected. RESULTS: The data revealed that during the same researched period, the Federal District has maintained the health care system budget, whereas states and municipalities have increased their budgets for the same spending. CONCLUSIONS: By analyzing the results, there is clearly a disparity regarding the investment expended by the entities of the Federation. Although municipalities and states have gradually increased their application of resources to health care, the federal state has maintained the same budget. These results reveal a bit of concern about public health funding.

  4. Uzbekistan: health system review.

    Science.gov (United States)

    Ahmedov, Mohir; Azimov, Ravshan; Mutalova, Zulkhumor; Huseynov, Shahin; Tsoyi, Elena; Rechel, Bernd

    2014-01-01

    Uzbekistan is a central Asian country that became independent in 1991 with the break-up of the Soviet Union. Since then, it has embarked on several major health reforms covering health care provision, governance and financing, with the aim of improving efficiency while ensuring equitable access. Primary care in rural areas has been changed to a two-tiered system, while specialized polyclinics in urban areas are being transformed into general polyclinics covering all groups of the urban population. Secondary care is financed on the basis of past expenditure and inputs (and increasingly self-financing through user fees), while financing of primary care is increasingly based on capitation. There are also efforts to improve allocative efficiency, with a slowly increasing share of resources devoted to the reformed primary health care system. Health care provision has largely remained in public ownership but nearly half of total health care expenditure comes from private sources, mostly in the form of out-of-pocket expenditure. There is a basic benefits package, which includes primary care, emergency care and care for certain disease and population categories. Yet secondary care and outpatient pharmaceuticals are not included in the benefits package for most of the population, and the reliance on private health expenditure results in inequities and catastrophic expenditure for households. While the share of public expenditure is slowly increasing, financial protection thus remains an area of concern. Quality of care is another area that is receiving increasing attention. PMID:25689490

  5. Burden of out-of-pocket expenditure for road traffic injuries in urban India

    Directory of Open Access Journals (Sweden)

    Kumar G

    2012-08-01

    Full Text Available Abstract Background Road traffic injuries (RTI are an increasing public health problem in India where out-of-pocket (OOP expenditures on health are among the highest in the world. We estimated the OOP expenses for RTI in a large city in India. Methods Information on medical and non-medical expenditure was documented for RTI cases of all ages that reported alive or dead to the emergency departments of two public hospitals and a large private hospital in Hyderabad. Differential risk of catastrophic OOP total expenditure (COPE-T and medical expenditure (COPE-M, and distress financing was assessed for 723 RTI cases that arrived alive at the study hospitals with multiple logistic regression. Catastrophic expenditure was defined as expenditure > 25% of the RTI patient’s annual household income. Variation in intensity of COPE-M in RTI was assessed using multiple classification analysis (MCA. Results The median OOP medical and non-medical expenditure was USD 169 and USD 163, respectively. The prevalence of COPE-M and COPE-T was 21.9% (95% CI 18.8-24.9 and 46% (95% CI 42–49.3, respectively. Only 22% had access to medical insurance. Being admitted to a private hospital (OR 5.2, 95% CI 2.7–9.9 and not having access to insurance (OR 3.8, 95% CI 1.9–7.6 were significantly associated with risk of having COPE – M. Similar results were seen for COPE - T. MCA analysis showed that the burden of OOP medical expenditure was mainly associated with in-patient days in hospital (Eta =0.191. Prevalence of distress financing was 69% (95% CI 65.5-72.3 with it being significantly higher for those reporting to the public hospitals (OR 2.8, 95% CI 1.7-4.6, those belonging to the lowest per capita annual household income quartile (OR 7.0, 95% CI 3.7-13.3, and for those without insurance access (OR 3.4, 95% CI 2.0-5.7. Conclusions This paper has outlined the high burden of out-of-pocket medical and total expenditure associated with RTI in India. These data

  6. Can Health Technology Assessment (HTA) provide a solution to tackle the increasing health-care expenditure in India?

    Science.gov (United States)

    Dang, Amit; Vallish, B N

    2016-01-01

    The private health-care system in India is effective but expensive. Due to the absence of a comprehensive and well-penetrated insurance scheme that caters to the majority of the Indian population, most of the private health care consultations are out-of-pocket (OOP), and this is pushing many people to poverty. In this article, we describe the concept of health technology assessment (HTA), and review its possible role in improving the health-care system in India. We additionally comment on its present status and possible role of its implementation in the Indian context. PMID:27350708

  7. Explaining health marginalisation of the lower educated: the role of cross-national variations in health expenditure and labour market conditions.

    Science.gov (United States)

    Gesthuizen, Maurice; Huijts, Tim; Kraaykamp, Gerbert

    2012-05-01

    Several studies have shown ample cross-national variation in the risk that lower educated people run to be in poor health. However, explanations for this cross-national variation are still scarce. In this article we aim at filling this lacuna by investigating to what extent cross-national variation in the health gap between the lower and higher educated in Europe is explained by governmental health expenditure, namely, how much governments contribute to a country's total healthcare costs, and labour market conditions, that is, unemployment rates and modernisation of the labour market. We used information from the European Social Survey (ESS) 2002-2008 on more than 90,000 individuals in 32 European nations, and estimated hierarchical models with cross-level interactions to test our expectations. Our results show that the relative risk of being in poor health of lower educated individuals is smaller in countries where the government spends much on healthcare and with a highly modernised labour market. PMID:21834939

  8. Health care seeking behaviour and expenditure pattern among Scrub Typhus patients attending a tertiary care hospital in Mysore city

    Directory of Open Access Journals (Sweden)

    Rajesh Jayanandan

    2015-05-01

    areas, unskilled workers and children were affected predominantly. With timely diagnosis and appropriate treatment, significant morbidity and mortality could be prevented. Promotion of various public and private health insurance schemes among public would minimise the OOP expenditure and prevents debts. [Int J Res Med Sci 2015; 3(5.000: 1181-1188

  9. Unemployment, public–sector health care expenditure and HIV mortality: An analysis of 74 countries, 1981–2009

    Directory of Open Access Journals (Sweden)

    Mahiben Maruthappu

    2015-06-01

    Full Text Available Background: The global economic downturn has been associated with increased unemployment and reduced public–sector expenditure on health care (PSEH. We determined the association between unemployment, PSEH and HIV mortality. Methods: Data were obtained from the World Bank and the World Health Organisation (1981–2009. Multivariate regression analysis was implemented, controlling for country–specific demographics and infrastructure. Time–lag analyses and robustness–checks were performed. Findings: Data were available for 74 countries (unemployment analysis and 75 countries (PSEH analysis, equating to 2.19 billion and 2.22 billion people, respectively, as of 2009. A 1% increase in unemployment was associated with a significant increase in HIV mortality (men: 0.1861, 95% CI: 0.0977 to 0.2744, P<0.0001, women: 0.0383, 95% CI: 0.0108 to 0.0657, P=0.0064. A 1% increase in PSEH was associated with a significant decrease in HIV mortality (men: –0.5015, 95% CI: –0.7432 to –0.2598, P=0.0001; women: –0.1562, 95% CI: –0.2404 to –0.0720, P=0.0003. Time–lag analysis showed that significant changes in HIV mortality continued for up to 5 years following variations in both unemployment and PSEH. Interpretation: Unemployment increases were associated with significant HIV mortality increases. PSEH increases were associated with reduced HIV mortality. The facilitation of access–to–care for the unemployed and policy interventions which aim to protect PSEH could contribute to improved HIV outcomes.

  10. The Ongoing Catastrophe

    DEFF Research Database (Denmark)

    Kublitz, Anja

    2016-01-01

    as camps. Based on fieldwork among Palestinians in the Danish camps, this article explores why my interlocutors describe their current lives as a catastrophe. Al-Nakba literally means the catastrophe and, in Palestinian national discourse, it is used to designate the event of 1948, when the Palestinians...

  11. A story of transformation following catastrophic loss.

    Science.gov (United States)

    Rateau, Margaret R

    2010-08-01

    The emotional impact following catastrophic loss is a highly individualized and personal experience. Such an experience may be life transforming and can significantly influence the course of one's emotional recovery. Through the gathering of story, a clearer understanding of the transformational experience may lead to more appropriate mental health support for those most in need. The purposes of this article are to share the author's 4-year autobiographical story following catastrophic loss from a house explosion and fire, to discuss the transpersonal perspective on transformation, and to offer the use of story for practice and research applications for persons experiencing catastrophic loss. PMID:20650371

  12. Family healthcare expenditure on children affiliated to the Medical Insurance for a New Generation Gasto en salud de los hogares con niños afiliados al Seguro Médico para una Nueva Generación

    OpenAIRE

    Evelyne Eugenia Rodríguez-Ortega; Elvira Mireya Pasillas-Torres

    2012-01-01

    OBJECTIVE: To analyze household health expenditures on children who are beneficiaries of the Medical Insurance for a New Generation (SMNG), program created in 2007 to cover healthcare costs of children without social security born after December 1st, 2006. MATERIALS AND METHODS: Using the SMNG National Survey, out-the-pocket and catastrophic spending on child health were calculated using several definitions. Results are presented by socioeconomic level, rural and urban areas and for Oportunid...

  13. Understanding Atmospheric Catastrophes

    Science.gov (United States)

    Chao, Winston C.

    2009-01-01

    The atmosphere, as in other parts of nature, is full of phenomena that involve rapid transitions from one (quasi-) equilibrium state to another--- i.e. catastrophes. These (quasi-) equilibria are the multiple solutions of the same dynamical system. Unlocking the mystery behind a catastrophe reveals not only the physical mechanism responsible for the transition, but also how the (quasi-) equilibria before and after the transition are maintained. Each catastrophe is different, but they do have some common traits. Understanding these common traits is the first step in studying these catastrophes. In this seminar, three examples chosen based on the speaker's research interest--tropical cyclogenesis, stratospheric sudden warming, and monsoon onset--are given to illustrate how atmospheric catastrophes can be studied.

  14. Expenditure Cascades

    OpenAIRE

    2014-01-01

    Prevailing economic models of consumer behavior completely ignore the well-documented link between context and evaluation. We propose and test a theory that explicitly incorporates this link. Changes in one group's spending shift the frame of reference that defines consumption standards for others just below them on the income scale, giving rise to expenditure cascades. Our model, a descendant of James Duesenberry's relative income hypothesis, predicts the observed ways in which individual sa...

  15. 42 CFR 403.754 - Monitoring expenditure level.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Monitoring expenditure level. 403.754 Section 403..., Conditions of Participation, and Payment § 403.754 Monitoring expenditure level. (a) Tracking expenditures... between the trigger level and Medicare expenditures for a FFY results in a carry forward that...

  16. Catastrophic events and older adults.

    Science.gov (United States)

    Cloyd, Elizabeth; Dyer, Carmel B

    2010-12-01

    The plight of older adults during catastrophic events is a societal concern. Older persons have an increased prevalence of cognitive disorders, chronic illnesses, and mobility problems that limit their ability to cope. These disorders may result in a lack of mental capacity and the ability to discern when they should evacuate or resolve problems encountered during a catastrophe. Some older persons may have limited transportation options, and many of the elderly survivors are at increased risk for abuse, neglect, and exploitation. Recommendations for future catastrophic events include the development of a federal tracking system for elders and other vulnerable adults, the designation of separate shelter areas for elders and other vulnerable adults, and involvement of gerontological professionals in all aspects of emergency preparedness and care delivery, including training of frontline workers. Preparation through preevent planning that includes region-specific social services, medical and public health resources, volunteers, and facilities for elders and vulnerable adults is critical. Elders need to be protected from abuse and fraud during catastrophic events. A public health triage system for elders and other vulnerable populations in pre- and postdisaster situations is useful, and disaster preparedness is paramount. Communities and members of safety and rescue teams must address ethical issues before an event. When older adults are involved, consideration needs to be given to triage decision making, transporting those who are immobile, the care of older adults who receive palliative care, and the equitable distribution of resources. Nurses are perfectly equipped with the skills, knowledge, and training needed to plan and implement disaster preparedness programs. In keeping with the tradition of Florence Nightingale, nurses can assume several crucial roles in disaster preparedness for older adults. Nurses possess the ability to participate and lead community

  17. 我国公共卫生支出效率分析%The Efficiency Analysis of China’s Public Expenditure on Health

    Institute of Scientific and Technical Information of China (English)

    邓大松; 吴迪

    2015-01-01

    This paper use the Data Envelopment Analysis(DEA)on the data of 31 provinces and cities in our country as an independent decision-making unit, choose the government expenditure on health per person, the num⁃ber of bed in health care institutions per thousand people ,the number of medical staff member per thousand people,the number of health care institutions as the input variables. Choose the bed utilization rate, physicians daily visits and hu⁃man mortality as output variables to analyze the efficiency of public health expenditure in China. The results shows that the public health expenditure has such problems as inadequate input scale and irrational structure, etc.%文章运用数据包络分析方法(DEA)将中国31个省市作为独立决策单元,选择人均政府卫生支出、千人卫生机构床位数、千人卫生技术人数与卫生机构数为投入变量,将床位利用率、医师日均担负诊疗人次与人口死亡率为产出变量对中国公共卫生支出的效率进行分析。通过研究发现中国公共卫生支出存在投入规模不足及结构不合理等问题,并根据这些问题提出相应的政策建议。

  18. Habitability and cosmic catastrophes

    CERN Document Server

    Hanslmeier, Arnold; McKay, Christopher P

    2008-01-01

    Catastrophic cosmic events such as asteroid impacts appear in the range of some 100 million years and have drastically affected evolution. The author discusses whether and how such events could have occurred in recently found extrasolar planetary systems.

  19. Catastrophic Antiphospholipid Syndrome.

    Science.gov (United States)

    El-Shereef, Rawhya R; El-Abedin, Zein; Abdel Aziz, Rashad; Talat, Ibrahim; Saleh, Mohammed; Abdel-Samia, Hanna; Sameh, Amro; Sharha, Mahmoud

    2016-01-01

    This paper reports one case of successfully treated patients suffering from a rare entity, the catastrophic antiphospholipid syndrome (CAPS). Management of this patient is discussed in detail. PMID:27375916

  20. Catastrophic Antiphospholipid Syndrome

    Directory of Open Access Journals (Sweden)

    Rawhya R. El-Shereef

    2016-01-01

    Full Text Available This paper reports one case of successfully treated patients suffering from a rare entity, the catastrophic antiphospholipid syndrome (CAPS. Management of this patient is discussed in detail.

  1. Projecting future drug expenditures--2003.

    Science.gov (United States)

    Shah, Nilay D; Hoffman, James M; Vermeulen, Lee C; Hunkler, Robert J; Hontz, Karrie M

    2003-01-15

    Drug expenditure projections for 2003 and factors likely to influence drug costs are discussed. The United States continues to face the challenge of increased growth in health expenditures, and drug expenditures are continuing to increase faster than the growth in total health care expenditures. These increases can be largely attributed to an increase in the average age of the U.S. population and technological advancement. On the basis of price inflation and non-price inflationary factors, including increases in volume, shifts in patient and therapeutic intensity, and expected approval of new drugs, a 10-12% increase in drug expenditures in 2003 for the inpatient setting and a 13.5-15.5% increase for ambulatory care settings are forecasted. While few new drugs are expected to greatly influence expenditures in 2003, the continued diffusion of recently approved drugs such as drotrecogin alfa and nesiritide will have a dramatic impact on total drug expenditures and must be carefully considered in the budgeting process. An agent likely to have a significant impact on HIV treatment is enfuvirtide, the first in a new class of antiretrovirals (fusion inhibitors), but its high cost ($10,000-$15,000 per year) may limit patients' access to this medication. An expanded user's guide is provided to assist the reader in appropriate application of this information in the drug budgeting process. Technological, demographic, and market-based changes and changes in public policy will continue to influence pharmaceutical expenditures in the coming year. An understanding of the overall drivers of medication expenditures and vigilance in monitoring pharmaceutical innovation are critical in the effective management of these resources. PMID:12561658

  2. Entanglement in quantum catastrophes

    CERN Document Server

    Emary, C; Brandes, T; Emary, Clive; Lambert, Neill; Brandes, Tobias

    2005-01-01

    We classify entanglement singularities for various two-mode bosonic systems in terms of catastrophe theory. Employing an abstract phase-space representation, we obtain exact results in limiting cases for the entropy in cusp, butterfly, and two-dimensional catastrophes. We furthermore use numerical results to extract the scaling of the entropy with the non-linearity parameter, and discuss the role of mixing entropies in more complex systems.

  3. Catastrophes in surface scattering

    International Nuclear Information System (INIS)

    Theoretical and experimental studies concerning atom-surface interactions in the energy range from hyperthermal to approximately 100 eV are reported. An extended study of the interaction of low energetic alkalis (sodium and potassium) with a silver crystal is presented. Finally the ultimate experimental result in this research, the first observation of catastrophes in surface scattering, is shown. The results clearly indicate the strength of the catastrophe analysis in gas-surface scattering. 218 refs.; 40 figs.; 170 schemes; 4 tabs

  4. Health gains and financial risk protection afforded by public financing of selected interventions in Ethiopia: An extended cost-effectiveness analysis

    OpenAIRE

    Dr. Stéphane Verguet, PhD; Zachary D Olson, MA; Joseph B Babigumira, PhD; Dawit Desalegn, MD; Kjell Arne Johansson, PhD; Margaret E Kruk, MD; Carol E Levin, PhD; Rachel A Nugent, PhD; Clint Pecenka, PhD; Mark G Shrime, MD; Solomon Tessema Memirie, MD; David A Watkins, MD; Prof. Dean T Jamison, PhD

    2015-01-01

    Background: The way in which a government chooses to finance a health intervention can affect the uptake of health interventions and consequently the extent of health gains. In addition to health gains, some policies such as public finance can insure against catastrophic health expenditures. We aimed to evaluate the health and financial risk protection benefits of selected interventions that could be publicly financed by the government of Ethiopia. Methods: We used extended cost-effectiven...

  5. Household expenditure components and the poverty and inequality relationship in Malawi

    OpenAIRE

    Mussa, Richard

    2011-01-01

    The paper looks at how inequality in household expenditure components affects total inequality and poverty in Malawi. Total household expenditure is disaggregated into four mutually exclusive and exhaustive expenditure items namely; expenditure on food, expenditure on health, expenditure on education, and expenditure on non food and non human capital items. Using data from the second integrated household survey (IHS2), we find that the elasticities of poverty with respect to within-component ...

  6. Catastrophizing and Parental Response to Child Symptom Complaints

    OpenAIRE

    Langer, Shelby L.; Romano, Joan M.; Levy, Rona L; Walker, Lynn S.; Whitehead, William E.

    2009-01-01

    This study investigated whether catastrophic thinking about pain by children with functional abdominal pain or by their parents is associated with health outcomes in the child. Subjects were 132 parent-child dyads. Child catastrophizing predicted child depression, anxiety and functional disability. Parents’ catastrophizing cognitions about their own pain predicted self-reported protective responses to their children’s abdominal pain (responding in ways that encourage illness behavior). Protec...

  7. Emergency obstetric care in Mali: catastrophic spending and its impoverishing effects on households

    Directory of Open Access Journals (Sweden)

    Catherine Arsenault

    2013-03-01

    Full Text Available OBJECTIVE: To investigate the frequency of catastrophic expenditures for emergency obstetric care, explore its risk factors, and assess the effect of these expenditures on households in the Kayes region, Mali. METHODS: Data on 484 obstetric emergencies (242 deaths and 242 near-misses were collected in 2008-2011. Catastrophic expenditure for emergency obstetric care was assessed at different thresholds and its associated factors were explored through logistic regression. A survey was subsequently administered in a nested sample of 56 households to determine how the catastrophic expenditure had affected them. FINDINGS: Despite the fee exemption policy for Caesareans and the maternity referral-system, designed to reduce the financial burden of emergency obstetric care, average expenses were 152 United States dollars (equivalent to 71 535 Communauté Financière Africaine francs and 20.7 to 53.5% of households incurred catastrophic expenditures. High expenditure for emergency obstetric care forced 44.6% of the households to reduce their food consumption and 23.2% were still indebted 10 months to two and a half years later. Living in remote rural areas was associated with the risk of catastrophic spending, which shows the referral system's inability to eliminate financial obstacles for remote households. Women who underwent Caesareans continued to incur catastrophic expenses, especially when prescribed drugs not included in the government-provided Caesarean kits. CONCLUSION: The poor accessibility and affordability of emergency obstetric care has consequences beyond maternal deaths. Providing drugs free of charge and moving to a more sustainable, nationally-funded referral system would reduce catastrophic expenses for households during obstetric emergencies.

  8. The Dynamic Relationship of Total Health Expenditure and Economic Growth%我国卫生总费用与经济增长的动态关系

    Institute of Scientific and Technical Information of China (English)

    杨洋

    2014-01-01

    To study the dynamic relationship of total health expenditure and economic growth so as to provide references for designing health economic policies. Methods: Using the regression models with multiple structural changes to estimate the structural change point of model parameter. Results: Compared to the elastic coefficient of economic growth, the total health expenditure and social health expenditure remained stably, the elasticity coefficient of government spending on health increased after decreased while elastic coefficient of personal spending health costs decreased after increased. Conclusion:In the early years of 1990s, the responsibility of government in health care financing funding weakened, which led to the increasing personal expenses. The situation began to reverse since 2004.%目的:研究我国卫生总费用以及其筹资结构与经济增长的动态关系,为我国卫生经济政策的制定提供依据。方法:运用具有多个结构突变点的回归模型,估计模型参数发生结构突变的时点。结果:卫生总费用和社会支出卫生费用相对于经济增长的弹性系数保持稳定,政府支出卫生费用相对于经济增长的弹性系数先变小再变大,而个人支出卫生费用相对于经济增长的弹性系数先变大再变小。结论:在20世纪90年代初,政府支出在卫生筹资领域的责任弱化,导致个人支出负担大大加剧,自2004年以来,这种局面开始逆转。

  9. Medical Expenditure Panel Survey (MEPS) Query Tool

    Data.gov (United States)

    U.S. Department of Health & Human Services — MEPSnet HC Query Tool MEPSnet/Household Component provides easy access to nationally representative statistics of health care use, expenditures, sources of payment,...

  10. Financial access to health care for older people in Cambodia: 10-year trends (2004-14) and determinants of catastrophic health expenses

    OpenAIRE

    Jacobs, Bart; de Groot, Richard; Fernandes Antunes, Adélio

    2016-01-01

    Background Older people make up an increasing proportion of the population in low- and middle-income countries. This brings a number of challenges, as their health needs are greater than, and different from, those of younger people. In general, these health systems are not geared to address their needs, and traditional support systems tend to erode, potentially causing financial hardship when accessing health care. This paper provides an overview of older Cambodians’ financial access to healt...

  11. Catastrophic Crop Insurance

    OpenAIRE

    Edwards, William M.

    2003-01-01

    Beginning in 1995 farmers were offered the chance to carry a minimum level of Multiple Peril Crop Insurance (MPCI) coverage at very little cost. This catastrophic or CAT insurance coverage replaces the protection offered to crop producers under federal disaster programs in recent years.

  12. The financial protection effect of Ghana National Health Insurance Scheme: evidence from a study in two rural districts

    OpenAIRE

    Wang Hong; Rajkotia Yogesh; Nguyen Ha TH

    2011-01-01

    Abstract Background One of the key functions of health insurance is to provide financial protection against high costs of health care, yet evidence of such protection from developing countries has been inconsistent. The current study uses the case of Ghana to contribute to the evidence pool about insurance's financial protection effects. It evaluates the impact of the country's National Health Insurance Scheme on households' out-of-pocket spending and catastrophic health expenditure. Methods ...

  13. World military expenditures and global cardiovascular mortality.

    Science.gov (United States)

    Brenner, M Harvey

    2016-02-01

    Can we estimate the consequences of world military expenditures for the physical and mental health of nations that produce and purchase armaments? If anxiety and fear are promoting military expenditures, then those sentiments may well reflect poorer mental health and war-related stress as it influences cardiovascular illness rates. Further, extensive military expenditure by a society implies that other societal needs are allocated fewer resources, including nutrition, water and sanitation, health care, and economic development. We use a model focused on military expenditures to predict cardiovascular mortality in world samples of industrialized and developing countries over 2000-2011. The cardiovascular mortality model controls for economic development, smoking, body mass index, systolic blood pressure, and carbon dioxide emissions. Military expenditures as proportion of gross domestic product show significant positive relations to cardiovascular disease mortality in linear multiple regression analyses, using both cross-sectional and pooled cross-sectional time-series approaches. PMID:26675148

  14. Inequity in costs of seeking sexual and reproductive health services in India and Kenya

    OpenAIRE

    Haghparast-Bidgoli, Hassan; Pulkki-Brännström, Anni-Maria; Lafort, Yves; Beksinska, Mags; Rambally, Letitia; Roy, Anuradha; Reza-Paul, Sushena; Ombidi, Wilkister; Gichangi, Peter; Skordis-Worrall, Jolene

    2015-01-01

    Objective: This study aims to assess inequity in expenditure on sexual and reproductive health (SRH) services in India and Kenya. In addition, this analysis aims to measure the extent to which payments are catastrophic and to explore coping mechanisms used to finance health spending. Methods: Data for this study were collected as a part of the situational analysis for the "Diagonal Interventions to Fast Forward Enhanced Reproductive Health" (DIFFER) project, a multi-country project with f...

  15. Comparisons of annual health care utilization, drug consumption, and medical expenditure between the elderly and general population in Taiwan

    Directory of Open Access Journals (Sweden)

    Wan-Hsuan Lu, MS

    2016-06-01

    Conclusion: Elderly people had higher medical utilization than the general population, which may contribute to a fragmented health care system. Strategies to integrate health care for older people would be considered a first priority task of policymakers and health professionals.

  16. Catastrophic primary antiphospholipid syndrome

    International Nuclear Information System (INIS)

    Catastrophic antiphospholipid syndrome (CAPLS) was diagnosed in a 64-year-old male who was admitted to our hospital with dyspnea. The clinical and radiological examinations showed pulmonary thromboembolism, and so thromboembolectomy was performed. Abdominal distension rapidly developed several days later, and the abdominal computed tomography (CT) abdominal scan revealed thrombus within the superior mesenteric artery with small bowel and gall bladder distension. Cholecystectomy and jejunoileostomy were performed, and gall bladder necrosis and small bowel infarction were confirmed. The anticardiolipin antibody was positive. Anticoagulant agents and steroids were administered, but the patient expired 4 weeks after surgery due to acute respiratory distress syndrome (ARDS). We report here on a case of catastrophic APLS with manifestations of pulmonary thromboembolism, rapidly progressing GB necrosis and bowel infarction

  17. Catastrophic primary antiphospholipid syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Byun, Joo Nam [Chosun University Hospital, Gwangju (Korea, Republic of); Ryu, Sang Wan [Miraero21 Medical Center, Gwangju (Korea, Republic of)

    2006-09-15

    Catastrophic antiphospholipid syndrome (CAPLS) was diagnosed in a 64-year-old male who was admitted to our hospital with dyspnea. The clinical and radiological examinations showed pulmonary thromboembolism, and so thromboembolectomy was performed. Abdominal distension rapidly developed several days later, and the abdominal computed tomography (CT) abdominal scan revealed thrombus within the superior mesenteric artery with small bowel and gall bladder distension. Cholecystectomy and jejunoileostomy were performed, and gall bladder necrosis and small bowel infarction were confirmed. The anticardiolipin antibody was positive. Anticoagulant agents and steroids were administered, but the patient expired 4 weeks after surgery due to acute respiratory distress syndrome (ARDS). We report here on a case of catastrophic APLS with manifestations of pulmonary thromboembolism, rapidly progressing GB necrosis and bowel infarction.

  18. Valuing Catastrophic Citrus Losses

    OpenAIRE

    Adams, Damian C.; Kilmer, Richard L.; Moss, Charles B.; Schmitz, Andrew

    2004-01-01

    Courts are often required to estimate changes in welfare to agricultural operations from catastrophic events. For example, courts must assign damages in lawsuits, such as with pesticide drift cases, or determine "just compensation" when the government takes private land for public use, as with the removal of dairy farms from environmentally sensitive land or destruction of canker-contaminated citrus trees. In economics, the traditional method of quantifying producer losses is estimating chang...

  19. The limits of catastrophe aversion.

    Science.gov (United States)

    Peterson, Martin

    2002-06-01

    We discuss the management of catastrophe-risks from a theoretical point of view. The concept of a catastrophe is informally and formally defined, and a number of desiderata for catastrophe-averse decision rules are introduced. However, the proposed desiderata turn out to be mutually inconsistent. As a consequence of this result, it is argued that the "rigid" form of catastrophe aversion articulated by, for example, the maximin rule, the maximum probable loss rule, (some versions of) the precautionary principle, and the rule proposed in Ekenberg et al. (1997, 2000) should be given up. An alternative form of "non-rigid" catastrophe aversion is considered. PMID:12088231

  20. 42 CFR 403.750 - Estimate of expenditures and adjustments.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Estimate of expenditures and adjustments. 403.750...-Benefits, Conditions of Participation, and Payment § 403.750 Estimate of expenditures and adjustments. (a) Estimates. CMS estimates the level of expenditures for services provided under this subpart before the...

  1. Classification of enterprise expenditures

    Directory of Open Access Journals (Sweden)

    Tatiana Ostapenko

    2013-05-01

    Full Text Available The need to diversify share of costs is grounded. It is proposed to classify expenditures by types of income (loss of current activity (covered and uncovered expenditures, by the level of costs to its planned size (planned cost; costs that exceed the planned size; costs that are lower than the planned size, with the aim to influence the activity result (effective and ineffective expenditures, by the period of their appearance (intermediate and annual expenditures.The existing classification of expenditures by kinds of activity is improved through emphasizing such feature: by ability to increase enterprise cost (essential and unessential expenditures. The traditional definition of exhausted (consumed and unexhausted (not consumed expenditures that helped to separate expenses in their structure which don’t ensure formation of exhausted and unexhausted expenditures (management costs is criticized

  2. Medical Expenditure Panel Survey Household Component

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medical Expenditure Panel Survey (MEPS) Household Component (HC) collects data from a sample of families and individuals in selected communities across the...

  3. Reconciling Medical Expenditure Estimates from the MEPS...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Reconciling Medical Expenditure Estimates from the MEPS and NHEA, 2007, published in Volume 2, Issue 4 of the Medicare and Medicaid Research Review, provides a...

  4. Russia - Public Expenditure Review

    OpenAIRE

    World Bank

    2011-01-01

    The primary objective of the Public Expenditure Review (PER) is to assist the Ministry of Finance (MOF) in identifying opportunities for efficiency gains in some key categories of government expenditure. In this context, policy makers face two related fiscal dilemmas. First, how can expenditure efficiency are increased to provide public services with fewer resources? Second, how can the fi...

  5. Grau de cobertura dos planos de saúde e distribuição regional do gasto público em saúde Level of private health insurance coverage and regional distribution of public health expenditure

    Directory of Open Access Journals (Sweden)

    Samuel Kilsztajn

    2001-12-01

    Full Text Available O artigo analisa o grau de cobertura dos planos de saúde segundo as classes de rendimento mensal familiar e por unidade da federação e a distribuição dos recursos da Rede-SUS e do gasto público total em saúde por usuário dos serviços públicos de saúde nas regiões Norte-Nordeste e Centro-Sul do país. São apresentados e discutidos também os indicadores do gasto público total em saúde como percentual do PIB gerado nas regiões.This paper analyses the level of private health insurance coverage by classes of income and by states in Brazil and the distribution of the total public health expenditure by public health users in the North-Northeast and Central-South regions of the country. The paper also presents and discusses the total public health expenditure as a percentage of regional GDP.

  6. CATASTROPHIC EVENTS MODELING

    Directory of Open Access Journals (Sweden)

    Ciumas Cristina

    2013-07-01

    Full Text Available This paper presents the emergence and evolution of catastrophe models (cat models. Starting with the present context of extreme weather events and features of catastrophic risk (cat risk we’ll make a chronological illustration from a theoretical point of view of the main steps taken for building such models. In this way the importance of interdisciplinary can be observed. The first cat model considered contains three modules. For each of these indentified modules: hazard, vulnerability and financial losses a detailed overview and also an exemplification of a potential case of an earthquake that measures more than 7 on Richter scale occurring nowadays in Bucharest will be provided. The key areas exposed to earthquake in Romania will be identified. Then, based on past catastrophe data and taking into account present conditions of housing stock, insurance coverage and the population of Bucharest the impact will be quantified by determining potential losses. In order to accomplish this work we consider a scenario with data representing average values for: dwelling’s surface, location, finishing works. On each step we’ll make a reference to the earthquake on March 4 1977 to see what would happen today if a similar event occurred. The value of Bucharest housing stock will be determined taking firstly the market value, then the replacement value and ultimately the real value to quantify potential damages. Through this approach we can find the insurance coverage of potential losses and also the uncovered gap. A solution that may be taken into account by public authorities, for example by Bucharest City Hall will be offered: in case such an event occurs the impossibility of paying compensations to insured people, rebuilding infrastructure and public buildings and helping the suffering persons should be avoided. An actively public-private partnership should be created between government authorities, the Natural Disaster Insurance Pool, private

  7. Abdominal Vascular Catastrophes.

    Science.gov (United States)

    Singh, Manpreet; Koyfman, Alex; Martinez, Joseph P

    2016-05-01

    Abdominal vascular catastrophes are among the most challenging and time sensitive for emergency practitioners to recognize. Mesenteric ischemia remains a highly lethal entity for which the history and physical examination can be misleading. Laboratory tests are often unhelpful, and appropriate imaging must be quickly obtained. A multidisciplinary approach is required to have a positive impact on mortality rates. Ruptured abdominal aortic aneurysm likewise may present in a cryptic fashion. A specific type of ruptured aneurysm, the aortoenteric fistula, often masquerades as the more common routine gastrointestinal bleed. The astute clinician recognizes that this is a more lethal variant of gastrointestinal hemorrhage. PMID:27133247

  8. Free Medicines Thanks to Retirement: Impact of Coinsurance Exemption on Pharmaceutical Expenditures and Hospitalization Offsets in a national health service.

    Science.gov (United States)

    Puig-Junoy, Jaume; García-Gómez, Pilar; Casado-Marín, David

    2016-06-01

    This paper examines the impact of coinsurance exemption for prescription medicines applied to elderly individuals in Spain after retirement. We use a rich administrative dataset that links pharmaceutical consumption and hospital discharge records for the full population aged 58 to 65 years in January 2004 covered by the public insurer in a Spanish region, and we follow them until December 2006. We use a difference-in-differences strategy and exploit the eligibility age for Social Security to control for the endogeneity of the retirement decision. Our results show that this uniform exemption increases the consumption of prescription medicines on average by 17.5%, total pharmaceutical expenditure by 25% and the costs borne by the insurer by 60.4%, without evidence of any offset effect in the form of lower short term probability of hospitalization. The impact is concentrated among consumers of medicines for acute and other non-chronic diseases whose previous coinsurance rate was 30% to 40%. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26082341

  9. Cosmic impacts, cosmic catastrophes. II

    Science.gov (United States)

    Chapman, Clark R.; Morrison, David

    1990-01-01

    The role of extraterrestrial impacts in shaping the earth's history is discussed, arguing that cosmic impacts represent just one example of a general shift in thinking that has made the idea of catastrophes respectable in science. The origins of this view are presented and current catastrophic theory is discussed in the context of modern debate on the geological formation of the earth. Various conflicting theories are reviewed and prominent participants in the ongoing scientific controversy concerning catastrophism are introduced.

  10. Manipulation of pain catastrophizing: An experimental study of healthy participants

    Directory of Open Access Journals (Sweden)

    Joel E Bialosky

    2008-11-01

    Full Text Available Joel E Bialosky1*, Adam T Hirsh2,3, Michael E Robinson2,3, Steven Z George1,3*1Department of Physical Therapy; 2Department of Clinical and Health Psychology; 3Center for Pain Research and Behavioral Health, University of Florida, Gainesville, Florida, USAAbstract: Pain catastrophizing is associated with the pain experience; however, causation has not been established. Studies which specifically manipulate catastrophizing are necessary to establish causation. The present study enrolled 100 healthy individuals. Participants were randomly assigned to repeat a positive, neutral, or one of three catastrophizing statements during a cold pressor task (CPT. Outcome measures of pain tolerance and pain intensity were recorded. No change was noted in catastrophizing immediately following the CPT (F(1,84 = 0.10, p = 0.75, partial η2 < 0.01 independent of group assignment (F(4,84 = 0.78, p = 0.54, partial η2 = 0.04. Pain tolerance (F(4 = 0.67, p = 0.62, partial η2 = 0.03 and pain intensity (F(4 = 0.73, p = 0.58, partial η2 = 0.03 did not differ by group. This study suggests catastrophizing may be difficult to manipulate through experimental pain procedures and repetition of specific catastrophizing statements was not sufficient to change levels of catastrophizing. Additionally, pain tolerance and pain intensity did not differ by group assignment. This study has implications for future studies attempting to experimentally manipulate pain catastrophizing.Keywords: pain, catastrophizing, experimental, cold pressor task, pain catastrophizing scale

  11. Using an ounce of prevention: does it reduce health care expenditures and reap pounds of profits? A study of the financial impact of wellness and health risk screening programs.

    Science.gov (United States)

    Phillips, Janet F

    2009-01-01

    As we are all well aware, health care expenditures in the United States are out of control and growing at epic proportions. Since private industry shoulders a significant burden of paying these rising health care costs, the huge and ever increasing sum paid by these corporations continues to impact the US economy translating into higher prices of services and manufactured goods and reduced job opportunities when companies outsource jobs or locate manufacturing facilities to avoid paying health care benefits for workers. As a result, health care expenditures have become a centerpiece of an enormous public policy debate as Congress is currently working on several versions of a bill to completely revise health care from the ground up. This research project was accomplished to examine the effectiveness of one approach to control rising health care costs and contain corporate financial responsibility--the establishment of wellness and health risk screening programs to improve the health of employees. Total health care cost per insured individual was gathered through an online survey directly from health care benefit administrators. The survey also asked information about wellness and health risk screening programs and the related responses were used to determine if there were a relationship between health care costs and health prevention programs. While statistical analysis was hampered in the current study because of the small sample size, some valid conclusions were reached. The study was successful in identifying a benchmark of Average Total Health Care Cost per Individual from $5,100 to $5,800 for 2005 through 2007. This is especially interesting in light of the fact that an average of $7,026 was spent on health care per person in 2006 in the United States. The study was also able to contribute an estimate of the increase realized in these expenditures of 6 percent in 2007 over 2006, and 4 percent in 2006 over 2005, which were in fact similar to the national average

  12. Medicaid expenditures for children living with smokers

    Directory of Open Access Journals (Sweden)

    Levy Douglas E

    2011-05-01

    Full Text Available Abstract Background Children's exposure to secondhand smoke is associated with increased morbidity. We estimated Medicaid expenditures for children living with smokers compared to those living with no smokers in the United States. Methods Data were overall and service-specific (i.e., inpatient, ambulatory, emergency department, prescription drug, and dental annual Medicaid expenditures for children 0-11 years old from the 2000-2007 Medical Expenditures Panel Surveys. Smokers' presence in households was determined by adult respondents' self reports. There were 25,835 person-years of observation. We used multivariate analyses to adjust for child, parent, and geographic characteristics. Results Children with Medicaid expenditures were nearly twice as likely to live with a smoker as other children in the U.S. population. Adjusted analyses revealed no detectable differences in children's overall Medicaid expenditures by presence of smokers in the household. Medicaid children who lived with smokers on average had $10 (95% CI $3, $18 higher emergency department expenditures per year than those living with no smokers. Conclusions Living with at least one smoker (a proxy for secondhand smoke exposure is unrelated to children's overall short-term Medicaid expenditures, but has a modest impact on emergency department expenditures. Additional research is necessary to understand the relationship between secondhand smoke exposure and long-term health and economic outcomes.

  13. Ukraine: Health system review.

    Science.gov (United States)

    Lekhan, Valery; Rudiy, Volodymyr; Richardson, Erica

    2010-01-01

    The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. The Ukrainian health system has preserved the fundamental features of the Soviet Semashko system against a background of other changes, which are developed on market economic principles. The transition from centralized financing to its extreme decentralization is the main difference in the health system in comparison with the classic Soviet model. Health facilities are now functionally subordinate to the Ministry of Health, but managerially and financially answerable to the regional and local self-government, which has constrained the implementation of health policy and fragmented health financing. Health care expenditure in Ukraine is low by regional standards and has not increased significantly as a proportion of gross domestic product (GDP) since the mid 1990s; expenditure cannot match the constitutional guarantees of access to unlimited care. Although prepaid schemes such as sickness funds are growing in importance, out-of-pocket payments account for 37.4% of total health expenditure. The core challenges for Ukrainian health care therefore remain the ineffective protection of the population from the risk of catastrophic health care costs and the structural inefficiency of the health system, which is caused by the inefficient system of health care financing. Health system weaknesses are highlighted by increasing rates of avoidable mortality. Recent political impasse has complicated health system reforms and policy-makers face significant challenges in overcoming popular distrust and

  14. Potential for Application of a Probabilistic Catastrophe Risk Modelling Framework to Poverty Outcomes

    OpenAIRE

    Porter, Catherine; White, Emily

    2016-01-01

    This paper analyzes the potential to combine catastrophe risk modelling (CAT risk modeling) with economic analysis of vulnerability to poverty using the example of drought hazard impacts on the welfare of rural households in Ethiopia. The aim is to determine the potential for applying a derived set of damage (vulnerability) functions based on realized shocks and household expenditure/consu...

  15. Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) - Smoking-Attributable Expenditures (SAE)

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2005-2009. SAMMEC - Smoking-Attributable Mortality, Morbidity, and Economic Costs. Smoking-attributable expenditures (SAEs) are excess health care expenditures...

  16. Presidential Address: Catastrophe Theory and Catastrophes in China's Civil Service Examinations (Part 1).

    Science.gov (United States)

    D'Costa, Ayres

    1991-01-01

    Introduces Rene Thom's catastrophe theory, which is based upon complex theorems in multidimensional geometry. Catastrophe theory analysis begins by identifying the occurrence of major discontinuities, or catastrophes, in a system such as civil service exams, resulting in catastrophic change. (KS)

  17. Volcanoes and global catastrophes

    Science.gov (United States)

    Simkin, Tom

    1988-01-01

    The search for a single explanation for global mass extinctions has let to polarization and the controversies that are often fueled by widespread media attention. The historic record shows a roughly linear log-log relation between the frequency of explosive volcanic eruptions and the volume of their products. Eruptions such as Mt. St. Helens 1980 produce on the order of 1 cu km of tephra, destroying life over areas in the 10 to 100 sq km range, and take place, on the average, once or twice a decade. Eruptions producing 10 cu km take place several times a century and, like Krakatau 1883, destroy life over 100 to 1000 sq km areas while producing clear global atmospheric effects. Eruptions producting 10,000 cu km are known from the Quaternary record, and extrapolation from the historic record suggests that they occur perhaps once in 20,000 years, but none has occurred in historic time and little is known of their biologic effects. Even larger eruptions must also exist in the geologic record, but documentation of their volume becomes increasingly difficult as their age increases. The conclusion is inescapable that prehistoric eruptions have produced catastrophes on a global scale: only the magnitude of the associated mortality is in question. Differentiation of large magma chambers is on a time scale of thousands to millions of years, and explosive volcanoes are clearly concentrated in narrow belts near converging plate margins. Volcanism cannot be dismissed as a producer of global catastrophes. Its role in major extinctions is likely to be at least contributory and may well be large. More attention should be paid to global effects of the many huge eruptions in the geologic record that dwarf those known in historic time.

  18. Gasto federal en salud en población no asegurada: México 1980-1995 Federal expenditure in health for non-insured population: Mexico 1980-1995

    Directory of Open Access Journals (Sweden)

    ALEJANDRO LARA

    1997-03-01

    Full Text Available Las crisis económicas que han afectado a México desde principios de los años ochenta han influido de manera determinante en el gasto público en bienestar social y, por lo mismo, en el gasto público en salud. En este trabajo se discute la relación que ha existido entre las estrategias de ajuste y el gasto en salud en población no asegurada, así como la distribución de este gasto por regiones. En la primera parte se describe la evolución del gasto público general, el gasto en bienestar social y el gasto público en salud en México entre 1980 y 1995. En la segunda parte se describe con mayor detalle la distribución del gasto público en salud en ese mismo periodo entre la población no asegurada de las cinco regiones en las que dividió al país la Encuesta Nacional de Salud II. La principal conclusión que se desprende de este trabajo es que en el periodo 1980-1995 se mantuvieron las brechas en el gasto en salud para población no asegurada que desde tiempos remotos existen entre las cinco regiones de México. Estas brechas afectan sobre todo a los estados más marginados –que se ubican en su gran mayoría en el sur del país–, no guardan ninguna relación con las diferencias regionales en las condiciones de salud y corren el riesgo no sólo de mantenerse sino incluso de profundizarse como resultado de los nuevos recortes relativos del gasto en bienestar social que contempla la política de ajuste adoptada por la presente administración.In the last fifteen years Mexico suffered several economic crisis which have negatively affected public expenditure in social welfare and, as a consequence, public expenditure in health. This paper discusses the relationship between the adjustment policies adopted to confront these crisis and public expenditure in health care for the non-insured population, as well as the regional distribution of this expenditure. In part one, the evolution of general public expenditure, public expenditure in social

  19. Colombia : Public Expenditure Review

    OpenAIRE

    World Bank

    2005-01-01

    The thrust of the argument in this report is that, from the fiscal policy perspective, Colombia's long term economic performance will best benefit from: lower public sector debt levels; a lower size of public expenditure; a simpler and (almost) neutral tax structure; a closer linkage between revenue and expenditure responsibilities at different government levels; stronger demand incentives and private sector participation in connection with social expenditures and the related public services...

  20. 基于证据的重特大疾病医保政策界定分析%Analysis on Evidence-based Definition of Catastrophic Illness in Social Health Insurance System of China

    Institute of Scientific and Technical Information of China (English)

    张晓; 刘蓉; 刘孟娜

    2015-01-01

    The definition of catastrophic illness in health insurance policy should base on its goals rather than expanded social responsibility and health care functions, should seek a way to use the fund fairly, justly and effectively under the constraints of limited medical insurance fund, and should take a optimal way to achieve the policy objectives. Through analysis on the practical experience, we define the contents and goals of catastrophic illness in health insurance policy, and specify, in the construction of medical security system, how to use insurance fund more effectively and make insurance system running more efficiently to achieve the policy goal of basic medical insurance, and to reflect the rationality in our insurance system.%重特大疾病的医保政策界定,应基于医保制度目标,而非扩大化的社会责任和医疗职能,应在有限医保基金约束条件下,寻求如何体现基金使用公平、公正与高效的效果,以最优方式和路径完成其政策目标。对此,本文旨在通过政策实践分析,对重特大疾病医保的政策概念内涵与政策目标进行界定和分析,明确在医疗保障制度建设中,医保应如何更加有效地发挥基金的作用,保证医保健康高效运行,实现基本医保制度中重特大疾病保障的政策目标,体现制度的理性。

  1. Geographic Distribution of VA Expenditures Report (GDX)

    Data.gov (United States)

    Department of Veterans Affairs — Geographic Distribution of VA Expenditures Report (GDX) located on the Expenditures page in the Expenditure Tables category. This report details VA expenditures at...

  2. Nonlinear dynamics in an OLG growth model with young and old age labour supply: the role of public health expenditure

    OpenAIRE

    Gori, Luca; Sodini, Mauro

    2011-01-01

    This paper analyses the dynamics of a two-dimensional overlapping generations model with young and old age labour supply. It is shown that the public provision of health investments, which, in turn, affects the demand for material consumption, may represent a source of local indeterminacy, nonlinear dynamics and multiplicity of equilibria. Furthermore, global indeterminacy may also occur because of the co-existence of two attractors with tangled basins of attraction.

  3. Catastrophic antiphospholipid Syndrome

    International Nuclear Information System (INIS)

    The antiphospholipid syndrome (APS) is characterized by venous, arterial thrombosis and miscarriages along with lupic anticoagulant and antibodies against anticardiolipin. The catastrophic antiphospholipid syndrome (CAPS) has been described since 1992 like a multiple organic dysfunction caused by multiple vascular thrombosis in three or more organs. The patients who suffer from this syndrome may have or not history of APS. There are two or three mechanisms that may cause the CAPS, alone or in combination: These are: 1. The multisystemic thrombotic disease with emphasis in microvasculature occlusion of the organs and occlusion of big arterial or veins 2. The disseminated intravascular coagulation (DIC) superimpose in 15% to 50% of the patients that, of course, conducted to an occlusive disease of arterioles, veins or capillaries. 3. A systemic inflammatory response syndrome (SIRS) induced by citoquines. In this review it is described clinical and laboratory features, pathogenesis and treatment of CAPS. For this purpose, it was searched for Medline from 1993 to 2000 and revised the most significant issues obtained by this medium

  4. An evaluation of the impact of patient cost sharing for antihypertensive medications on adherence, medication and health care utilization, and expenditures

    Directory of Open Access Journals (Sweden)

    Pesa JA

    2012-01-01

    Full Text Available Jacqueline A Pesa1, Jill Van Den Bos2, Travis Gray2, Colleen Hartsig2, Robert Brett McQueen3, Joseph J Saseen3, Kavita V Nair31Janssen Scientific Affairs, LLC, Louisville, CO, USA; 2Milliman, Inc, Denver, CO, USA; 3University of Colorado Anschutz Medical Campus, Aurora, CO, USAObjective: To assess the impact of patient cost-sharing for antihypertensive medications on the proportion of days covered (PDC by antihypertensive medications, medical utilization, and health care expenditures among commercially insured individuals assigned to different risk categories.Methods: Participants were identified from the Consolidated Health Cost Guidelines (CHCG database (January 1, 2006–December 31, 2008 based on a diagnosis (index claim for hypertension, continuous enrollment ≥12 months pre- and post-index, and no prior claims for antihypertensive medications. Participants were assigned to: low-risk group (no comorbidities, high-risk group (1+ selected comorbidities, or very high-risk group (prior hospitalization for 1+ selected comorbidities. The relationship between patient cost sharing and PDC by antihypertensive medications was assessed using standard linear regression models, controlling for risk group membership, and various demographic and clinical factors. The relationship between PDC and health care service utilization was subsequently examined using negative binomial regression models.Results: Of the 28,688 study patients, 66% were low risk. The multivariate regression model supported a relationship between patient cost sharing per 30-day fill and PDC in the following year. For every US$1.00 increase in cost sharing, PDC decreased by 1.1 days (P < 0.0001. Significant predictors of PDC included high risk, older age, gender, Charlson Comorbidity Index score, geography, and total post-index insurer- and patient-paid costs. An increase in PDC was associated with a decrease in all-cause and hypertension-related inpatient, outpatient, and emergency

  5. Should Governments Provide Catastrophe Insurance?

    OpenAIRE

    Jaffee, Dwight; Russell, Thomas

    2005-01-01

    Hurricane Katrina and the terrorist attacks of 9/11 2001 have focused attention on the appropriate role of government in providing insurance against catastrophes. This paper argues that wherever possible governments should follow policies which enable the continuation of a private insurance market. In the event that government must itself provide catastrophe insurance it should follow the same actuarially based pricing and reserving rules that would be followed by a competitive private market.

  6. Radiation occupational health interventions offered to radiation workers in response to the complex catastrophic disaster at the Fukushima Daiichi Nuclear Power Plant.

    Science.gov (United States)

    Shimura, Tsutomu; Yamaguchi, Ichiro; Terada, Hiroshi; Okuda, Kengo; Svendsen, Erik Robert; Kunugita, Naoki

    2015-05-01

    The Fukushima Daiichi Nuclear Power Plant (NPP) 1 was severely damaged from the chain reaction of the Great East Japan Earthquake and Tsunami on 11 March 2011, and the consequent meltdown and hydrogen gas explosions. This resulted in the worst nuclear accident since the Chernobyl accident of 1986. Just as in the case of Chernobyl, emergency workers were recruited to conduct a wide range of tasks, including disaster response, rescuing activities, NPP containment, and radiation decontamination. This paper describes the types and efficacy of the various occupational health interventions introduced to the Fukushima NPP radiation workers. Such interventions were implemented in order to prevent unnecessary radiation overexposure and associated adverse health effects and work injuries. Less than 1% of all emergency workers were exposed to external radiation of >100 mSv, and to date no deaths or health adversities from radiation have been reported for those workers. Several occupational health interventions were conducted, including setting of new regulatory exposure limits, improving workers' radiation dosimetry, administration of stable iodine, running an occupational health tracking system, and improving occupational medicine and preventative care. Those interventions were not only vital for preventing unnecessary radiation, but also for managing other general health issues such as mental health, heat illness and infectious diseases. Long-term administration of the aforementioned occupational health interventions is essential to ensure the ongoing support and care for these workers, who were put under one of the most severe occupational health risk conditions ever encountered. PMID:25413928

  7. Radiation occupational health interventions offered to radiation workers in response to the complex catastrophic disaster at the Fukushima Daiichi Nuclear Power Plant

    International Nuclear Information System (INIS)

    The Fukushima Daiichi Nuclear Power Plant (NPP) 1 was severely damaged from the chain reaction of the Great East Japan Earthquake and Tsunami on 11 March 2011, and the consequent meltdown and hydrogen gas explosions. This resulted in the worst nuclear accident since the Chernobyl accident of 1986. Just as in the case of Chernobyl, emergency workers were recruited to conduct a wide range of tasks, including disaster response, rescuing activities, NPP containment, and radiation decontamination. This paper describes the types and efficacy of the various occupational health interventions introduced to the Fukushima NPP radiation workers. Such interventions were implemented in order to prevent unnecessary radiation overexposure and associated adverse health effects and work injuries. Less than 1% of all emergency workers were exposed to external radiation of >100 mSv, and to date no death or health adversities from radiation have been reported for those workers. Several occupational health interventions were conducted, including setting of new regulatory exposure limits, improving workers' radiation dosimetry, administration of stable iodine, running an occupational health tracking system, and improving occupational medicine and preventative care. Those interventions were not only vital for preventing unnecessary radiation, but also for managing other general health issues such as mental health, heat illness and infectious disease. Long-term administration of the aforementioned occupational health interventions is essential to ensure the ongoing support and care for these workers, who were put under one of the most severe occupational health risk conditions ever encountered. (author)

  8. EU pharmaceutical expenditure forecast

    Science.gov (United States)

    Urbinati, Duccio; Rémuzat, Cécile; Kornfeld, Åsa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aballéa, Samuel; Mzoughi, Olfa; Toumi, Mondher

    2014-01-01

    Background and Objectives With constant incentives for healthcare payers to contain their pharmaceutical budgets, forecasting has become critically important. Some countries have, for instance, developed pharmaceutical horizon scanning units. The objective of this project was to build a model to assess the net effect of the entrance of new patented medicinal products versus medicinal products going off-patent, with a defined forecast horizon, on selected European Union (EU) Member States’ pharmaceutical budgets. This model took into account population ageing, as well as current and future country-specific pricing, reimbursement, and market access policies (the project was performed for the European Commission; see http://ec.europa.eu/health/healthcare/key_documents/index_en.htm). Method In order to have a representative heterogeneity of EU Member States, the following countries were selected for the analysis: France, Germany, Greece, Hungary, Poland, Portugal, and the United Kingdom. A forecasting period of 5 years (2012–2016) was chosen to assess the net pharmaceutical budget impact. A model for generics and biosimilars was developed for each country. The model estimated a separate and combined effect of the direct and indirect impacts of the patent cliff. A second model, estimating the sales development and the risk of development failure, was developed for new drugs. New drugs were reviewed individually to assess their clinical potential and translate it into commercial potential. The forecast was carried out according to three perspectives (healthcare public payer, society, and manufacturer), and several types of distribution chains (retail, hospital, and combined retail and hospital). Probabilistic and deterministic sensitivity analyses were carried out. Results According to the model, all countries experienced drug budget reductions except Poland (+€41 million). Savings were expected to be the highest in the United Kingdom (−€9,367 million), France

  9. Tax Expenditures in Croatia

    Directory of Open Access Journals (Sweden)

    Vjekoslav Bratić

    2006-06-01

    Full Text Available The tax system of the Republic of Croatia contains a large number of very diverse kinds of tax expenditures whose the declared aim is to achieve certain social and economic objectives. This paper considers all the items that constitute tax expenditures in Croatia, within the systems of the personal income tax, corporate income tax, and real estate transfer tax and value added tax. The objective of the article is to determine the real level of tax expenditures per form of tax in the 2001-2004 period. We hypothesised that the tax expenditures in the analysed forms of tax are both high and growing, which was ultimately borne out, for almost all the analysed items in the tax forms considered are growing.

  10. Budget Constrained Expenditure Multipliers

    OpenAIRE

    Guerra, Ana Isabel; Sancho, Ferrán

    2010-01-01

    We show that standard expenditure multipliers capture economy-wide effects of new government projects only when financing constraints are not binding. In actual policy making, however, new projects usually need financing. Under liquidity constraints, new projects are subject to two opposite effects: an income effect and a set of spending substitution effects. The former is the traditional, unrestricted, multiplier effect; the latter is the result of expenditure reallocation to ...

  11. Health care expenditures and income

    OpenAIRE

    Αντωνιάδης, Χρήστος Α.

    2009-01-01

    Τα τελευταία χρόνια, η σχέση μεταξύ των πραγματικών κατά κεφαλήν δαπανών υγείας και του πραγματικού κατά κεφαλήν εθνικού εισοδήματος αποτελεί ένα ζήτημα ιδιαίτερου ενδιαφέροντος στη βιβλιογραφία που σχετίζεται με τα οικονομικά της υγείας. Πάνω από το 90% της παρατηρούμενης μεταβλητότητας των δαπανών για την υγεία μπορεί να εξηγηθεί από τη μεταβλητότητα του κατά κεφαλήν εθνικού εισοδήματος, και ειδικότερα, η εισοδηματική ελαστικότητα για τη ζήτηση της υγείας φαίνεται να ξεπερνά τη μονάδα, γεγο...

  12. Sudden stratospheric warmings as catastrophes

    Science.gov (United States)

    Chao, W. C.

    1985-01-01

    The sudden stratospheric warming (SSW) process is qualitatively studied using a conceptual and numerical approach guided by catastrophe theory. A simple example of a catastrophe taken from nonlinear dynamics is given, and results from previous modelling studies of SSW are interpreted in light of catastrophe theory. Properties of this theory such as hysteresis, cusp, and triggering essential to SSW are numerically demonstrated using the truncated quasi-geostrophic beta-plane model of Holton and Mass (1976). A qualitative explanation of the transition from the steady regime to the vacillation regime is given for the Holton and Mass model in terms of the topographically induced barotropic Rossby wave instability. Some implications for the simulation and prediction of SSW are discussed.

  13. Explaining health marginalisation of the lower educated: The role of cross-national variations in health expenditure and labour market conditions

    NARCIS (Netherlands)

    Gesthuizen, M.J.W.; Huijts, T.H.M.; Kraaykamp, G.L.M.

    2012-01-01

    Several studies have shown ample cross-national variation in the risk that lower educated people run to be in poor health. However, explanations for this cross-national variation are still scarce. In this article we aim at filling this lacuna by investigating to what extent cross-national variation

  14. 42 CFR 52c.6 - Expenditure of grant funds.

    Science.gov (United States)

    2010-10-01

    ... the applicable cost principles prescribed by subpart Q of 45 CFR part 74. (b) The Secretary may permit... 42 Public Health 1 2010-10-01 2010-10-01 false Expenditure of grant funds. 52c.6 Section 52c.6... RESEARCH SUPPORT PROGRAM § 52c.6 Expenditure of grant funds. (a) Any funds granted pursuant to this...

  15. 42 CFR 52d.7 - Expenditure of grant funds.

    Science.gov (United States)

    2010-10-01

    ... of the awards, and the applicable cost principles prescribed by subpart Q of 45 CFR part 74, except... 42 Public Health 1 2010-10-01 2010-10-01 false Expenditure of grant funds. 52d.7 Section 52d.7... INSTITUTE CLINICAL CANCER EDUCATION PROGRAM § 52d.7 Expenditure of grant funds. (a) Any funds...

  16. Oil sands tax expenditures

    International Nuclear Information System (INIS)

    The oil sands are a strategic Canadian resource for which federal and provincial governments provide financial incentives to develop and exploit. This report describes the Oil Sands Tax Expenditure Model (OSTEM) developed to estimate the size of the federal income tax expenditure attributed to the oil sands industry. Tax expenditures are tax concessions which are used as alternatives to direct government spending for achieving government policy objectives. The OSTEM was developed within the business Income Tax Division of Canada's Department of Finance. Data inputs for the model were obtained from oil sands developers and Natural Resources Canada. OSTEM calculates annual revenues, royalties and federal taxes at project levels using project-level projections of capital investment, operating expenses and production. OSTEM calculates tax expenditures by comparing taxes paid under different tax regimes. The model also estimates the foregone revenue as a percentage of capital investment. Total tax expenditures associated with investment in the oil sands are projected to total $820 million for the period from 1986 to 2030, representing 4.6 per cent of the total investment. 10 refs., 2 tabs., 7 figs

  17. The Climate Catastrophe as Blockbuster

    DEFF Research Database (Denmark)

    Eskjær, Mikkel Fugl

    2013-01-01

    Modern disaster films constitute a specific cultural form that speaks to the anxieties of the “risk society.” This essay looks at how risks like climate change is presented and constructed in popular culture. It regards blockbuster representations as part of a wider discourse of “catastrophism...

  18. Constructive criterion of catastrophe inevitability

    International Nuclear Information System (INIS)

    A mathematical procedure is proposed for the constructive criteria of nuclear catastrophe inevitability. It was concluded that the procedure can fulfill the objective set, and it allows to make a full formal safety classification of object states. (N.T.). 1 ref., 1 fig

  19. Pain-related catastrophizing in pain patients and people with pain in the general population.

    NARCIS (Netherlands)

    Boer, M.J. de; Struys, M.M.; Versteegen, G.J.

    2012-01-01

    BACKGROUND: Catastrophizing is a defining factor in the pain experience and strongly contributes to the prediction of various aspects of health. Catastrophizing is not just present in pain patients, but may also be present in people with non-clinical pain. The aim of the present study is to investig

  20. Pain-related catastrophizing in pain patients and people with pain in the general population

    NARCIS (Netherlands)

    de Boer, M. J.; Struys, M. M. R. F.; Versteegen, G. J.

    2012-01-01

    Background Catastrophizing is a defining factor in the pain experience and strongly contributes to the prediction of various aspects of health. Catastrophizing is not just present in pain patients, but may also be present in people with non-clinical pain. The aim of the present study is to investiga

  1. Energy Expenditure During Extravehicular Activity Through Apollo

    Science.gov (United States)

    Paul, Heather L.

    2012-01-01

    Monitoring crew health during manned space missions has always been an important factor to ensure that the astronauts can complete the missions successfully and within safe physiological limits. The necessity of real-time metabolic rate monitoring during extravehicular activities (EVAs) came into question during the Gemini missions, when the energy expenditure required to complete EVA tasks exceeded the life support capabilities for cooling and humidity control and, as a result, crew members ended the EVAs fatigued and overworked. This paper discusses the importance of real-time monitoring of metabolic rate during EVAs, and provides a historical look at energy expenditure during EVAs through the Apollo Program.

  2. Pressures to Increase Public Expenditure and Patterns of Procyclical Expenditure

    OpenAIRE

    Andrew Abbott; Philip Jones

    2014-01-01

    This paper draws on the literature that explains why governments spend procyclically, to predict the pattern of cyclical expenditure across government budgets. Procyclical expenditure increases at a faster rate than income in economic upturns and falls at a faster rate in recessions. The more politicians indulge pressures to increase expenditure in an economic upturn, the more they find it difficult to sustain expenditure in a recession. In this paper, differences in politicians' willingness ...

  3. Catastrophic medical protection: a plan for sharing excessive costs.

    Science.gov (United States)

    Hester, R D

    1982-01-01

    Cost sharing provisions in both private and public health insurance plans have greatly increased consumer out-of-pocket expenses for medical services in recent years. The effects of these provisions, coupled with the effects of massive unemployment, have been that many individuals are unable to afford adequate health insurance protection. To protect the nation's health, new proposals to expand health coverage have given rise to catastrophic health insurance. This new health policy priority may assist many low-wage and unemployed workers to meet their cost-sharing obligations in the face of rising medical costs. PMID:10298874

  4. Student Service Expenditures Matter

    Science.gov (United States)

    Ehrenberg, Ronald G.; Webber, Douglas A.

    2010-01-01

    The "Great Recession" has caused a fiscal crisis in both public and private higher education that is unmatched in recent memory. Institutions' attention is focused on what they can cut out of their budgets. Student-service expenditures are often seen as discretionary in institutional budgets; they are viewed by some critics as "frills" that make…

  5. Empirical Analysis on the Relationship of Total Health Expenditure, Physical Capital Investment and Economic Growth%卫生总费用、物质资本投入与经济增长关系实证分析

    Institute of Scientific and Technical Information of China (English)

    聂丽

    2013-01-01

    目的:分析我国国内生产总值、卫生总费用、物质资本投入3个变量间关系,为我国卫生经济政策制定及分配制度改革提供依据。方法:采用1978-2011年统计年鉴数据,建立VAR模型研究变量间动态关系。结果:通过单位根检验得出模型较稳定,3个变量间有Granger关系,通过脉冲响应函数得出: GDP增加会引起卫生费用和物质资本投入增加,物质资本与卫生费用变化具有反向关系等。结论:卫生总费用与物质资本相比具有更强经济增长效应,政府应合理分配卫生费用,从提高劳动者素质角度提高物质资本的社会效益从而促进经济增长。%Objective: By analyzing the three variables relationship of GDP, total health expenditure and physical capital input, to provide basis for health economic policy and distribution system reform in China. Methods: Using the data from 1978 to 2011, the VAR model of the dynamic relationship is established. Results: The establishment of VAR model is stable by unit root test, there is Granger relation between the 3 variables, the result of the impulse response function is obtained that GDP will increase the input of health costs and physical capital, and physical capital and health expenditure have a reverse relation. Conclusion: Total health expenditure has greater effect on economic growth compared with physical capital, the government should allocate health costs, improve social benefits from the prospective of improving the quality of workers to promote economic growth.

  6. Coping with ecological catastrophe: crossing major thresholds

    Directory of Open Access Journals (Sweden)

    John Cairns, Jr.

    2004-08-01

    Full Text Available The combination of human population growth and resource depletion makes catastrophes highly probable. No long-term solutions to the problems of humankind will be discovered unless sustainable use of the planet is achieved. The essential first step toward this goal is avoiding or coping with global catastrophes that result from crossing major ecological thresholds. Decreasing the number of global catastrophes will reduce the risks associated with destabilizing ecological systems, which could, in turn, destabilize societal systems. Many catastrophes will be local, regional, or national, but even these upheavals will have global consequences. Catastrophes will be the result of unsustainable practices and the misuse of technology. However, avoiding ecological catastrophes will depend on the development of eco-ethics, which is subject to progressive maturation, comments, and criticism. Some illustrative catastrophes have been selected to display some preliminary issues of eco-ethics.

  7. Severe catastrophes and public reactions

    International Nuclear Information System (INIS)

    nuclear opposition. Economical basis of nuclear energy stagnation is in not very successful competition of nuclear engineering with fossil energy production technologies. Much money has been spent for improvement of safety of NPPs. Social roots of the opposition are linked with a bad experience of the public with demonstration of the nuclear energy- The explosion of atomic bombs, some contamination of the territories after nuclear arm tests, misfortunes with TMI-2 and Chernobyl have created a stable enmity and non-acceptance of the all connected with 'atom'. The mass media have strongly promoted the dissemination of the fear of radiation exposures. There is also an influence on that attitude the radiation protection regulation via the declaration of the linear no-threshold dependence of the radiation detriments and dose of exposure. Such concept ignores the adoptive features of all living. But modem studies have showed that protracted irradiation at the same dose is much less dangerous compared with sharp one. It could change public attitude to nuclear energy in the society. Role of nuclear communication for public informing: The reactions of public on various technological and man-made events differ significantly and are being determined not scales of catastrophes but the mental impression and a multiplication of psychological stresses in the society by mass -media. In present situation a nuclear community has to improve the contacts with the pubic, to launch more effective campaign for explanation of real adventures of nuclear power. It needs to compare the risks of climate warming and health detriments from different electricity production technologies and to show that nuclear power is a single alternative all fossil burning techniques of electricity production. It's the truth the nuclear power is a real method of fight for suppression of emission the greenhouse gases, isn't it? (author)

  8. Energy expenditure during overfeeding

    OpenAIRE

    Westerterp Klaas R; Joosen Annemiek MCP

    2006-01-01

    Abstract The large inter-individual variation in weight gain during standardized overfeeding together with a weight gain that is often less than theoretically calculated from the energy excess suggest that there are differences between persons in the capacity to regulate energy expenditure and hence metabolic efficiency. Adaptive thermogenesis is defined as the regulated production of heat in response to environmental changes in temperature and diet, resulting in metabolic inefficiency. The q...

  9. Trends in exploration expenditures

    International Nuclear Information System (INIS)

    The American Petroleum Institute and the Department of Energy have contributed to the U.S. petroleum industry estimates of expenditures in exploration. The estimates of expenditures were for scattered years until 1959; from that year forward a continuous record is available. The petroleum industry in the United States is now spending about $10 billion per year in the search for new oil and gas fields. In 1986 dollars, this level is about that of the 1960s, a period of reduced exploratory effort. In the 1960s and 1970s the industry spent about 25% of its revenue in exploration. In the 1980s the percentage spent in exploration has decreased; in the period 1985 to 1988 the percent of revenue spent in exploring for new oil and gas fields was at or about 15% - a significantly lower level from past history. Levels of exploratory overhead, previously at the level of 10% of revenue, have been about 20% in the 1985 to 1988 period. Expenditure levels tell much about the reinvestment rate of the industry and the optimism or pessimism of those who approve funds for the search for new oil and gas fields

  10. 42 CFR 419.30 - Base expenditure target for calendar year 1999.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Base expenditure target for calendar year 1999. 419.30 Section 419.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Services § 419.30 Base expenditure target for calendar year 1999. (a) CMS estimates the aggregate...

  11. Is Geothermal Simulation a "Catastrophe"?

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, V.V.; Pinder, George F.

    1980-12-16

    All numerical simulators of geothermal reservoirs depend upon an accurate representation of the thermodynamics of steam-water systems. These relationships are required to render tractable the system of balance equations derived from the physics of flow through porous media. While it is generally recognized that the steam-water system (i.e. two phase) is not in thermodynamic equilibrium, equihbrium thermodynamics are employed in its description. In this paper, we present an alternative view based on non-equilibrium thermodynamics. The underpinnings of this approach are found in a branch of topology generally referred to as "catastrophe theory". [Thom, 1975

  12. Is geothermal simulation a catastrophe

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, V.V.; Pinder, G.F.

    1980-01-01

    All numerical simulators of geothermal reservoirs depend upon an accurate representation of the thermodynamics of steam-water systems. These relationships are required to render tractable the system of balance equations derived from the physics of flow through porous media. While it is generally recognized that the steam-water system (i.e., two phase) is not in thermodynamic equilibrium, equilibrium thermodynamics are employed in its description. An alternative view based on non-equilibrium thermodynamics is presented. The underpinnings of this approach are found in a branch of topology generally referred to as catastrophe theory.

  13. A catastrophe in quantum mechanics

    International Nuclear Information System (INIS)

    The standard scattering theory (SST) in nonrelativistic quantum mechanics (QM) is analyzed. Self-contradictions of SST are deconstructed. A direct way to calculate scattering probability without introduction of a finite volume is discussed. Substantiation of SST in textbooks with the help of wave packets is shown to be incomplete. A complete theory of wave packet scattering on a fixed center is presented, and its similarity to the plane wave scattering is demonstrated. The neutron scattering on a monatomic gas is investigated, and several problems are pointed out. A catastrophic ambiguity of the cross section is revealed, and a way to resolve this ambiguity is discussed

  14. The Diseconomies of Environmental Catastrophes

    OpenAIRE

    Cairns, John

    2006-01-01

    Four factors are almost certain to lead to one or more catastrophes unless major remedial measures are taken. (1) China has replaced the United States as the world s leading consumer of resources, except for oil (Brown, 2006a), but China is already a major factor in the world market in this area also. Together, China and the United States consume approximately half the world s resources and the global population is still increasing on a finite planet. (2) The over 20% global ecological oversh...

  15. Catastrophic models of materials destruction

    Science.gov (United States)

    Kupchishin, A. I.; Taipova, B. G.; Kupchishin, A. A.; Voronova, N. A.; Kirdyashkin, V. I.; Fursa, T. V.

    2016-02-01

    The effect of concentration and type of fillers on mechanical properties of composite material based on polyimide were studied. Polyethylene terephthalate (PET, polyester), polycarbonate (PCAR) and montmorillonite (MM) were used as the fillers. The samples were prepared by mechanically blending the polyimide-based lacquer solutions with different concentrations of the second component. The concentration of filler and its class, especially their internal structure and technology of synthesis determine features of physical and mechanical properties of obtained materials. Models of catastrophic failure of material satisfactorily describe the main features depending on tension ct from deformation e.

  16. Yoga attitudes in chronic low back pain: Roles of catastrophizing and fear of movement.

    Science.gov (United States)

    Combs, Martha A; Thorn, Beverly E

    2015-08-01

    Chronic low back pain is a significant public health problem and, although underused, yoga may be an effective complementary treatment. The current study examined associations of pain catastrophizing and fear of movement with attitudes toward yoga in adults with chronic low back pain. Participants completed three quantitative questionnaires assessing specific constructs: beliefs about yoga, fear of movement, and pain catastrophizing. A semi-structured in-person interview was then conducted to obtain specific pain-related information. Hierarchical regression and mediational analyses were used to test hypotheses. Consistent with the fear-avoidance model of chronic pain, catastrophizing and fear of movement were negatively associated with yoga attitudes. Specifically, fear of movement was a mediator between catastrophizing and attitudes toward yoga. Individuals with higher levels of catastrophizing and fear of movement may be less likely to consider a pain treatment involving physical movement. PMID:26256134

  17. Extensional rheometer based on viscoelastic catastrophes outline

    DEFF Research Database (Denmark)

    2014-01-01

    The present invention relates to a method and a device for determining viscoelastic properties of a fluid. The invention resides inter alia in the generation of viscoelastic catastrophes in confined systems for use in the context of extensional rheology. The viscoelastic catastrophe is according to...... the invention generated in a bistable fluid system, and the flow conditions for which the catastrophe occurs can be used as a fingerprint of the fluid's viscoelastic properties in extensional flow....

  18. Las evidencias benefician al sistema de salud: reforma para remediar el gasto catastrófico y empobrecedor en salud en México Evidence is good for your health system: policy reform to remedy catastrophic and impoverishing health spending in Mexico

    Directory of Open Access Journals (Sweden)

    Felicia Marie Knaul

    2007-01-01

    Full Text Available La falta de protección financiera en salud es una enfermedad recientemente diagnosticada de los sistemas de salud. El síntoma más obvio es que las familias enfrentan la ruina económica y el empobrecimiento por financiar su atención médica. México fue uno de los primeros países en diagnosticar el problema, atribuirlo a la falta de protección financiera y proponer una terapia sistémica a través de la reforma del sistema de salud. Este trabajo analiza la manera en que México convirtió las evidencias sobre los gastos catastróficos y empobrecedores en salud en un catalizador de la renovación institucional a través de la reforma que creó el Seguro Popular de Salud (SPS. Presentamos tanto las tendencias de los últimos 15 años sobre la evolución de los gastos catastróficos y emprobrecedores en salud, como las evidencias recientes sobre el mejoramiento en estos indicadores con la expansión del SP. Los resultados de la experiencia mexicana sugieren que la organización y el financiamiento del sistema de salud han jugado un papel muy importante en la reducción del empobrecimiento y en la protección de los hogares durante los periodos de crisis financiera individual y colectiva.Absence of financial protection in health is a recently diagnosed "disease" of health systems. The most obvious symptom is that families face economic ruin and poverty as a consequence of financing their health care. Mexico was one of the first countries to diagnose the problem, attribute it to lack of financial protection, and propose systemic therapy through health reform. In this article we assess how Mexico turned evidence on catastrophic and impoverishing health spending into a catalyst for institutional renovation through the reform that created Seguro Popular de Salud (Popular Health Insurance. We present 15-year trends on the evolution of catastrophic and impoverishing health spending, including evidence on how the situation is improving. The results

  19. The financing and effectiveness of agricultural expenditure

    OpenAIRE

    Chatellier, Vincent

    2008-01-01

    This text presents a critical analysis on the financial and effectiveness of public expenditure allocated to European agriculture. It deals with the proposals made by the European Commission under the health check of the Common Agricultural Policy (CAP). To provide some answers to the questions raised by his interlocutors (European parliament), the author draws on his analysis of agricultural policy and simulations applied to the French Farm Accountancy Data Network (FADN). The first part dea...

  20. FLYPAPER EFFECTS ANOMALY OF WEST PAPUA CAPITAL PUBLIC EXPENDITURE

    Directory of Open Access Journals (Sweden)

    Marthen Anthon Pentury

    2013-04-01

    Full Text Available In fiscal decentralization, local governments should be able to provide public service facilities for all communities. This study aims to determine the existence of flypaper effect in the total capital public expenditure and capital expenditure on education, health and infrastructure in districts in West Papua, 2003-2006. Tools of analysis used is panel data regression. The General Allocation Fund (DAU, the Special Allocation Fund (DAK and the Special Autonomy Fund (DOK partially and simultaneously have positive impact on total capital spending and capital expenditure in education, health, and infrastructure. It is also indicated the anomaly of flypaper effect in DAU, DAK, and DOK.Keywords: Flypaper effect, anomaly, fiscal decentralization, capital expendituresJEL classification numbers: H50, H75

  1. Advertising Expenditure and Consumer Prices

    OpenAIRE

    Ferdinand Rauch

    2011-01-01

    This paper studies the effect of a change in the marginal costs of advertising on advertising expenditures of firms and consumer prices across industries. It makes use of a unique policy change that caused a decrease of the taxation on advertising expenditures in parts of Austria and a simultaneous increase in other parts. Advertising expenditures move immediately in the opposite direction to the marginal costs of advertising. Simultaneously the price reaction to advertising is negative in so...

  2. Catastrophe mechanism & classification of discontinuity behavior in thermal science (Ⅰ) --Fold catastrophe

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The mechanism of discontinuity behavior has important significance in the study of thermal science,such as fire,combustion,explosion and heat transfer.This sort of discontinuity behavior and the catastrophe caused by system nonlinearity may be equivalently classified according to the catastrophe model promulgated by catastrophe theory.Under the conditions of uniform temperature and thermal isolation,the self-ignition behavior of a Semenov System can be viewed as a result of the fold catastrophe of the system.

  3. The relationship between budgetary expenditure and economic growth in Poland

    OpenAIRE

    Gurgul, Henryk; Lach, Lukasz; Mestel, Roland

    2011-01-01

    Abstract This paper investigates the association between different kinds of budgetary expenditure and economic growth of Poland. The empirical analysis makes use of linear and nonlinear Granger causality tests to evaluate the applicability of Wagner’s Law and that of the contrasting Keynesian theory.We employ aggregate and disaggregate data with the sub-categories of most important budgetary expenditure, including health care and social security, education and science, national defence and pu...

  4. Estimating expenditure impacts without expenditure data using asset proxies

    OpenAIRE

    Martin Wittenberg

    2009-01-01

    When asset indices are used in regressions the coefficients obtained are typically difficult to interpret. We show how lower bounds on expenditure effects can be extracted, if the relationship between the assets and expenditure can be calibrated on an auxiliary data set.

  5. Academic Training: Predicting Natural Catastrophes

    CERN Multimedia

    Françoise Benz

    2005-01-01

    2005-2006 ACADEMIC TRAINING PROGRAMME LECTURE SERIES 12, 13, 14, 15, 16 December from 11:00 to 12:00 - Main Auditorium, bldg. 500 Predicting Natural Catastrophes E. OKAL / Northwestern University, Evanston, USA 1. Tsunamis -- Introduction Definition of phenomenon - basic properties of the waves Propagation and dispersion Interaction with coasts - Geological and societal effects Origin of tsunamis - natural sources Scientific activities in connection with tsunamis. Ideas about simulations 2. Tsunami generation The earthquake source - conventional theory The earthquake source - normal mode theory The landslide source Near-field observation - The Plafker index Far-field observation - Directivity 3. Tsunami warning General ideas - History of efforts Mantle magnitudes and TREMOR algorithms The challenge of 'tsunami earthquakes' Energy-moment ratios and slow earthquakes Implementation and the components of warning centers 4. Tsunami surveys Principles and methodologies Fifteen years of field surveys and re...

  6. Catastrophe Finance: An Emerging Discipline

    Science.gov (United States)

    Elsner, James B.; Burch, R. King; Jagger, Thomas H.

    2009-08-01

    While the recent disasters in the world's financial markets demonstrate that finance theory remains far from perfected, science also faces steep challenges in the quest to predict and manage the effects of natural disasters. Worldwide, as many as half a million people have died in disasters such as earthquakes, tsunamis, and tropical cyclones since the turn of the 21st century [Wirtz, 2008]. Further, natural disasters can lead to extreme financial losses, and independent financial collapses can be exacerbated by natural disasters. In financial cost, 2008 was the second most expensive year on record for such catastrophes and for financial market declines. These extreme events in the natural and financial realms push the issue of risk management to the fore, expose the deficiencies of existing knowledge and practice, and suggest that progress requires further research and training at the graduate level.

  7. Catastrophic disruption experiments: Recent results

    Science.gov (United States)

    Martelli, G.; Ryan, E. V.; Nakamura, A. M.; Giblin, I.

    1994-01-01

    This paper presents a review of the progress in the field of catastrophic disruption experiments over the past 4 years, since the publication of the review paper by Fujiwara et al. (1989). We describe the development of new techniques to produce shattering impacts relevant to the study of the collisional evolution of the asteroids, and summarize the results from numerous experiments which have been performed to date, using a variety of materials for both the impactor and the targets. Some of these, such as ice-on-ice, loose aggregates and pressurized targets, are quite new and have provided novel and exciting results. Some of the gaps existing previously in the data on fragment ejection-angle distributions, as well as translational and rotational velocity fields (including fine fragments) have been filled, and these new results will be surveyed.

  8. Climate Catastrophe - The Giant Swindle

    International Nuclear Information System (INIS)

    Energy is the life-blood of civilization. More than 80% of global energy is supplied by fossil fuels. And this will continue for the foreseeable future - if an implementation of the Kyoto Protocol does not lead to a dramatic decrease of these fuels causing worldwide turmoil of unprecedented dimensions. However, the scaremongering with a 'climate catastrophe' allegedly caused by 'greenhouse gas' emissions from the burning of fossil fuels is a huge hoax. Its only 'scientific' base is the IPCC management's enigmatic assessment: 'The balance of evidence suggests a discernable human influence on climate'. But even IPCC had to admit at the World Energy Conference in Tokyo in 1996: 'We have no evidence'. And all the scaremongering assertions of the protagonists of 'global warming' have been convincingly refuted by the world elite of scientists. This paper will: - show how the whole anti-CO2 campaign has been manipulated from the very beginning till today; - give great many scientific and logical reason why the arguments of the scaremongers are incorrect; - outline the catastrophic economic and social consequences of the proposed anti-CO2 measures - without any benefit for the environment of climate; - name the driving forces behind this campaign and their interests. The witchhunt against CO2 is an incredible scientific and political scandal, CO2 does not damage the environment at all, and labelling it a 'climate killer' is absurd. On the contrary, this gas is vital for the life on our plant, and a stronger concentration of CO2 will be beneficial by doubling plant growth and with this combatting global famine. And to pretend that we could influence - with a CO2 tax - the climate, is insane arrogance. Man is absolutely helpless when confronted with the forces of nature. The squandering of multimillions USD of taxpayer's money for the travelling circus of 'Climate summits' and the stultification of the population must stop. The 'global warming' lie is the biggest

  9. Why do Education Expenditures Fail to Reduce Child Labor? Looking for an Optimal Composition of the Social Expenditures

    OpenAIRE

    Grigoriou, Christopher; Rota-Graziosi, Grégoire

    2005-01-01

    In a framework, where child labor results from a risky choice between working and schooling, we study the reason why public education expenditures may fail to reduce child labor. We determine an optimal composition of social expenditures between education and health which minimizes child labor for a given government's budget. This is tested with panel data over 81 developing countries. It is evidenced that the unbalanced structure of the social spending favourable to education to the detrimen...

  10. Catastrophe theory with application in nuclear technology

    International Nuclear Information System (INIS)

    The monograph is structured on the following seven chapters: 1. Correlation of risk, catastrophe and chaos at the level of polyfunctional systems with nuclear injection; 1.1 Approaching the risk at the level of power systems; 1.2 Modelling the chaos-catastrophe-risk correlation in the structure of integrated classical and nuclear processes; 2. Catastrophe theory applied in ecosystems models and applications; 2.1 Posing the problems in catastrophe theory; 2.2 Application of catastrophe theory in the engineering of the power ecosystems with nuclear injection; 4.. Decision of abatement of the catastrophic risk based on minimal costs; 4.1 The nuclear power systems sensitive to risk-catastrophe-chaos in the structure of minimal costs; 4.2 Evaluating the market structure on the basis of power minimal costs; 4.3 Decisions in power systems built on minimal costs; 5. Models of computing the minimal costs in classical and nuclear power systems; 5.1 Calculation methodologies of power minimal cost; 5.2 Calculation methods of minimal costs in nuclear power sector; 6. Expert and neuro expert systems for supervising the risk-catastrophe-chaos correlation; 6.1 The structure of expert systems; 6.2 Application of the neuro expert program; 7. Conclusions and operational proposals; 7.1 A synthesis of the problems presented in this work; 7.2 Highlighting the novel aspects applicable in the power systems with nuclear injection

  11. Adaptation to and Recovery from Global Catastrophe

    Directory of Open Access Journals (Sweden)

    Seth D. Baum

    2013-03-01

    Full Text Available Global catastrophes, such as nuclear war, pandemics and ecological collapse threaten the sustainability of human civilization. To date, most work on global catastrophes has focused on preventing the catastrophes, neglecting what happens to any catastrophe survivors. To address this gap in the literature, this paper discusses adaptation to and recovery from global catastrophe. The paper begins by discussing the importance of global catastrophe adaptation and recovery, noting that successful adaptation/recovery could have value on even astronomical scales. The paper then discusses how the adaptation/recovery could proceed and makes connections to several lines of research. Research on resilience theory is considered in detail and used to develop a new method for analyzing the environmental and social stressors that global catastrophe survivors would face. This method can help identify options for increasing survivor resilience and promoting successful adaptation and recovery. A key point is that survivors may exist in small isolated communities disconnected from global trade and, thus, must be able to survive and rebuild on their own. Understanding the conditions facing isolated survivors can help promote successful adaptation and recovery. That said, the processes of global catastrophe adaptation and recovery are highly complex and uncertain; further research would be of great value.

  12. Fracto—emissions in Catastrophic Cleavage Process

    Institute of Scientific and Technical Information of China (English)

    HonglaiTAN; WeiYANG

    1996-01-01

    Fracto-emissions accompanying crack propagation are observed in the recent experiments.The energy impulses during and after fracture stimulate the fracto-emissions.Model concerning atomic scale cleavage processes is proposed to formulate a catastrophic fracure theory relevant to these phenomena.A criterion for catastrophic jump of the cleavage potential is applied to representative crystals.

  13. 76 FR 50929 - Catastrophic Risk Protection Endorsement

    Science.gov (United States)

    2011-08-17

    ..., published at 48 FR 29115, June 24, 1983. Executive Order 12988 This proposed rule has been reviewed in...; ] DEPARTMENT OF AGRICULTURE Federal Crop Insurance Corporation 7 CFR Part 402 RIN 0563-AC31 Catastrophic Risk... Federal Crop Insurance Corporation (FCIC) proposes to amend the Catastrophic Risk Protection...

  14. Environmental Catastrophes Under Time-inconsistent Preferences

    NARCIS (Netherlands)

    Michielsen, T.O.

    2013-01-01

    Abstract I analyze optimal natural resource use in an intergenerational model with the risk of a catastrophe. Each generation maximizes a weighted sum of discounted utility (positive) and the probability that a catastrophe will occur at any point in the future (negative). The model generates time-in

  15. Catastrophe mechanism and classification of discontinuity behavior in thermal science (Ⅱ) -- Cusp catastrophe

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The catastrophe mechanisms of thermal performance characteristics of the firebox gas combustion system were analyzed from the viewpoint of catastrophe theory. The mathematical models of cusp catastrophe were established. The relationship between the thermal performance characteristics and the changing of system control variables was studied. The cusp catastrophe mechanisms of typical performance characteristics, such as kicking and lagging, and those of transition from quenching to igniting were explained. It was illustrated that discontinuity behavior of thermal systems with an "S" motion feature curve and lagging feature may be equivalently classified according to the topology of cusp catastrophe, influenced by two groups of independent control variables.

  16. Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013

    Science.gov (United States)

    Gupt, Anadi; Kaur, Prabhdeep; Kamraj, P.; Murthy, B. N.

    2016-01-01

    Introduction Health insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY), should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE) for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL) families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013. Methods We conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains. Results Overall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%). The median overall OOPE was $39 (Rs 2567) in the non-beneficiaries group as compared to $ 11 (Rs 713) in the beneficiaries group (p<0.01). Median expenditure on in house and out house drugs and consumables was $ 23 (Rs 1500) in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01). Non-beneficiary status was significantly associated [OR: 2.4 (1.3–4.3)] with OOPE above median independently and also after adjusting for various covariates. Conclusion RSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility. PMID:26895419

  17. Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013.

    Directory of Open Access Journals (Sweden)

    Anadi Gupt

    Full Text Available Health insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY, should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013.We conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains.Overall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%. The median overall OOPE was $39 (Rs 2567 in the non-beneficiaries group as compared to $11 (Rs 713 in the beneficiaries group (p<0.01. Median expenditure on in house and out house drugs and consumables was $23 (Rs 1500 in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01. Non-beneficiary status was significantly associated [OR: 2.4 (1.3-4.3] with OOPE above median independently and also after adjusting for various covariates.RSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility.

  18. Expenditures for Early Intervention Services

    Science.gov (United States)

    Hebbeler, Kathleen; Levin, Jesse; Perez, Maria; Lam, Irene; Chambers, Jay G.

    2009-01-01

    What does it cost to provide early intervention services? Data collected as part of the National Early Intervention Longitudinal Study were used to determine expenditures for infants, toddlers, and their families receiving services through Part C programs. The study found that the national average total expenditure for early intervention services…

  19. 78 FR 54796 - Research Expenditures

    Science.gov (United States)

    2013-09-06

    ... document proposes regulations to amend the definition of research and experimental expenditures under... definition of research and experimental expenditures contained in Sec. 1.174-2(a)(1) to depreciable property... subsequent event, the proposed regulations provide that the ultimate success, failure, sale, or other use...

  20. Nepal : Public Expenditure Review - Roads

    OpenAIRE

    World Bank

    2011-01-01

    The report, Nepal Public Expenditure Review - Roads, was completed June 2011. The report states that the Government of Nepal has achieved several of the Millennium Development Goals (MDGs), while maintaining macroeconomic stability and prudent fiscal management. Strengthening public expenditure management is an ongoing reform agenda of the government's Three Year Plan, an inclusive devel...

  1. Energy Expenditure of Sport Stacking

    Science.gov (United States)

    Murray, Steven R.; Udermann, Brian E.; Reineke, David M.; Battista, Rebecca A.

    2009-01-01

    Sport stacking is an activity taught in many physical education programs. The activity, although very popular, has been studied minimally, and the energy expenditure for sport stacking is unknown. Therefore, the purposes of this study were to determine the energy expenditure of sport stacking in elementary school children and to compare that value…

  2. Texas hospitals with higher health information technology expenditures have higher revenue: A longitudinal data analysis using a generalized estimating equation model

    OpenAIRE

    Lee, Jinhyung; Choi, Jae-Young

    2016-01-01

    Background The benefits of health information technology (IT) adoption have been reported in the literature, but whether health IT investment increases revenue generation remains an important research question. Methods Texas hospital data obtained from the American Hospital Association (AHA) for 2007–2010 were used to investigate the association of health IT expenses and hospital revenue. The generalized estimation equation (GEE) with an independent error component was used to model the data ...

  3. How do Expenditure Rules affect Fiscal Behaviour?

    OpenAIRE

    Peter Wierts

    2008-01-01

    This paper investigates the role of self-enforced national expenditure rules in limiting the expenditure bias and procyclical expenditure increases/decreases due to revenue windfalls/shortfalls. A simple model predicts that expenditure rules can have the intended effects, but only if the political and institutional costs of non compliance are sufficiently large. Empirical estimations provide some support that expenditure rules affect expenditure outcomes in the hypothesised manner, especially...

  4. Coverage and Financial Risk Protection for Institutional Delivery: How Universal Is Provision of Maternal Health Care in India?

    Science.gov (United States)

    Prinja, Shankar; Bahuguna, Pankaj; Gupta, Rakesh; Sharma, Atul; Rana, Saroj Kumar; Kumar, Rajesh

    2015-01-01

    Background India aims to achieve universal access to institutional delivery. We undertook this study to estimate the universality of institutional delivery care for pregnant women in Haryana state in India. To assess the coverage of institutional delivery, we analyze service coverage (coverage of public sector institutional delivery), population coverage (coverage among different districts and wealth quintiles of the population) and financial risk protection (catastrophic health expenditure and impoverishment as a result of out-of-pocket expenditure for delivery). Methods We analyzed cross-sectional data collected from a randomly selected sample of 12,191 women who had delivered a child in the last one year from the date of data collection in Haryana state. Five indicators were calculated to evaluate coverage and financial risk protection for institutional delivery—proportion of public sector deliveries, out-of-pocket expenditure, percentage of women who incurred no expenses, prevalence of catastrophic expenditure for institutional delivery and incidence of impoverishment due to out-of-pocket expenditure for delivery. These indicators were calculated for the public and private sectors for 5 wealth quintiles and 21 districts of the state. Results The coverage of institutional delivery in Haryana state was 82%, of which 65% took place in public sector facilities. Approximately 63% of the women reported no expenditure on delivery in the public sector. The mean out-of-pocket expenditures for delivery in the public and private sectors in Haryana were INR 771 (USD 14.2) and INR 12,479 (USD 229), respectively, which were catastrophic for 1.6% and 22% of households, respectively. Conclusion Our findings suggest that there is considerably high coverage of institutional delivery care in Haryana state, with significant financial risk protection in the public sector. However, coverage and financial risk protection for institutional delivery vary substantially across

  5. Financial protection in health in Turkey: the effects of the Health Transformation Programme.

    Science.gov (United States)

    Yardim, Mahmut S; Cilingiroglu, Nesrin; Yardim, Nazan

    2014-03-01

    Financial protection should be the principal objective of any health system. Commonly used indicators for financial protection are out-of-pocket (OOP) payments as a share of total health expenditure and the amount of households driven into poverty by catastrophic health expenditures (CHEs). In the last decade, OOP health payments consisted of approximately one-fifth of the health finance resources in Turkey. Until the year 2008, Turkish health system covered different public and private financing programmes as well as different types of service provision. After 2008, universal financial coverage became a part of the Health Transformation Programme (HTP). This study aimed to evaluate the financial protection in health in the era of health reforms in Turkey between 2003 and 2009. Household expenditures were derived from nationally representative Turkish Household Budget Surveys (HBSs), 2003, 2006 and 2009. Proportion of households facing CHE and impoverishment are calculated by using the methodology proposed by Ke Xu. Probability of incurring and volume of OOP spending were assessed across the health insurance groups by two-part model approach using logistic and OLS regression methods. Our findings showed that the probability of incurring and volume of OOP spending increased gradually in publicly insured households between 2003 and 2009. However, there was a diminishing trend in CHE in Turkey during the period under consideration. The official data showing an ∼3-fold increase in per capita health care use since 2003 and our study findings on decreasing CHE in this period can be interpreted as positive impact of HTP. On the other hand, increased household consumption as a share of OOP health payment and the deterioration in the progressivity of OOP spending in this period should be monitored closely. PMID:23411120

  6. Quantum catastrophes: a case study

    Science.gov (United States)

    Znojil, Miloslav

    2012-11-01

    The bound-state spectrum of a Hamiltonian H is assumed real in a non-empty domain D of physical values of parameters. This means that for these parameters, H may be called crypto-Hermitian, i.e. made Hermitian via an ad hoc choice of the inner product in the physical Hilbert space of quantum bound states (i.e. via an ad hoc construction of the operator Θ called the metric). The name quantum catastrophe is then assigned to the N-tuple-exceptional-point crossing, i.e. to the scenario in which we leave the domain D along such a path that at the boundary of D, an N-plet of bound-state energies degenerates and, subsequently, complexifies. At any fixed N ⩾ 2, this process is simulated via an N × N benchmark effective matrix Hamiltonian H. It is being assigned such a closed-form metric which is made unique via an N-extrapolation-friendliness requirement. This article is part of a special issue of Journal of Physics A: Mathematical and Theoretical devoted to ‘Quantum physics with non-Hermitian operators’.

  7. Quantum catastrophes: a case study

    International Nuclear Information System (INIS)

    The bound-state spectrum of a Hamiltonian H is assumed real in a non-empty domain D of physical values of parameters. This means that for these parameters, H may be called crypto-Hermitian, i.e. made Hermitian via an ad hoc choice of the inner product in the physical Hilbert space of quantum bound states (i.e. via an ad hoc construction of the operator Θ called the metric). The name quantum catastrophe is then assigned to the N-tuple-exceptional-point crossing, i.e. to the scenario in which we leave the domain D along such a path that at the boundary of D, an N-plet of bound-state energies degenerates and, subsequently, complexifies. At any fixed N ⩾ 2, this process is simulated via an N × N benchmark effective matrix Hamiltonian H. It is being assigned such a closed-form metric which is made unique via an N-extrapolation-friendliness requirement. This article is part of a special issue of Journal of Physics A: Mathematical and Theoretical devoted to ‘Quantum physics with non-Hermitian operators’. (paper)

  8. Equity in health care financing in Portugal: findings from the Household Budget Survey 2010/2011.

    Science.gov (United States)

    Quintal, Carlota; Lopes, José

    2016-07-01

    Equity in health care financing is recognised as a main goal in health policy. It implies that payments should be linked to capacity to pay and that households should be protected against catastrophic health expenditure (CHE). The risk of CHE is inversely related to the share of out-of-pocket payments (OOP) in total health expenditure. In Portugal, OOP represented 26% of total health expenditure in 2010 [one of the highest among Organisation for Economic Co-operation and Development (OECD) countries]. This study aims to identify the proportion of households with CHE in Portugal and the household factors associated with this outcome. Additionally, progressivity indices are calculated for OOP and private health insurance. Data were taken from the Portuguese Household Budget Survey 2010/2011. The prevalence of CHE is 2.1%, which is high for a developed country with a universal National Health Service. The main factor associated with CHE is the presence of at least one elderly person in households (when the risk quadruples). Payments are particularly regressive for medicines. Regarding the results by regions, the Kakwani index for total OOP is larger (negative) for the Centre and lower, not significant, for the Azores. Payments for voluntary health insurance are progressive. PMID:26573411

  9. The association between age and mortality related hospital expenditures: Evidence from a complete national registry

    Directory of Open Access Journals (Sweden)

    Fredrik Alexander Gregersen

    2014-01-01

    Full Text Available The aim of this paper is to contribute to the debate on population aging and growth in health expenditures, by providing precise estimates on how mortality related expenditures are influenced by age. Using a complete register of inpatient hospital admissions to create gender-cohort specific panels for each of the 430 Norwegian municipalities, we are able to identify mortality related hospital expenditures by separating the impact of mortality on current hospital expenditures from the impact of patients’ age and gender. We apply model estimates to quantify the mortality-related hospital expenditures for twenty age groups. The results suggest that mortality-related hospital expenditures are a decreasing function of age. Furthermore, the results clearly suggest that, both age and mortalities should be included when predicting future health care expenditures. The estimation results suggest that 9.2 % of all hospital expenditures is associated with treating individuals in their last year of life. Our results also suggest that the reduction in mortality rates in the period from 1998 to 2009 have, cet. par. contributed to an estimated reduction in total hospital expenditures of 0.6 billion NOK, a difference corresponding to 2 % of the expenditures in 2009. (The appendix can be found under "Supplementary Files" in the menu to the right

  10. Gasto de hogares durante la hospitalización de menores derechohabientes, con diagnóstico de leucemia, en dos hospitales en México Out-of-pocket expenditures during hospitalization of young leukemia patients with state medical insurance in two Mexican hospitals

    Directory of Open Access Journals (Sweden)

    Arnoldo Rocha-García

    2003-08-01

    Full Text Available OBJETIVO: Estimar el gasto de los hogares durante la primera hospitalización en 51 menores de 15 años de edad con leucemia, atendidos en dos hospitales del Instituto Mexicano del Seguro Social, en México durante 1997. MATERIAL Y MÉTODOS: Estudio transversal hecho en 1997 en el Distrito Federal y en León, Guanajuato. Se aplicó un cuestionario a los padres de 51 menores de 15 años de edad con diagnóstico de leucemia, hospitalizados por primera vez, en dos unidades del Instituto Mexicano del Seguro Social. Se capturó la información de los costos directos e indirectos enfrentados por los hogares durante esa primera hospitalización. Se aplicó el Indice de Precios al Consumidor (1997-2002 para expresar las estimaciones en precios de 2002. Se estimaron indicadores de gasto promedio y gastos catastróficos. Se establecieron los factores asociados, mediante un modelo de regresión lineal, utilizando el gasto total durante la hospitalización como variable dependiente. RESULTADOS: El costo promedio por paciente hospitalizado es de 7 318 pesos. El 86% corresponde a gastos asociados con la atención y 14% a costos indirectos. Para 14% de los hogares este gasto fue catastrófico. En 47% de los casos la erogación rebasó 100% de su ingreso disponible durante el periodo. Estos gastos se asociaron con lugar de residencia, nivel de ingreso y tipo de seguro. CONCLUSIONES: Ser derechohabiente de la seguridad social reduce los gastos de bolsillo por atención directa de los pacientes, pero no reduce los gastos complementarios, que pueden resultar onerosos para una elevada proporción de hogares. El costo de la primera hospitalización significó, en más de la mitad de los casos estudiados, el consumo de los ahorros, el endeudamiento o la venta de propiedades de los hogares, y dificultó la continuidad del tratamiento.OBJECTIVE: To estimate out-of-pocket expenditures for health care during the first hospitalization of children treated for leukemia in

  11. Drug Expenditure Trends in the Canadian Provinces: Magnitude and Causes from 1998 to 2004

    OpenAIRE

    Morgan, Steve

    2005-01-01

    This analysis uses a consistent pan-Canadian dataset – Canadian CompuScript from IMS Health, Canada – to quantify trends in per capita drug expenditures within each Canadian province over the period of 1998 to 2004. The impacts of changes in six potential determinants of drug expenditure are calculated for every province. Each of the six detailed cost drivers falls into one of three broad categories: volume effects, price effects and therapeutic choices. Despite wide variation in expenditure ...

  12. Insuring catastrophes and the role of governments

    Science.gov (United States)

    Boyer, M. M.; Nyce, C. M.

    2013-08-01

    In this paper we model the cost of providing insurance coverage against natural and man-made hazards. We propose an insurance market model that explains (1) the use of reinsurance to help finance the cost of catastrophic events and (2) the implicit (or explicit) presence of government entities acting as (re)insurers of last resort. Using an economic model, we show how insurance programmes should be designed to cover the losses due to a possible catastrophic natural hazard. Our results show that the optimal structure of a reinsurance programme minimizes the cost of offering insurance protection. We also show how government intervention can reduce the cost of insurance against natural catastrophes and increase policyholders' welfare. Our paper therefore offers public policy implications as to the role and presence of government as an insurer of last resort and the minimum insurance premium necessary to cover the cost of catastrophic events.

  13. Catastrophes in Scale-Free Networks

    Institute of Scientific and Technical Information of China (English)

    ZHOU Tao; WANG Bing-Hong

    2005-01-01

    @@ An alternative model about cascading occurrences caused by perturbation is established to search the mechanism because catastrophes in networks occur. We investigate the avalanche dynamics of our model on two-dimensional Euclidean lattices and scale-free networks and find that the avalanche dynamic behaviour is sensitive to the topological structure of networks. The simulation results show that the catastrophes occur much more frequently in scale-free networks than those in Euclidean lattices, and the greatest catastrophe in scale-free networks is much more serious than that in Euclidean lattices. Furthermore, we have studied how to reduce the catastrophes'degree, and have schemed out an effective strategy, called the targeted safeguard strategy for scale-free networks.

  14. Catastrophic event modeling. [lithium thionyl chloride batteries

    Science.gov (United States)

    Frank, H. A.

    1981-01-01

    A mathematical model for the catastrophic failures (venting or explosion of the cell) in lithium thionyl chloride batteries is presented. The phenomenology of the various processes leading to cell failure is reviewed.

  15. Insuring catastrophes and the role of governments

    Directory of Open Access Journals (Sweden)

    M. M. Boyer

    2013-08-01

    Full Text Available In this paper we model the cost of providing insurance coverage against natural and man-made hazards. We propose an insurance market model that explains (1 the use of reinsurance to help finance the cost of catastrophic events and (2 the implicit (or explicit presence of government entities acting as (reinsurers of last resort. Using an economic model, we show how insurance programmes should be designed to cover the losses due to a possible catastrophic natural hazard. Our results show that the optimal structure of a reinsurance programme minimizes the cost of offering insurance protection. We also show how government intervention can reduce the cost of insurance against natural catastrophes and increase policyholders' welfare. Our paper therefore offers public policy implications as to the role and presence of government as an insurer of last resort and the minimum insurance premium necessary to cover the cost of catastrophic events.

  16. Microtubule dynamics: Caps, catastrophes, and coupled hydrolysis

    DEFF Research Database (Denmark)

    Flyvbjerg, H.; Holy, T.E.; Leibler, S.

    1996-01-01

    probability distributions relating to available experimental data are derived. Caps are found to be short and the total rate of hydrolysis at a microtubule end is found to be dynamically coupled to growth. The so-called catastrophe rate is a simple function of the microtubule growth rare and fits experimental...... data. A constant nonzero catastrophe rare, identical for both microtubule ends, is predicted at large growth rates. The delay time for dilution-induced catastrophes is stochastic with a simple distribution that fits the experimental one and, like the experimental one, does not depend on the rate of...... unified description of several apparently contradictory experimental data. Experimental results for the catastrophe rate at different concentrations of magnesium ions and of microtubule associated proteins are discussed in terms of the model. Feasible experiments are suggested that can provide decisive...

  17. The financial protection effect of Ghana National Health Insurance Scheme: evidence from a study in two rural districts

    Directory of Open Access Journals (Sweden)

    Wang Hong

    2011-01-01

    Full Text Available Abstract Background One of the key functions of health insurance is to provide financial protection against high costs of health care, yet evidence of such protection from developing countries has been inconsistent. The current study uses the case of Ghana to contribute to the evidence pool about insurance's financial protection effects. It evaluates the impact of the country's National Health Insurance Scheme on households' out-of-pocket spending and catastrophic health expenditure. Methods We use data from a household survey conducted in two rural districts, Nkoranza and Offinso, in 2007, two years after the initiation of the Ghana National Health Insurance Scheme. To address the skewness of health expenditure data, the absolute amount of out-of-pocket spending is estimated using a two-part model. We also conduct a probit estimate of the likelihood of catastrophic health expenditures, defined at different thresholds relative to household income and non-food consumption expenditure. The analysis controls for chronic and self-assessed health conditions, which typically drive adverse selection in insurance. Results At the time of the survey, insurance coverage was 35 percent. Although the benefit package of insurance is generous, insured people still incurred out-of-pocket payment for care from informal sources and for uncovered drugs and tests at health facilities. Nevertheless, they paid significantly less than the uninsured. Insurance has been shown to have a protective effect against the financial burden of health care, reducing significantly the likelihood of incurring catastrophic payment. The effect is particularly remarkable among the poorest quintile of the sample. Conclusions Findings from this study confirm the positive financial protection effect of health insurance in Ghana. The effect is stronger among the poor group than among general population. The results are encouraging for many low income countries who are considering a

  18. Valuing Catastrophe Bonds Involving Credit Risks

    OpenAIRE

    Jian Liu; Jihong Xiao; Lizhao Yan; Fenghua Wen

    2014-01-01

    Catastrophe bonds are the most important products in catastrophe risk securitization market. For the operating mechanism, CAT bonds may have a credit risk, so in this paper we consider the influence of the credit risk on CAT bonds pricing that is different from the other literature. We employ the Jarrow and Turnbull method to model the credit risks and get access to the general pricing formula using the Extreme Value Theory. Furthermore, we present an empirical pricing study of the Property C...

  19. Catastrophic avalanches and methods of their control

    Directory of Open Access Journals (Sweden)

    N. A. Volodicheva

    2014-01-01

    Full Text Available Definition of such phenomenon as “catastrophic avalanche” is presented in this arti-cle. Several situations with releases of catastrophic avalanches in mountains of Caucasus, Alps, and Central Asia are investigated. Materials of snow-avalanche ob-servations performed since 1960s at the Elbrus station of the Lomonosov Moscow State University (Central Caucasus were used for this work. Complex-valued measures of engineering protection demonstrating different efficiencies are consid-ered.

  20. Mindfulness, Acceptance and Catastrophizing in Chronic Pain

    OpenAIRE

    de Boer, Maaike J.; Steinhagen, Hannemike E.; Versteegen, Gerbrig J.; Struys, Michel M.R.F.; Sanderman, Robbert

    2014-01-01

    Objectives: Catastrophizing is often the primary target of the cognitive-behavioral treatment of chronic pain. Recent literature on acceptance and commitment therapy (ACT) suggests an important role in the pain experience for the concepts mindfulness and acceptance. The aim of this study is to examine the influence of mindfulness and general psychological acceptance on pain-related catastrophizing in patients with chronic pain. Methods: A cross-sectional survey was conducted, including 87 chr...

  1. Catastrophizing and Causal Beliefs in Whiplash

    OpenAIRE

    Buitenhuis, J.; de Jong, P J; Jaspers, J. P. C.; Groothoff, J. W.

    2008-01-01

    Study Design. Prospective cohort study. Objective. This study investigates the role of pain catastrophizing and causal beliefs with regard to severity and persistence of neck complaints after motor vehicle accidents. Summary of Background Data. In previous research on low back pain, somatoform disorders and chronic fatigue syndrome, pain catastrophizing and causal beliefs were found to be related to perceived disability and prognosis. Furthermore, it has been argued with respect to whiplash t...

  2. The Economic and Policy Consequences of Catastrophes

    OpenAIRE

    Robert S. Pindyck; Neng Wang

    2013-01-01

    How likely is a catastrophic event that would substantially reduce the capital stock, GDP, and wealth? How much should society be willing to pay to reduce the probability or impact of a catastrophe? We answer these questions and provide a framework for policy analysis using a general equilibrium model of production, capital accumulation, and household preferences. Calibrating the model to economic and financial data, we estimate the mean arrival rate of shocks and their size distribution, the...

  3. Tax Expenditures: A Theoretical Review

    Directory of Open Access Journals (Sweden)

    Vjekoslav Bratić

    2006-06-01

    Full Text Available Tax expenditures are an instrument frequently used when a government wishes to achieve certain economic and social effects. But because of the increasing number and scope of tax expenditures, their proper use, quality of administration and record-keeping have become a major challenge for the tax authorities and the whole of the government. The article considers and explains very diverse forms of tax expenditure such as reliefs, tax deductions, tax allowances, tax exceptions and special rates of taxation and the ways in which they are defined and calculated. The key problems in the analysis are the absence of a single definition and of methodology for the calculations; these ultimately make it impossible to compare tax expenditures between or among countries.

  4. Working versus schooling: the impact of social expenditure

    OpenAIRE

    Christopher Grigoriou; Grégoire Rota-Graziosi

    2008-01-01

    We develop a theoretical model where child labour results from a household’s trade-off between sending a child to school or to work. Education is considered as a risky investment, since the survival of the child is not certain. We explore the effects of public expenditure on education and health on child labour, specifying a transmission mechanism for each kind of spending. On the one hand, we establish that health expenditure reduces child labour all the more as child mortality rate is high....

  5. Working vesus schooling the impact of social expenditure

    OpenAIRE

    Grigoriou, Christopher; Grégoire Rota Graziosi

    2008-01-01

    We develop a theoritical model where child labour results from a household’s trade-off between sending a child to school or to work. Education is considered as a risky investment, since the survival of the child is not certain. We explore the effects of public expenditure on education and health on child labour, specifying a transmission mechanism for each kind of spending. On the one hand, we establish that health expenditure reduces child labour all the more as child mortality rate is high....

  6. Mindfulness, acceptance and catastrophizing in chronic pain.

    Directory of Open Access Journals (Sweden)

    Maaike J de Boer

    Full Text Available OBJECTIVES: Catastrophizing is often the primary target of the cognitive-behavioral treatment of chronic pain. Recent literature on acceptance and commitment therapy (ACT suggests an important role in the pain experience for the concepts mindfulness and acceptance. The aim of this study is to examine the influence of mindfulness and general psychological acceptance on pain-related catastrophizing in patients with chronic pain. METHODS: A cross-sectional survey was conducted, including 87 chronic pain patients from an academic outpatient pain center. RESULTS: The results show that general psychological acceptance (measured with the AAQ-II is a strong predictor of pain-related catastrophizing, independent of gender, age and pain intensity. Mindfulness (measured with the MAAS did not predict levels of pain-related catastrophizing. DISCUSSION: Acceptance of psychological experiences outside of pain itself is related to catastrophizing. Thus, acceptance seems to play a role in the pain experience and should be part of the treatment of chronic pain. The focus of the ACT treatment of chronic pain does not necessarily have to be on acceptance of pain per se, but may be aimed at acceptance of unwanted experiences in general. Mindfulness in the sense of "acting with awareness" is however not related to catastrophizing. Based on our research findings in comparisons with those of other authors, we recommend a broader conceptualization of mindfulness and the use of a multifaceted questionnaire for mindfulness instead of the unidimensional MAAS.

  7. Redistributive Taxation and Public Expenditures

    OpenAIRE

    Bandyopadhyay, Sanghamitra; Esteban, Joan

    2007-01-01

    We introduce a model of redistributive income taxation and public expenditure. Besides redistributing personal income by means of taxes and transfers, the government supplies goods and services. The government chooses the tax schedule that is found acceptable by the largest share possible of the population. We show that there is a unique income tax schedule that is universally acceptable. The progressivity of the income tax is shown to depend on the composition of the public expenditure and o...

  8. Public expenditure planning in Albania

    OpenAIRE

    Bogdani, Irena Dh.

    2002-01-01

    This paper looks at public expenditure planning in Albania, presenting and analysing the first two post-communist era Medium-Term Expenditure Plans (METPs) that have been introduced by the Albanian government for the periods 2000-2001 and 2002-2004, respectively. Albania's medium-term macroeconomic perspectives and elements of fiscal decentralisation, as incorporated by the Local Government Law of Albania, are presented, too. It is found that, taking into account the first years of post-commu...

  9. 22 CFR 71.7 - Reports on catastrophes abroad.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Reports on catastrophes abroad. 71.7 Section 71... catastrophes abroad. Whenever a great catastrophe occurs abroad, either on land or on sea, the officer within whose district the catastrophe takes place or into whose district the survivors are brought shall...

  10. Expenditure Composition in Indian State Governments

    OpenAIRE

    M. Seenuvasan

    2005-01-01

    The study of Expenditure Composition on scientific basis helps us to understand the relative importance, quality, effects and nature of various kinds of expenditure. The study of expenditure composition at the disaggregative level would be of useful to policy makers to examine and evaluate the effects and efficiency of allocation of fiscal resources on desirable directions. Prof Shiras said that the test of public expenditure is not the aggregate expenditure, but it is the pattern of expendit...

  11. Research on catastrophe control in 1-D system

    Institute of Scientific and Technical Information of China (English)

    SUN Yao; TANG Li-ping; LI Xue-lian

    2003-01-01

    A new method of catastrophe control is described in one dimension nonlinear system. Catastrophe control based on catastrophe theory is a brand new area for control theory. A certain catastrophe is created at a desired location by appropriate control, which has preferred properties. Washout filter is presented and applied to preserve the original equilibrium of a system. Washout filter aided dynamic feedback controller is developed for the creation of catastrophe, and an example is given to illustrate the process. Catastrophe control may provide a new way of designing warning signals of impending collapse or catastrophe for monitoring and control purposes.

  12. Pricing for Catastrophe Bonds Based on Expected-value Model

    Directory of Open Access Journals (Sweden)

    Junfei Chen

    2013-02-01

    Full Text Available As the catastrophes cannot be avoided and result in huge economic losses, therefore the compensation issue for catastrophe losses become an important research topic. Catastrophe bonds can effectively disperse the catastrophe risks which mainly undertaken by the government and the insurance companies currently and focus on capital more effectively in broad capital market, therefore to be an ideal catastrophe securities product. This study adopts Expectancy Theory to supplement and improve the pricing of catastrophe bonds based on Value Theory. A model of expected utility is established to determine the conditions of the expected revenue R of catastrophe bonds. The pricing model of the value function is used to get the psychological value of R,U (R-R‾, for catastrophe bonds. Finally, the psychological value is improved by the value according to expected utility and this can more accurately evaluate catastrophe bonds at a reasonable price. This research can provide decision-making for the pricing of catastrophe bonds.

  13. Downward Catastrophe of Solar Magnetic Flux Ropes

    Science.gov (United States)

    Zhang, Quanhao; Wang, Yuming; Hu, Youqiu; Liu, Rui

    2016-07-01

    2.5-dimensional time-dependent ideal magnetohydrodynamic (MHD) models in Cartesian coordinates were used in previous studies to seek MHD equilibria involving a magnetic flux rope embedded in a bipolar, partially open background field. As demonstrated by these studies, the equilibrium solutions of the system are separated into two branches: the flux rope sticks to the photosphere for solutions at the lower branch but is suspended in the corona for those at the upper branch. Moreover, a solution originally at the lower branch jumps to the upper, as the related control parameter increases and reaches a critical value, and the associated jump is here referred to as an upward catastrophe. The present paper advances these studies in three aspects. First, the magnetic field is changed to be force-free; the system still experiences an upward catastrophe with an increase in each control parameter. Second, under the force-free approximation, there also exists a downward catastrophe, characterized by the jump of a solution from the upper branch to the lower. Both catastrophes are irreversible processes connecting the two branches of equilibrium solutions so as to form a cycle. Finally, the magnetic energy in the numerical domain is calculated. It is found that there exists a magnetic energy release for both catastrophes. The Ampère's force, which vanishes everywhere for force-free fields, appears only during the catastrophes and does positive work, which serves as a major mechanism for the energy release. The implications of the downward catastrophe and its relevance to solar activities are briefly discussed.

  14. Medical Care Use and Expenditures for Children across Stages of the Family Life Cycle.

    Science.gov (United States)

    Cunningham, Peter J.

    1990-01-01

    Investigated differences in use of and expenditures for children's health services across stages of family life cycle and how family characteristics affected medical care use and expenditures for children differently, depending on family life cycle stage. Found variation across family life cycle stages in terms of children's mean number of…

  15. Greek's health, waiting for the 'deus ex machina'.

    Science.gov (United States)

    Fanourgiakis, John; Kanoupakis, Emmanuel

    2014-10-01

    Greece from May 2010 has been following Troika's (European Commission, European Central Bank and International Monetary Fund) austere policies in all over the public finance sector. Troika's instructions which are adopted by the politicians resulted to depressed and weak citizens. The consequences in health care sector are becoming visible across the society. A big part of Greek's society is uninsured without any access to public health care system. The vulnerable social groups confront catastrophic health care expenditures and impoverishment with no social net protection. Greeks are paying the price of their irrational way of living. The current paper has gathered from the literature the early effects of the implementation of these policies on public health and healthcare. PMID:24902711

  16. Environmental catastrophes under time-inconsistent preference

    Energy Technology Data Exchange (ETDEWEB)

    Michielsen, T.

    2013-02-15

    I analyze optimal natural resource use in an intergenerational model with the risk of a catastrophe. Each generation maximizes a weighted sum of discounted utility (positive) and the probability that a catastrophe will occur at any point in the future (negative). The model generates time inconsistency as generations disagree on the relative weights on utility and catastrophe prevention. As a consequence, future generations emit too much from the current generation's perspective and a dynamic game ensues. I consider a sequence of models. When the environmental problem is related to a scarce exhaustible resource, early generations have an incentive to reduce emissions in Markov equilibrium in order to enhance the ecosystem's resilience to future emissions. When the pollutant is expected to become obsolete in the near future, early generations may however increase their emissions if this reduces future emissions. When polluting inputs are abundant and expected to remain essential, the catastrophe becomes a self-fulfilling prophecy and the degree of concern for catastrophe prevention has limited or even no effect on equilibrium behaviour.

  17. Catastrophes and nuclear accidents in the former USSR

    International Nuclear Information System (INIS)

    In the former USSR, the nuclear safety, the environment protection and the preservation of workers and population health were not the first priority for the Soviet Union authorities. The fabrication of nuclear weapons, the construction of nuclear submarines and the production of an abundant energy source were the only goals at that time. This book describes and explains the circumstances of the nuclear catastrophes and accidents that have occurred during this era. It tries to estimate their impacts on populations and environment and their possible consequences in a near or far future. (J.S.)

  18. The importance of catastrophizing for successful pharmacological treatment of peripheral neuropathic pain

    Directory of Open Access Journals (Sweden)

    Toth C

    2014-06-01

    Full Text Available Cory Toth, Shauna Brady, Melinda Hatfield Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada Objective: Catastrophizing may be a negative predictor of pain-related outcomes. We evaluated the impact of catastrophizing upon success of first-line pharmacotherapy in the management of neuropathic pain (NeP due to peripheral polyneuropathy. Methods: Patients with confirmed NeP with NeP Visual Analog Scale (VAS pain severity score ≥4 (0–10 scale completed the Coping Strategies Questionnaire (CSQ catastrophizing subscale at baseline. Pharmacological therapy consisting of first-line agents gabapentin, pregabalin, or a tricyclic antidepressant was initiated. Other measures examined included the Karnofsky Performance Scale, Beck Depression Inventory, EuroQol Quality of Life Health Questionnaire, and Modified Brief Pain Inventory. At 3 and 6 months, questionnaires were repeated and adverse effect reporting was completed. Outcome measures assessed were pharmacotherapy success (≥30% relief of NeP and tolerability over 6 months of follow-up. Bivariate relationships using Pearson product-moment correlations were examined for baseline CSQ catastrophizing subscale score and the change in the NeP VAS scores and medication discontinuation. Results: Sixty-six patients were screened, 62 subjects participated, and 58 subjects (94% completed the final follow-up visit. Greater catastrophizing was associated with poor pain relief response and greater likelihood of discontinuation of pharmacotherapy, reports of greater disability, and impaired quality of life. Duration of pain was negatively associated with likelihood of pharmacotherapy success. Conclusion: Catastrophizing exerts maladaptive effects on outcomes with pharmacotherapy in NeP patients. Detection of catastrophizing during clinical visits when pharmacological therapy is being considered can be a predictive factor for patient outcomes. Keywords: neuropathic pain

  19. Valuing Catastrophe Bonds Involving Credit Risks

    Directory of Open Access Journals (Sweden)

    Jian Liu

    2014-01-01

    Full Text Available Catastrophe bonds are the most important products in catastrophe risk securitization market. For the operating mechanism, CAT bonds may have a credit risk, so in this paper we consider the influence of the credit risk on CAT bonds pricing that is different from the other literature. We employ the Jarrow and Turnbull method to model the credit risks and get access to the general pricing formula using the Extreme Value Theory. Furthermore, we present an empirical pricing study of the Property Claim Services data, where the parameters in the loss function distribution are estimated by the MLE method and the default probabilities are deduced by the US financial market data. Then we get the catastrophe bonds value by the Monte Carlo method.

  20. Financial protection from health spending in the Philippines: policies and progress.

    Science.gov (United States)

    Bredenkamp, Caryn; Buisman, Leander R

    2016-09-01

    The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has tripled since 2000, from 2.5% to 7.7%. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate, pushing more than 1.5 million people into poverty. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance from the poor to the near-poor, a policy of zero copayments for the poor, a deepening of the benefit package and provider payment reform aimed at cost-containment-are to be commended. Indeed, between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, quick wins could include issuing health insurance cards to the poor to increase awareness of coverage and limiting out-of-pocket spending by clearly defining a clear copayment structure for non-poor members. An in-depth analysis of the pharmaceutical sector would help to shed light on why medicines impose such a large financial burden on households. PMID:27072948

  1. Pollution Abatement and Control Expenditures Survey (PACE)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Pollution Abatement Costs and Expenditures (PACE) survey is the most comprehensive national source of pollution abatement costs and expenditures related to...

  2. On a new global catastrophic ICT model

    DEFF Research Database (Denmark)

    Riaz, M. Tahir; Bhalerao, Dipashree M.; Madsen, Ole Brun;

    2011-01-01

    Many parts of India are prone to natural disasters, particularly caused by earthquakes and floods because of its geographical location. The Catastrophic areas can be rural, remote or urban anywhere in the world. It has been understood that earthquakes directly do not cause causalities but instead...

  3. 78 FR 52832 - Catastrophic Risk Protection Endorsement

    Science.gov (United States)

    2013-08-27

    .... See the Notice related to 7 CFR part 3015, subpart V, published at 48 FR 29115, June 24, 1983... the Federal Register at 76 FR 50929-50931. The public was afforded 60 days to submit written comments... Federal Crop Insurance Corporation 7 CFR Part 402 RIN 0563-AC31 Catastrophic Risk Protection...

  4. Determinants of military expenditure in Zimbabwe

    OpenAIRE

    Zachary Tambudzai

    2011-01-01

    While many articles have been written on the determinants of military expenditure in developing countries, few have attempted to use a qualitative approach to investigate the underlying motives for military expenditure. This article uses data drawn from interviews with key informants and documentary sources to study the determinants of military expenditure in Zimbabwe. Findings suggest that Zimbabwe’s military expenditure since 1980 has been influenced more by internal political dynamics than...

  5. Government consumption expenditures and the current account

    OpenAIRE

    Michele Cavallo

    2005-01-01

    This paper distinguishes between two components of government consumption, expenditure on final goods and expenditure on hours, and compares the effects of changes in these two on the current account. I find that changes in government expenditure on hours do not directly affect the current account and that their impact is considerably smaller than the impact produced by changes in government expenditure on final goods. These findings indicate that considering government consumption as entirel...

  6. Copula bivariate probit models: with an application to medical expenditures

    OpenAIRE

    Winkelmann, Rainer

    2011-01-01

    The bivariate probit model is frequently used for estimating the eff*ect of an endogenous binary regressor (the "treatment") on a binary health outcome variable. This paper discusses simple modifi*cations that maintain the probit assumption for the marginal distributions while introducing non-normal dependence using copulas. In an application of the copula bivariate probit model to the effect of insurance status on the absence of ambulatory health care expenditure, a model based on the Frank ...

  7. Expenditure policy in Angola : impact on economic development and inequality

    OpenAIRE

    Delgado, Albertina da Rosa

    2013-01-01

    Government Expenditure (GE) is an instrument by which the State distributes resources with efficiency and responsibility. Several studies have analysed the relationship between GE and economic growth, as well as the relationship between inequality and GE by region. Studies in Africa have found a positive relationship between education and health spending with respect to economic growth, which means that the greater public investment in education and health, the greater the economic growth. ...

  8. 76 FR 50887 - Elections Regarding Start-Up Expenditures, Corporation Organizational Expenditures, and...

    Science.gov (United States)

    2011-08-17

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BE77 Elections Regarding Start-Up Expenditures, Corporation... final regulations relating to elections to deduct start-up expenditures, organizational expenditures of... the lesser of (1) the amount of the start-up expenditures that relate to the active trade or...

  9. Chernobyl catastrophe: Information for people living in the contaminated areas

    International Nuclear Information System (INIS)

    The radioactive blow-outs after the Chernobyl Nuclear Power Plant catastrophe reached many states. The largest amount of them (according to experts' estimations - 70%) fell out on the Belarus territory. The estimation of radioecological, medico-biological, economic and social consequences of the Chernobyl catastrophe has shown that unimaginable damage was incurred on Belarus and its territory became the zone of ecological calamity. More than 14 years have passed since the Chernobyl NPP accident but some of the problems caused by the catastrophe have not been solved. This is bound up, first of all, with a high collective dosage absorbed by the population, with difficulties in forecasting and prophylactics of remote radiological effects, with ecological and economic crisis. The consequences of the disaster greatly affect all the aspects of vital activities of the affected regions and the state as a whole. Destructive tendencies have been revealed in all spheres of the life activity of people who experienced radiation effects. The processes of social adaptation and socio-psychological support of the population inhabiting the contaminated territory and resettled as well, require considerable optimisation. Negative factors of the Chernobyl catastrophe, which are significant for human health can be divided into two groups as follows: radiation-based, directly related to influence of ionising radiation and non radiation based, related to changes in habitat and prolonged psychological stress. The specific peculiarities of psychogenic disorders caused by the catastrophe are determined by the following reasons: insufficient knowledge of radiation effects; constant apprehension for the health and well-being of themselves and their families, especially children; unexpected change of the life stereotype (forced resettlement, the break of the former life, changing the place and the character of work, etc.); the necessity of constant keeping precaution measures and prophylactic

  10. The impact of age and sex on healthcare expenditure of households in Bangladesh

    OpenAIRE

    Sarker, Abdur Razzaque; Mahumud, Rashidul Alam; Sultana, Marufa; Ahmed, Sayem; Ahmed, Wahid; Khan, Jahangir AM

    2014-01-01

    The impact of age and sex on health care expenditure has recently become one of the major concerns in many developing countries like Bangladesh. Age and sex differences in the use of health care services can be substantial at several stages of life which are reflected in overall healthcare expenditure. We examined the impact of age and sex of the population on overall healthcare expenditure of households in Bangladesh. A total of 10,705 populations who spent for receiving any type of healthca...

  11. INCORPORATING CATASTROPHES INTO INTEGRATED ASSESSMENT: SCIENCE, IMPACTS, AND ADAPTATION

    Science.gov (United States)

    Incorporating potential catastrophic consequences into integrated assessment models of climate change has been a top priority of policymakers and modelers alike. We review the current state of scientific understanding regarding three frequently mentioned geophysical catastrophes,...

  12. Industrial arsenic contamination causes catastrophic changes in freshwater ecosystems

    Science.gov (United States)

    Chen, Guangjie; Shi, Haibin; Tao, Jianshuang; Chen, Li; Liu, Yuanyuan; Lei, Guoliang; Liu, Xiaohai; Smol, John P.

    2015-11-01

    Heavy metal pollution is now widely recognized to pose severe health and environmental threats, yet much of what is known concerning its adverse impacts on ecosystem health is derived from short-term ecotoxicological studies. Due to the frequent absence of long-term monitoring data, little is known of the long-tem ecological consequences of pollutants such as arsenic. Here, our dated sediment records from two contaminated lakes in China faithfully document a 13.9 and 21.4-fold increase of total arsenic relative to pre-1950 background levels. Concurrently, coherent responses in keystone biota signal pronounced ecosystem changes, with a >10-fold loss in crustacean zooplankton (important herbivores in the food webs of these lake systems) and a >5-fold increase in a highly metal-tolerant alga. Such fundamental ecological changes will cascade through the ecosystem, causing potentially catastrophic consequences for ecosystem services in contaminated regions.

  13. CATASTROPHE FRACTURE OF THIN-WALL PRESSURE TUBES

    Institute of Scientific and Technical Information of China (English)

    魏德敏; 杨桂通

    2002-01-01

    Catastrophe theory was used to investigate the fracture behavior of thin-wall cylindrical tubes subjected to nternal explosive pressure. Based on the energy theory and catastrophe theory, a cusp catastrophe model for the fracture was established, and a critical condition associated with the model is given.

  14. Axial and focal-plane diffraction catastrophe integrals

    Energy Technology Data Exchange (ETDEWEB)

    Berry, M V [H H Wills Physics Laboratory, Tyndall Avenue, Bristol BS8 1TL (United Kingdom); Howls, C J [School of Mathematics, University of Southampton, Southampton, SO17 1BJ (United Kingdom)

    2010-09-17

    Exact expressions in terms of Bessel functions are found for some of the diffraction catastrophe integrals that decorate caustics in optics and mechanics. These are the axial and focal-plane sections of the elliptic and hyperbolic umbilic diffraction catastrophes, and symmetric elliptic and hyperbolic unfoldings of the X{sub 9} diffraction catastrophes. These representations reveal unexpected relations between the integrals.

  15. Iodine and thyroid gland with or without nuclear catastrophe

    Directory of Open Access Journals (Sweden)

    Kovačev-Zavišić Branka

    2012-01-01

    Full Text Available Introduction. Iodine, as a trace element, is a necessary and limiting substrate for thyroid gland hormone synthesis. It is an essential element that enables the thyroid gland to produce thyroid hormones thyroxine (T4 and triiodothyronine (T3. Synthesis of Thyroid Hormones and Iodine Metabolism. Three iodine molecules are added to make triiodothyronine, and four for thyroxine - the two key hormones produced by the thyroid gland. Iodine deficiency. The proper daily amount of iodine is required for optimal thyroid function. Iodine deficiency can cause hypothyroidism, developmental brain disorders and goiter. Iodine deficiency is the single most common cause of preventable mental retardation and brain damage in the world. It also decreases child survival, causes goiters, and impairs growth and development. Iodine deficiency disorders in pregnant women cause miscarriages, stillbirths, and other complications. Children with iodine deficiency disorders can grow up stunted, apathetic, mentally retarded, and incapable of normal movements, speech or hearing. Excessive Iodine Intake. Excessive iodine intake, which can trigger autoimmune thyroid disease and dysfunction, is on the other side. Iodine use in Case of Nuclear Catastrophe. In addition to other severe consequences of radioactivity, high amount of radioactive iodine causes significant increase in incidence of thyroid gland carcinoma after some of the nuclear catastrophes (Hiroshima, Nagasaki, Chernobyl, Fukushima. The incidence of thyroid carcinoma was increased mostly in children. This paper was aimed at clarifying some of the possibilities of prevention according to the recommendations given by the World Health Organization.

  16. Crisis Management Aspects of Bam Catastrophic Earthquake: Review Article

    Directory of Open Access Journals (Sweden)

    Homayoun Sadeghi-Bazargani

    2015-03-01

    Full Text Available Background: Bam earthquake was the most catastrophic natural disasters in recent years. The aim of this study was to review different aspects of crisis manage­ment during and after the catastrophic earthquake in Bam City, Iran.Methods: Data needed for this systematic review were collected through search­ing PubMed, EMBASE and SID databases, for the period from 2003 to 2011. Keywords included earthquake, Iran and Bam earthquake. The data were summarized and were analyzed using Content Analysis.Results: Out of 422 articles, 25 articles were included in the study. Crisis Manage­ment aspects and existing pitfalls were classified into seven categories including planning and organization, human resource management, management of logistics, international humanitarian aids, field performance of the military and security forces, health and medical service provision, and information manage­ment. Positive aspects and major pitfalls of crisis management have been introduced in all the mentioned categories. Conclusion: The available evidence indicated poor crisis management during Bam earthquake that resulted in aggravating the losses as well as diminishing the effect of interventions. Thus, concerning the importance of different aspects of the crisis management and the high prevalence of disasters in Iran, the observed vulnerability in disaster management process should be addressed.

  17. Expenditure patterns of older Americans, 2001-2009.

    Science.gov (United States)

    Banerjee, Sudipto

    2012-02-01

    PRE- AND POSTRETIREMENT EXPENSES: Before retirement, people pay FICA taxes, incur work-related expenses, and set aside money for retirement. But after retirement, most people have different financial obligations, and, as a result, retirees may still be able to maintain their level of preretirement well-being with very different income levels. Studying income, expenditures, and wealth-holding patterns together provides a more complete idea of how people are doing in terms of being able to afford retirement than arbitrary estimates such as income replacement ratios. UNIQUE DATA: This Issue Brief examines the expenditure patterns of the older section of the population. It uses data from the Consumption and Activities Mail Survey (CAMS), a supplement to the Health and Retirement Study (HRS), conducted by the Institute for Social Research at the University of Michigan, contains detailed expenditure data on 32 categories, and follows the same group of individuals over eight years In addition, the income and wealth data available in the HRS are used to establish the financial standing of older households. DECLINING EXPENSES: Household expenses steadily decline with age. With the age 65 expenditure as a benchmark, household expenditure falls by 19 percent by age 75, 34 percent by age 85, and 52 percent by age 95. HOME EXPENSES: Home and home-related expenses remain the single largest spending category for older Americans. On average, those over age 50 spend around 40-45 percent of their budget on home and home-related items. RISING HEALTH CARE EXPENSES: Health-related expenses are the second-largest component in the budget of older Americans. It is the only component which steadily increases with age. Health care expenses capture around 10 percent of the budget for those between 50-64, but increase to about 20 percent for those age 85 and over. DEMOGRAPHIC GROUPS: Singles, blacks, and high school dropouts do not have a sound financial standing in retirement. Their

  18. Educational Expenditure: Implications for Equality

    OpenAIRE

    McCoy, Selina; Smyth, Emer

    2003-01-01

    Inequalities in educational outcomes over time are described. Patterns of educational expenditure are outlined, highlighting differences between and within the primary, secondary and tertiary sectors. Recent policy developments are explored which involve targeting spending on "disadvantaged" schools, through special programmes and initiatives. The implications of educational failure for labour market and other outcomes among young people in particular and the adult population in general are d...

  19. On Catastrophe and Cavitation for Spherical Cavity

    Institute of Scientific and Technical Information of China (English)

    MingJIN; KefuHUANG; 等

    1999-01-01

    This work deals with catastrophe of a spherical cavity and cavitation of a spherical cavity for Hooke material with 1/2 Poisson's ratio.A nonlinear problem.which is the Cauchy traction problem,is solved analytically.The governing equations are written on the deformed region or on the present configuration.And the conditions are described on moving boundary.A closed form solution is found.Furthermore,a bifurcation solution in closed form is given from the trivial homogeneous solution of a solid sphere.The results indicate that there is a tangent bifurcation on the displacement-load curve for a sphere with a cavity.On the tangent bifurcation point,the cavity grows up suddenly,which is a kind of catastrophe,And there is a pitchfork bifurcation on the displacement-load curve for a solid sphere.On the pitchfork bifurcation point.there is a cavitation in the solid sphere.

  20. Microtubule dynamics: Caps, catastrophes, and coupled hydrolysis

    DEFF Research Database (Denmark)

    Flyvbjerg, H.; Holy, T.E.; Leibler, S.

    1996-01-01

    An effective theory is formulated for the dynamics of the guanosine triphosphate (GTP) cap believed to stabilize growing microtubules. The theory provides a ''coarse-grained'' description of the cap's dynamics. ''Microscopic'' details, such as the microtubule lattice structure and the fate of its...... data. A constant nonzero catastrophe rare, identical for both microtubule ends, is predicted at large growth rates. The delay time for dilution-induced catastrophes is stochastic with a simple distribution that fits the experimental one and, like the experimental one, does not depend on the rate of....... A recent experimental result for the size of the minimal cap that can stabilize a microtubule is shown to agree with the result predicted by the cap model, after its parameters have been extracted from previous experimental results. Thus the effective theory and cap model presented here provide a...

  1. Nonlinear physics: Catastrophe, chaos and complexity

    International Nuclear Information System (INIS)

    Currently in the world of physics, there is open debate on the role of the three C's - catastrophe, chaos and complexity. Seen as new ideas or paradigms, incapable of being harmonized within the realm of traditional physics, these terms seem to be creating turmoil in the classical physics establishment whose foundations date back to the early seventeenth century. This paper first defines catastrophe, chaos and complexity and shows how these terms are all connected to nonlinear dynamics and how they have long since been present within scientific treatises. It also evidences the relationship of the three C's with the concept of organization, inappropriately called self-organization, and with recognition and decisional strategies of cognitive systems. Relevant to natural science, the development of these considerations is necessitating the re-examination of the role and capabilities of human knowledge and a return to inter-disciplinary scientific-philosophical debate

  2. Valuing Catastrophic Losses for Perennial Agricultural Crops

    OpenAIRE

    Adams, Damian C.; Kilmer, Richard L.; Moss, Charles B.; Schmitz, Andrew

    2003-01-01

    Courts are often required to estimate changes in welfare to agricultural operations from catastrophic events. For example, courts must assign damages in lawsuits, such as with pesticide drift cases, or determine 'just compensation' when the government takes private land for public use, as with the removal of dairy farms from environmentally sensitive land or destruction of canker-contaminated citrus trees. In economics, the traditional method of estimating changes in producer welfare is the c...

  3. Recent catastrophic landslides and mitigation in China

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Increasing population density and development of mountainous terrain have brought human settlements within reach of landslide hazards.In recent years,due to the shortening of return period for severe natural events such as heavy rainfall,snowline retreating,great earthquake together with human activities,catastrophic landslides happened more frequently than before,resulting in large-scale casualties due to the increasing occurrences of rapid long-runout rock avalanches,especially in China.This paper present...

  4. Catastrophic Consequences of Kicking the Chameleon

    OpenAIRE

    Erickcek, Adrienne L.; Barnaby, Neil; Burrage, Clare; Huang, Zhiqi

    2013-01-01

    The physics of the "dark energy" that drives the current cosmological acceleration remains mysterious, and the dark sector may involve new light dynamical fields. If these light scalars couple to matter, a screening mechanism must prevent them from mediating an unacceptably strong fifth force locally. Here we consider a concrete example: the chameleon mechanism. We show that the same coupling between the chameleon field and matter employed by the screening mechanism also has catastrophic cons...

  5. Catastrophic Natural Disasters and Economic Growth

    OpenAIRE

    Cavallo, Eduardo; Galiani, Sebastian; Noy, Ilan; Pantano, Juan

    2010-01-01

    We examine the short and long run average causal impact of catastrophic natural disasters on economic growth by combining information from comparative case studies. We assess the counterfactual of the cases studied by constructing synthetic control groups taking advantage of the fact that the timing of large sudden natural disasters is an exogenous event. We find that only extremely large disasters have a negative effect on output both in the short and long run. However, we also show that thi...

  6. Fitting the Cusp Catastrophe in R: A cusp Package Primer

    Directory of Open Access Journals (Sweden)

    Raoul P. P. P. Grasman

    2009-11-01

    Full Text Available Of the seven elementary catastrophes in catastrophe theory, the “cusp” model is the most widely applied. Most applications are however qualitative. Quantitative techniques for catastrophe modeling have been developed, but so far the limited availability of flexible software has hindered quantitative assessment. We present a package that implements and extends the method of Cobb (Cobb and Watson 1980; Cobb, Koppstein, and Chen 1983, and makes it easy to quantitatively fit and compare different cusp catastrophe models in a statistically principled way. After a short introduction to the cusp catastrophe, we demonstrate the package with two instructive examples.

  7. Paleomagnetic study of the Tunguska catastrophe epicenter

    Science.gov (United States)

    Gladysheva, O. G.; Popov, V. V.

    2016-03-01

    The Tunguska catastrophe occurred in the area of the East Siberian magnetic anomaly on June 30, 1908. The epicenter of the explosive destruction of the Tunguska cosmic body (TCB) was above the central neck of a paleovolcano (Mt. Stoikovich). According to the paleomagnetic data available, the bedrocks on the top of Mt. Stoikovich carry remanent magnetization, which is substantially higher than that in rocks from neighboring mountains. Analysis of the results of paleomagnetic measurements of rock samples collected in the vicinity of the Tunguska catastrophe epicenter showed that the destruction of the cosmic body was accompanied by the formation of multidirectional magnetic fields, which provide disturbances spreading over a distance of 25 km from the epicenter. The chaotic distribution pattern of magnetization vectors measured in the soil in the vicinity of the Tunguska catastrophe epicenter confirms the previously expressed assumption that destruction of the TCB was accompanied with multiple discharges. According to this, we can conclude that the matter of the Tunguska cosmic body was dispersed around the epicenter in a zone approximately 25 km in diameter.

  8. A critical look at catastrophe risk assessments

    CERN Document Server

    Kent, A

    2004-01-01

    Recent papers by Busza et al. (BJSW) and Dar et al. (DDH) argue that astrophysical data can be used to establish bounds on the risk of a catastrophe in forthcoming collider experiments. The safety case set out by BJSW does not rely on these bounds, but on theoretical arguments, which BJSW find sufficiently compelling. However, DDH and other commentators (initially including BJSW) have suggested that the astrophysical bounds alone do give sufficient reassurance. This seems unsupportable when the bounds are expressed in terms of expected cost. For example, DDH's main bound, $p_{\\rm catastrophe} < 2 \\times 10^{-8}$, implies only that the expectation value of the number of deaths is bounded by 120. We thus reappraise the DDH and BJSW risk bounds by comparing risk policy in other areas. We find that requiring a catastrophe risk of no higher than 10^{-15} is necessary to be consistent with established policy for risk optimisation from radiation hazards, even if highly risk tolerant assumptions are made. A respec...

  9. Catastrophic fragmentation of asteroids: Evidence from meteorites

    Science.gov (United States)

    Keil, K.; Haack, H.; Scott, E. R. D.

    1994-01-01

    Meteorites are impact-derived fragments from approximately 85 parent bodies. For seven of these bodies, the meteorites record evidence suggesting that they may have been catastrophically fragmented. We identify three types of catastrophic events: (1) impact and reassemble events greater than 4.4 Gy ago, involving molten or very hot parent bodies (greater than 1200 C); this affected the parent bodies of the ureilites, Shallowater, and the mesosiderites. In each case, the fragments cooled rapidly (approximately 1-1000 C/day) and then reassembled. (2) Later impacts involving cold bodies which, in some cases, reassembled; this occurred on the H and L ordinary chondrite parent bodies. The L parent body probably suffered another catastrophic event about 500 My ago. (3) Recent impacts of cold, multi-kilometer-sized bodies that generated meter-sized meteoroids; this occurred on the parent bodies of the IIIAB irons (650 My ago), the IVA irons (400 My ago), and the H ordinary chondrite (7 My ago).

  10. Downward catastrophe of solar magnetic flux ropes

    CERN Document Server

    Zhang, Quanhao; Hu, Youqiu; Liu, Rui

    2016-01-01

    2.5D time-dependent ideal magnetohydrodynamic (MHD) models in Cartesian coordinates were used in previous studies to seek MHD equilibria involving a magnetic flux rope embedded in a bipolar, partially open background field. As demonstrated by these studies, the equilibrium solutions of the system are separated into two branches: the flux rope sticks to the photosphere for solutions at the lower branch but is suspended in the corona for those at the upper branch. Moreover, a solution originally at the lower branch jumps to the upper, as the related control parameter increases and reaches a critical value, and the associated jump is here referred to as upward catastrophe. The present paper advances these studies in three aspects. First, the magnetic field is changed to be force-free. The system still experiences an upward catastrophe with an increase in each control parameter. Secondly, under the force-free approximation, there also exists a downward catastrophe, characterized by a jump of a solution from the u...

  11. The Impact of Out-of-Pocket Payments on Health Care Inequity: The Case of National Health Insurance in South Korea

    Directory of Open Access Journals (Sweden)

    Weon-Young Lee

    2014-07-01

    Full Text Available The global financial crisis of 2008 has led to the reinforcement of patient cost sharing in health care policy. This study aimed to explore the impact of direct out-of pocket payments (OOPs on health care utilization and the resulting financial burden across income groups under the South Korean National Health Insurance (NHI program with universal population coverage. We used the fourth Korean National Health and Nutrition Examination Survey (KNHNES-IV and the Korean Household Income and Expenditure Survey (KHIES of 2007, 2008 and 2009. The Horizontal Inequity Index (HIwv and the average unit OOPs were used to measure income-related inequity in the quantitative and qualitative aspects of health care utilization, respectively. For financial burden, the incidence rates of catastrophic health expenditure (CHE were compared across income groups. For outpatient and hospital visits, there was neither pro-poor or pro-rich inequality. The average unit OOPs of the poorest quintile was approximately 75% and 60% of each counterpart in the richest quintile in the outpatient and inpatient services. For the CHE threshold of 40%, the incidence rates were 5.7%, 1.67%, 0.72%, 0.33% and 0.27% in quintiles I (the poorest quintile, II, III, IV and V, respectively. Substantial OOPs under the NHI are disadvantageous, particularly for the lowest income group in terms of health care quality and financial burden.

  12. Household expenditure on food at home in Malaysia

    OpenAIRE

    Tey, (John) Yeong-Sheng

    2008-01-01

    “Engel’s law” explains that the share of household expenditure on food typically falls as income and expenditure increase. The objectives of this study are to investigate the food expenditure patterns of different income groups and the relationships between household characteristics and expenditure patterns. Household Expenditure Survey 2004/2005 data from Department of Statistics was used to analyze the food expenditure pattern of households. An expenditure model was developed and the coeffi...

  13. Pain catastrophizing as a risk factor for chronic pain after total knee arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Burns LC

    2015-01-01

    Full Text Available Lindsay C Burns,1–3 Sarah E Ritvo,1 Meaghan K Ferguson,1 Hance Clarke,3–5 Ze’ev Seltzer,3,5 Joel Katz1,3–5 1Department of Psychology, York University, Toronto, ON, Canada; 2Arthritis Research Centre of Canada, Vancouver, BC, Canada; 3Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada; 4Department of Anesthesia, University of Toronto, Toronto, ON, Canada; 5Centre for the Study of Pain, Faculties of Dentistry and Medicine, University of Toronto, Toronto, ON, Canada Background: Total knee arthroplasty (TKA is a common and costly surgical procedure. Despite high success rates, many TKA patients develop chronic pain in the months and years following surgery, constituting a public health burden. Pain catastrophizing is a construct that reflects anxious preoccupation with pain, inability to inhibit pain-related fears, amplification of the significance of pain vis-à-vis health implications, and a sense of helplessness regarding pain. Recent research suggests that it may be an important risk factor for untoward TKA outcomes. To clarify this impact, we systematically reviewed the literature to date on pain catastrophizing as a prospective predictor of chronic pain following TKA. Methods: We searched MEDLINE, EMBASE, and PsycINFO databases to identify articles related to pain catastrophizing, TKA, risk models, and chronic pain. We reviewed titles and abstracts to identify original research articles that met our specified inclusion criteria. Included articles were then rated for methodological quality. including methodological quality. Due to heterogeneity in follow-up, analyses, and outcomes reported across studies, a quantitative meta-analysis could not be performed. Results: We identified six prospective longitudinal studies with small-to-mid-sized samples that met the inclusion criteria. Despite considerable variability in reported pain outcomes, pain catastrophizing was identified as a significant

  14. Revenue and Expenditure Separation Increases Rate of First Contact Care in Community Health Centers among Community Residents%社区卫生收支两条线改革对社区首诊的作用研究

    Institute of Scientific and Technical Information of China (English)

    郭泓; 梁小云; 金承刚

    2012-01-01

    Objective To evaluate the impact of revenue and expenditure separation (RES) on rate of first contact care in community health centers (CHCs) among community residents. Methods Baseline household survey was conducted in February 2009 , before the implementation of RES, and endline household survey was conducted between July and August 2011, after the implementation of RES. According to the baseline and endline household survey results, residents who visited CHC within two weeks before the conduction of each survey were included in this study. This study employed a pre - post quasi - experiment design and independent variables were selected based on the Andersen model. Multiple regression models were used to i-dentify the impact of RES on first contact care. Results During the two weeks before the RES implementation, 31 community residents first sought care in CHC, out of 95 who had used medical services, and the figure after the RES implementation was 89 out of 146. Multiple regression analysis showed that the rate of first contact care in CHC increased by 28. 3% (P = 0.000) . Conclusion RES has improved the rate of first contact care in CHC among the community residents. RES helped attract community residents for two main reasons. First, CHCs start to be financed by the government instead of revenue from medication and medical services, so overtreatment is controlled and spending is reduced. Second, a series of medical personnel performance appraisal methods are introduced along with RES, which promote the provision of public health services.%目的 评估收支两条线改革对居民到社区卫生服务中心进行首诊的作用效果.方法 分别于收支两条线改革前后进行居民入户调查,采取前后比较的类试验方法及安德森行为模型,利用多元Logistic回归控制其他因素的混杂,估计政策的净效应.结果 基线调查中,到社区卫生服务中心进行首诊的只有31人,社区首诊率为32.6%;终线调查中,

  15. State energy price and expenditure report 1994

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The price and expenditure estimates developed in the State Energy Price and Expenditure Data System (SEPEDS) are provided by energy source and economic sector and are published for the years 1970 through 1994. Consumption estimates used to calculate expenditures and the documentation for those estimates are taken from the State Energy Data Report 1994, Consumption Estimates (SEDR), published in October 1996. Expenditures are calculated by multiplying the price estimates by the consumption estimates, which are adjusted to remove process fuel; intermediate petroleum products; and other consumption that has no direct fuel costs, i.e., hydroelectric, geothermal, wind, solar, and photovoltaic energy sources. Documentation is included describing the development of price estimates, data sources, and calculation methods. 316 tabs.

  16. State energy price and expenditure report 1994

    International Nuclear Information System (INIS)

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The price and expenditure estimates developed in the State Energy Price and Expenditure Data System (SEPEDS) are provided by energy source and economic sector and are published for the years 1970 through 1994. Consumption estimates used to calculate expenditures and the documentation for those estimates are taken from the State Energy Data Report 1994, Consumption Estimates (SEDR), published in October 1996. Expenditures are calculated by multiplying the price estimates by the consumption estimates, which are adjusted to remove process fuel; intermediate petroleum products; and other consumption that has no direct fuel costs, i.e., hydroelectric, geothermal, wind, solar, and photovoltaic energy sources. Documentation is included describing the development of price estimates, data sources, and calculation methods. 316 tabs

  17. Beyond UHC: monitoring health and social protection coverage in the context of tuberculosis care and prevention.

    Directory of Open Access Journals (Sweden)

    Knut Lönnroth

    2014-09-01

    Full Text Available Tuberculosis (TB remains a major global public health problem. In all societies, the disease affects the poorest individuals the worst. A new post-2015 global TB strategy has been developed by WHO, which explicitly highlights the key role of universal health coverage (UHC and social protection. One of the proposed targets is that "No TB affected families experience catastrophic costs due to TB." High direct and indirect costs of care hamper access, increase the risk of poor TB treatment outcomes, exacerbate poverty, and contribute to sustaining TB transmission. UHC, conventionally defined as access to health care without risk of financial hardship due to out-of-pocket health care expenditures, is essential but not sufficient for effective and equitable TB care and prevention. Social protection interventions that prevent or mitigate other financial risks associated with TB, including income losses and non-medical expenditures such as on transport and food, are also important. We propose a framework for monitoring both health and social protection coverage, and their impact on TB epidemiology. We describe key indicators and review methodological considerations. We show that while monitoring of general health care access will be important to track the health system environment within which TB services are delivered, specific indicators on TB access, quality, and financial risk protection can also serve as equity-sensitive tracers for progress towards and achievement of overall access and social protection.

  18. Public expenditure and drug policies in Bulgaria in 2014

    OpenAIRE

    Toni Yonkov Vekov; Silviya Aleksandrova-Yankulovska

    2015-01-01

    Aim: The objective of this study was to provide an analysis of the factors which have a significant impact on the growth of public expenditure on medical products in Bulgaria. Methods: This research work consists of a critical analysis of the data reported by the National Health Insurance Fund in Bulgaria on the stability of the healthcare insurance model and the implementation of the budget for 2014. Results: The results from the current analysis indicate that the growth of public...

  19. Medicaid's Expenditures for Newer Pharmacotherapies for Adults with Disabilities

    OpenAIRE

    Shireman, Theresa I.; Hall, Jean P; Rigler, Sally K.; Moore, Janice M.

    2007-01-01

    Medicaid's drug expenditures have grown at double-digit inflation rates since 2000. These prescription drug costs are important contributors to increasing health care costs for disabled persons. In spite of this knowledge, little has been reported about specific patterns of medication use among disabled enrollees. We analyzed Kansas Medicaid data to describe trends in medication use patterns across 3 years among disabled beneficiaries. The marked shifts toward newer medications and disproport...

  20. Public Education Expenditures and Private School Enrollment

    OpenAIRE

    Fernanda Estevan

    2014-01-01

    In this paper, I investigate whether increases in public education expenditures lead to reductions in private school enrollment. In order to deal with the endogeneity of public expenditures, I use as a natural experiment the 1998 FUNDEF reform in Brazil that caused exogenous variations in local public school funding. Using data from Brazilian School and Population Censuses, I show that public education expenditures increases are associated with reductions in the share of private school enroll...

  1. Structure and determinants of consumer expenditures

    OpenAIRE

    Stejskal, Ladislav; Stávková, Jana

    2011-01-01

    The local and worldwide present economic situation is often judged and discussed on the basis of the consumer expenditures development. Consumer expenditures or a buying behaviour outcome of each individual market subject is in marketing defined as a product and service seeking, from that consumers expect satisfying of their needs. On the basis of the introduced determination authors conducted a marketing research. Results in combination with a marketing insight into consumer expenditures rea...

  2. Rationalising Public Expenditure in the Slovak Republic

    OpenAIRE

    Rauf Gönenç; Peter Walkenhorst

    2004-01-01

    Over the past decade, public expenditure in Slovakia was characterised by substantial social transfers and high public sector wage expenses. This paper analyses the main features of Slovakia’s public expenditure system, reviews expenditure trends, and discusses recent reform initiatives. The latter have concerned the introduction of medium-term budget projections, the switch towards performance-based budgeting, the limitation of extra-budgetary funds, the devolution of spending power to sub-c...

  3. Angola : Public Expenditure Management and Financial Accountability

    OpenAIRE

    World Bank

    2005-01-01

    One of the most salient features of Angola's public expenditure management and financial accountability framework is the coexistence of two parallel, but articulated, expenditure execution systems: the conventional system, coordinated by the National Treasury Directorate, and a non-conventional one centered around the national oil company Sonangol. A standard assessment of a country's fiscal framework would usually concentrate on the conventional system; the Public Expenditure Management and ...

  4. Sugar Production, Consumption, and Consumer Expenditure Analysis

    OpenAIRE

    Adrian Stancu

    2014-01-01

    The paper examines, firstly, the connection among sugar production, sugar consumption and population number. Secondly, it highlights the relationship between sugar consumption and the weight of sugar and confectionery consumer expenditure in the food and non-alcoholic beverages consumer expenditure category as well as in disposable income. Two matrices of countries were proposed based on the sugar consumption and the weight of sugar and confectionery consumer expenditure in the food and non-a...

  5. Household energy and consumption and expenditures, 1990

    International Nuclear Information System (INIS)

    The purpose of this supplement to the Household Energy Consumption and Expenditures 1990 report is to provide information on the use of energy in residential housing units, specifically at the four Census regions and nine Census division levels. This report includes household energy consumption, expenditures, and prices for natural gas, electricity, fuel oil, liquefied petroleum gas (LPG), and kerosene as well as household wood consumption. For national-level data, see the main report, Household Energy Consumption and Expenditures 1990

  6. A multivariate nonlinear analysis of tourism expenditures

    OpenAIRE

    Marta Disegna; Fabrizio Durante; Enrico Foscolo

    2013-01-01

    Independence among different tourism expenditure categories is the most convenient hypothesis for modeling decision–making processes. Nevertheless, the best-suited framework would require dependence among expenditures in order to face individual budget and ordered choices. To this end we provide a new multivariate copula-based logit model with explanatory variables. We applied our tools to the expenditures of the foreign tourists visiting South–Tyrol (Northern Italy), and we underlined the ne...

  7. Public Expenditure Management in Poland

    OpenAIRE

    Andrew Burns; Kwang-Yeol Yoo

    2002-01-01

    This paper assesses the public expenditure system in Poland and the scope for its reform. Though a number of important steps to control the future evolution of spending, such as pension reform and healthcare reform, have already made in Poland, much more needs to be done. Indeed budget consolidation and the government’s goal of increasing the economy’s potential rate of growth can best be achieved by a far ranging re-evaluation and reorientation of spending away from personal transfers that c...

  8. Geographic Distribution of VA Expenditures FY1996

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  9. Geographic Distribution of VA Expenditures FY2002

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  10. Geographic Distribution of VA Expenditures FY2003

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  11. Geographic Distribution of VA Expenditures FY1998

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  12. Geographic Distribution of VA Expenditures FY2008

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  13. Geographic Distribution of VA Expenditures FY2012

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  14. Geographic Distribution of VA Expenditures FY2006

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  15. Geographic Distribution of VA Expenditures FY2001

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  16. Geographic Distribution of VA Expenditures FY2000

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  17. Geographic Distribution of VA Expenditures FY2005

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  18. Geographic Distribution of VA Expenditures FY2004

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  19. Geographic Distribution of VA Expenditures FY2009

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  20. Geographic Distribution of VA Expenditures FY2010

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  1. Geographic Distribution of VA Expenditures FY2007

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  2. Geographic Distribution of VA Expenditures FY2011

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  3. Geographic Distribution of VA Expenditures FY1999

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  4. Geographic Distribution of VA Expenditures FY1997

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  5. Geographic Distribution of VA Expenditures FY2013

    Data.gov (United States)

    Department of Veterans Affairs — This report details VA expenditures at the state, county, and Congressional District level. It includes categories such as Compensation and Pension, Construction,...

  6. State energy price and expenditure report 1990

    International Nuclear Information System (INIS)

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the United States. The estimates are provided by energy source and economic sector. This report is an update of the State Energy Price and Expenditure Report 1989 published in September 1991. Energy price and expenditure estimates are published for the years 1970, 1975, 1980, and 1985 through 1990. Documentation follows the tables and describes how the price estimates are developed, including sources of data, methods of estimation, and conversion factors applied

  7. Catastrophic Fires in the Russian Federation

    Science.gov (United States)

    Sukhinin, A. I.; Soja, A. J.; McRae, D. J.; Cahoon, D. R.; Stocks, B. J.; Dubrovskaya, O. A.; Ji-Zhong, J.; Flannigan, M.; DeGroot, B.; Westberg, D.; Stackhouse, P. W.; Conard, S. G.; Hao, W. M.

    2011-12-01

    Impacts of climate change on the severity of wildfires and the implications for carbon emissions in the boreal zone are globally significant because Russia contains two-thirds of the world's boreal forest and peat lands. Wildfires in Russia burn from 2 to 20 million ha annually, depending on burning conditions, yet quantification of trends in fire patterns is hampered by the lack of accurate historic fire data. Official Russian wildfire records greatly underestimate burned areas. However, satellite data for Russia have become easily available for assessing area burned since 1980, and we are in the process of analyzing these data to map historic burned area and fire patterns. Catastrophic fire refers to large, uncontrollable fires that are associated with extreme weather conditions. In Russia, major catastrophic fire events are associated with stable anticyclonic systems, which lead to severe drought that supports extreme fire behavior. These forest fires result in large areas burned and high consumption of vegetation and organic soil horizons. Additionally, thick smoke can reduce visibility, which often paralyzes suppression efforts. In recent years, there have been several large and often economically devastating fire complexes across Russia (European Russia, Tyva, Sakha, Chita and the Far East). We present evidence of the association of these large fires with very high or extreme fire weather danger. We assert that these large fire systems have increased in severity in response to current changes in weather and climate, and we argue that catastrophic fires are likely to increase in the future, as climate warms in the northern hemisphere upper latitudes of Russia.

  8. A unified approach of catastrophic events

    Directory of Open Access Journals (Sweden)

    S. Nikolopoulos

    2004-01-01

    Full Text Available Although there is an accumulated charge of theoretical, computational, and numerical work, like catastrophe theory, bifurcation theory, stochastic and deterministic chaos theory, there is an important feeling that these matters do not completely cover the physics of real catastrophic events. Recent studies have suggested that a large variety of complex processes, including earthquakes, heartbeats, and neuronal dynamics, exhibits statistical similarities. Here we are studying in terms of complexity and non linear techniques whether isomorphic signatures emerged indicating the transition from the normal state to the both geological and biological shocks. In the last 15 years, the study of Complex Systems has emerged as a recognized field in its own right, although a good definition of what a complex system is, actually is eluded. A basic reason for our interest in complexity is the striking similarity in behaviour close to irreversible phase transitions among systems that are otherwise quite different in nature. It is by now recognized that the pre-seismic electromagnetic time-series contain valuable information about the earthquake preparation process, which cannot be extracted without the use of important computational power, probably in connection with computer Algebra techniques. This paper presents an analysis, the aim of which is to indicate the approach of the global instability in the pre-focal area. Non-linear characteristics are studied by applying two techniques, namely the Correlation Dimension Estimation and the Approximate Entropy. These two non-linear techniques present coherent conclusions, and could cooperate with an independent fractal spectral analysis to provide a detection concerning the emergence of the nucleation phase of the impending catastrophic event. In the context of similar mathematical background, it would be interesting to augment this description of pre-seismic electromagnetic anomalies in order to cover biological

  9. Income Imputation and the Analysis of Expenditure Data in the Consumer Expenditure Survey

    OpenAIRE

    Jonathan Fisher

    2006-01-01

    The Consumer Expenditure (CE) Survey began imputing income in its 2004 data. Imputation predicts income for households that reported receiving income but failed to report a specific value. In this study, I examine how income imputation affects analysis of the CE expenditure data. Most importantly, research that uses both income and expenditures from 2004 on will not have to restrict the sample to households that reported income. The expenditure results most sensitive to the introduction of in...

  10. Eurozone Imbalances: Measuring the Contribution of Expenditure Switching and Expenditure Volumes 1990-2013

    OpenAIRE

    Enno Schröder

    2015-01-01

    This paper introduces a decomposition of the trade ratio. The dynamics of the trade ratio are composed of contributions from expenditure switching, from the terms of trade, and from relative expenditure (i.e. the ratio of foreign to domestic expenditure). Country-specific, dynamically tradeweighted indicators of foreign expenditure are constructed for use in the application of the decomposition to 11 euro area countries in 1990-2013. Over 1999-2007, Germany and Spain shared the same pattern o...

  11. Remittances, expenditure patterns, and gender: Parametric and semiparametric evidence from Ecuador

    OpenAIRE

    Göbel, Kristin

    2013-01-01

    This study estimates the impact of migrants' remittances on households' spending decisions in Ecuador. Applying both parametric and semiparametric techniques, we find strong evidence that remittances enhance expenditures on education, health, and housing, but decrease expenditures on food. This supports the hypotheses that these inflows result in a stronger human capital accumulation and therefore improve the long-run production possibilities. We do not find strong differences in the impact o...

  12. Burkina Faso : The Budget as Centerpiece of PRSP Implementation, Public Expenditure Review

    OpenAIRE

    World Bank

    2005-01-01

    This Public expenditure Review (PER) builds on budget procedures and budget implementation, following three years of Poverty Reduction Strategy Paper (PRSP) implementation. It reviews progress in budget management, and budget priorities, proposes a closer institutional integration of programmatic budgeting with the PRSP process, and reviews recent developments, and expenditure policies in the health, and education sectors. The PER focuses on the budget process, which is formally transparent, ...

  13. Analysis and implications of the determinants of healthcare expenditure in African countries.

    Science.gov (United States)

    Okunade, Albert A

    2005-11-01

    The income elasticity of health care spending in the OECD countries tends toward luxury good values. Similar studies, based on more recent data, and capable of informing macroeconomic health policies of the African countries, do not currently exist. How the health care expenditure in Africa responds to changes in the Gross Domestic Products (GDP), Official Development Assistance (ODA), and other determinants, is also relevant for health policy because health care is a necessity in the 'basic needs' theory of economic development. This paper presents econometric model findings of the determinants of per-capita health expenditure (in PPPs) for 26 African countries, using the flexible Box-Cox model regression methods and 1995 cross-sectional data (sources: WRI, UNEP, UNDP, The World Bank). The economic and other determinants, capturing 74 percent of the variations in health expenditures, include per-capita GDP (in PPPs), ODA (US dollar), Gini income inequality index, population dependency ratio, internal conflicts, and the percentage of births attended by trained medical workers. Income inequality dampens, while the ODA and population per health personnel raise health care expenditure. The GDP elasticity of about 0.6 signals the tendency for health care to behave like a technical 'necessity'. Implications for sustainable basic health development policies are discussed. PMID:16379410

  14. Bankruptcy by catastrophes for major multi-nationals: stock exchange sensitivity for three catastrophes

    NARCIS (Netherlands)

    Van Gulijk, C.; Ale, B.J.M.

    2012-01-01

    This paper investigates the effect of major catastrophes have on stock exchange values for the major multi-nationals. The paper demonstrates that the Sharpe analysis is more sensitive in identifying effects than just following the daily stock values for assessing market response. It was found that m

  15. Catastrophes and conservation: Lessons from sea otters and the Exxon Valdez

    International Nuclear Information System (INIS)

    In this commentary, the author considers the effort to save sea otters after the Exxon Valdez oil spill. Despite immense expenditures, the emerging facts lead to two conclusions: population losses were poorly documented, and few animals were saved. These findings cast doubt on our ability to protect sea otters from future spills and lead to troubling questions about how to recognize and document the effects of catastrophic events, and, ultimately, the utility of highly visible and expensive efforts to save wildlife from perceived environmental catastrophes. On 24 March 1989, the Exxon Valdez ran aground on Bligh Reef in northeastern Prince William Sound, spilling more than 10 million gallons of crude oil. Catastrophic losses were expected and a monumental effort was made to save sea otters. The Exxon Valdez spill spread over a linear distance of more than 700 kilometers and soiled an estimated 5,300 kilometers of shoreline. While cleaning up and capturing oiled wildlife for rehabilitation, 878 sea otter carcasses were recovered - a minimal estimate of loss. However, many animals killed by the spill undoubtedly were not found. Losses have been estimated from pre- and post-spill surveys, although these surveys shed little light on the population-level effect, mainly because the size and distribution of the population just prior to the spill is poorly known. This is because a comprehensive survey of Prince William Sound and adjacent waters was not done immediately after the spill but before oil dispersed into southwestern Prince William Sound and the northern Gulf of Alaska. Thus, although the Exxon Valdez spill undoubtedly killed many sea otters and may have reduced populations substantially, available data lack the power to demonstrate population changes

  16. Averting Catastrophes: The Strange Economics of Scylla and Charybdis

    OpenAIRE

    Martin, Ian; Pindyck, R. S.

    2014-01-01

    How should we evaluate public policies or projects to avert, or reduce the likelihood of, a catastrophic event? Examples might include inspection and surveillance programs to avert nuclear terrorism, investments in vaccine technologies to help respond to a "mega-virus," or the construction of levees to avert major flooding. A policy to avert a particular catastrophe considered in isolation might be evaluated in a cost-benefit framework. But because society faces multiple potential catastrophe...

  17. Mutation accumulation and the catastrophic senescence of Pacific salmon

    CERN Document Server

    Penna, T J P; Stauffer, D; Stauffer, Dietrich

    1995-01-01

    The bit-string model of biological aging is used to simulate the catastrophic senescence of Pacific Salmon. We have shown that reproduction occuring only once and at a fixed age is the only ingredient needed to explain the catastrophic senescence according the mutation accumulation theory. Several results are presented, some of them with up to 10^8 fishes, showing how the survival rates in catastrophic senescence are affected by changes in the parameters of the model.

  18. Death, Catastrophe, and the Significance of Tragedy

    Directory of Open Access Journals (Sweden)

    Jennifer Ballengee

    2014-05-01

    Full Text Available This NANO note will examine the tension between representation, memorial, and the catastrophe of death that emerges in the space of tragedy, as the problem arises in two quite different works: Oedipus at Colonus, a fairly typical fifth-century Greek tragedy, and Falling Man, Don DeLillo’s novel that, in its attempt to address the events of 9/11, reflects in form and subject matter many of Aristotle’s terms of tragic representation. It is not the intent of this note to engage with the recent proliferation of work in “performance theory.” Rather than being concerned with an imagined exchange between audience and actor, this study examines how the supplementary relationship of gesture and speech in tragedy disrupts the public/private distinction, and how this articulation effects and enables the public memorialization of death. Thus, this paper will consider the representation of death as an event whose catastrophic, and somewhat mysterious, collision of the public and the private lends it its tragic significance.

  19. Inside Money, Procyclical Leverage, and Banking Catastrophes

    Science.gov (United States)

    Brummitt, Charles D.; Sethi, Rajiv; Watts, Duncan J.

    2014-01-01

    We explore a model of the interaction between banks and outside investors in which the ability of banks to issue inside money (short-term liabilities believed to be convertible into currency at par) can generate a collapse in asset prices and widespread bank insolvency. The banks and investors share a common belief about the future value of certain long-term assets, but they have different objective functions; changes to this common belief result in portfolio adjustments and trade. Positive belief shocks induce banks to buy risky assets from investors, and the banks finance those purchases by issuing new short-term liabilities. Negative belief shocks induce banks to sell assets in order to reduce their chance of insolvency to a tolerably low level, and they supply more assets at lower prices, which can result in multiple market-clearing prices. A sufficiently severe negative shock causes the set of equilibrium prices to contract (in a manner given by a cusp catastrophe), causing prices to plummet discontinuously and banks to become insolvent. Successive positive and negative shocks of equal magnitude do not cancel; rather, a banking catastrophe can occur even if beliefs simply return to their initial state. Capital requirements can prevent crises by curtailing the expansion of balance sheets when beliefs become more optimistic, but they can also force larger price declines. Emergency asset price supports can be understood as attempts by a central bank to coordinate expectations on an equilibrium with solvency. PMID:25136959

  20. Inside money, procyclical leverage, and banking catastrophes.

    Science.gov (United States)

    Brummitt, Charles D; Sethi, Rajiv; Watts, Duncan J

    2014-01-01

    We explore a model of the interaction between banks and outside investors in which the ability of banks to issue inside money (short-term liabilities believed to be convertible into currency at par) can generate a collapse in asset prices and widespread bank insolvency. The banks and investors share a common belief about the future value of certain long-term assets, but they have different objective functions; changes to this common belief result in portfolio adjustments and trade. Positive belief shocks induce banks to buy risky assets from investors, and the banks finance those purchases by issuing new short-term liabilities. Negative belief shocks induce banks to sell assets in order to reduce their chance of insolvency to a tolerably low level, and they supply more assets at lower prices, which can result in multiple market-clearing prices. A sufficiently severe negative shock causes the set of equilibrium prices to contract (in a manner given by a cusp catastrophe), causing prices to plummet discontinuously and banks to become insolvent. Successive positive and negative shocks of equal magnitude do not cancel; rather, a banking catastrophe can occur even if beliefs simply return to their initial state. Capital requirements can prevent crises by curtailing the expansion of balance sheets when beliefs become more optimistic, but they can also force larger price declines. Emergency asset price supports can be understood as attempts by a central bank to coordinate expectations on an equilibrium with solvency. PMID:25136959

  1. Effect of Neuromuscular Electrical Muscle Stimulation on Energy Expenditure in Healthy Adults

    Directory of Open Access Journals (Sweden)

    Ya-Ju Chang

    2011-02-01

    Full Text Available Weight loss/weight control is a major concern in prevention of cardiovascular disease and the realm of health promotion. The primary aim of this study was to investigate the effect of neuromuscular electrical stimulation (NMES at different intensities on energy expenditure (oxygen and calories in healthy adults. The secondary aim was to develop a generalized linear regression (GEE model to predict the increase of energy expenditure facilitated by NMES and identify factors (NMES stimulation intensity level, age, body mass index, weight, body fat percentage, waist/hip ratio, and gender associated with this NMES-induced increase of energy expenditure. Forty sedentary healthy adults (18 males and 22 females participated. NMES was given at the following stimulation intensities for 10 minutes each: sensory level (E1, motor threshold (E2, and maximal intensity comfortably tolerated (E3. Cardiopulmonary gas exchange was evaluated during rest, NMES, and recovery stage. The results revealed that NMES at E2 and E3 significantly increased energy expenditure and the energy expenditure at recovery stage was still significantly higher than baseline. The GEE model demonstrated that a linear dose-response relationship existed between the stimulation intensity and the increase of energy expenditure. No subject’s demographic or anthropometric characteristics tested were significantly associated with the increase of energy expenditure. This study suggested NMES may be used to serve as an additional intervention for weight loss programs. Future studies to develop electrical stimulators or stimulation electrodes to maximize the comfort of NMES are recommended.

  2. Gradient catastrophe and flutter in vortex filament dynamics

    CERN Document Server

    Konopelchenko, B G

    2011-01-01

    Gradient catastrophe and flutter instability in the motion of vortex filament within the localized induction approximation are analyzed. It is shown that the origin if this phenomenon is in the gradient catastrophe for the dispersionless Da Rios system which describes motion of filament with slow varying curvature and torsion. Geometrically this catastrophe manifests as a rapid oscillation of a filament curve in a point that resembles the flutter of airfoils. Analytically it is the elliptic umbilic singularity in the terminology of the catastrophe theory. It is demonstrated that its double scaling regularization is governed by the Painlev\\'e-I equation.

  3. Gradient catastrophe and flutter in vortex filament dynamics

    International Nuclear Information System (INIS)

    Gradient catastrophe and flutter instability in the motion of a vortex filament within the localized induction approximation are analyzed. It is shown that the origin of this phenomenon is in the gradient catastrophe for the dispersionless Da Rios system which describes the motion of a filament with slow varying curvature and torsion. Geometrically, this catastrophe manifests as a rapid oscillation of a filament curve in a point that resembles the flutter of airfoils. Analytically, it is the elliptic umbilic singularity in the terminology of the catastrophe theory. It is demonstrated that its double scaling regularization is governed by the Painleve-I equation. (fast track communication)

  4. Gradient catastrophe and flutter in vortex filament dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Konopelchenko, B G [Dipartimento di Fisica, Universita del Salento and INFN, Sezione di Lecce, 73100 Lecce (Italy); Ortenzi, G, E-mail: giovanni.ortenzi@unimib.it [Dipartimento di Matematica Pura ed Applicazioni, Universita di Milano Bicocca, 20125 Milano (Italy)

    2011-10-28

    Gradient catastrophe and flutter instability in the motion of a vortex filament within the localized induction approximation are analyzed. It is shown that the origin of this phenomenon is in the gradient catastrophe for the dispersionless Da Rios system which describes the motion of a filament with slow varying curvature and torsion. Geometrically, this catastrophe manifests as a rapid oscillation of a filament curve in a point that resembles the flutter of airfoils. Analytically, it is the elliptic umbilic singularity in the terminology of the catastrophe theory. It is demonstrated that its double scaling regularization is governed by the Painleve-I equation. (fast track communication)

  5. The Chernobyl catastrophe consequences in the Republic of Belarus. National report

    International Nuclear Information System (INIS)

    The estimation of radioecological, medico-biological, economic and social consequences of the Chernobyl catastrophe has shown that unimaginable damage was incurred on Belarus and its territory became the zone of ecological calamity. The Chernobyl NPP catastrophe has led to the contamination of almost the fourth part of the territory of Belarus where there lived 2,2 million people. The damage caused to the republic by the catastrophe makes up 32 annual budgets of the republic of the pre-accident period in account for the 30-years period for its overcoming. Radioecological situation in Belarus is characterized by complexity and heterogeneous contamination of the territory by different radionuclides and their presence on all the components of the environment. It stipulates the plurality of ways of external and internal irradiation of the population and jeopardizes its health. There is registered the worsening of the population's health, of evacuated and inhabiting the contaminated areas as well, with increase of a number of somatic diseases, including oncological diseases, there are disorders in the metabolic processes and functions of the main systems of the organism. The demographic indices are decreasing. Particular concern causes the children's morbidity growth and genetic consequences of the accident. The contamination of agricultural lands has stipulated in the neighboring the Chernobyl NPP zone the impossibility of their use for food production. On the other lands it has been required to re-profile the farms and create new technologies of the agricultural production. There have been revealed the destructive tendencies in all spheres of the life activity of people who experienced radiation effects. The processes of social adaptation and socio-psychological support of the population require considerable optimization. In spite of that for ten years passed after the catastrophe the discrepancy of its estimations has not been overcome completely. At the same time

  6. Virtual reality exposure therapy as treatment for pain catastrophizing in fibromyalgia patients: proof-of-concept study (Study Protocol

    Directory of Open Access Journals (Sweden)

    Spottiswoode Bruce

    2011-04-01

    in FMS patients. Proof-of-concept will either be established or negated. The results of this project are envisaged to revolutionize FMS and pain catastrophizing research and in the future, assist health professionals and FMS patients in reducing despondency regarding FMS management. Trial registration PACTR201011000264179

  7. Pharmaceutical expenditure changes in Serbia and Greece during the global economic recession

    OpenAIRE

    Mihajlo (Michael) Jakovljevic; Kyriakos Souliotis

    2016-01-01

    Aim: Clarity on health expenditures is essential for the timely identification of risks that jeopardize the democratic provision of health services and the credibility of health insurance systems. Furthermore, observing health outcomes with geographical scope is essential for making multilateral associations. This study aimed at conveying information on the variability of important economic parameters of the health sector of Serbia and Greece from 2007 to 2012, when the most serious financial...

  8. State energy price and expenditure report 1989

    Energy Technology Data Exchange (ETDEWEB)

    1991-09-30

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates for the 50 States, the District of Columbia, and the United States. The estimates are provided by energy source (e.g., petroleum, natural gas, coal, and electricity) and by major consuming or economic sector. This report is an update of the State Energy Price and Expenditure Report 1988 published in September 1990. Changes from the last report are summarized in a section of the documentation. Energy price and expenditure estimates are published for the years 1970, 1975, 1980, and 1985 through 1989. Documentation follows the tables and describes how the price estimates are developed, including sources of data, methods of estimation, and conversion factors applied. Consumption estimates used to calculate expenditures, and the documentation for those estimates, are from the State Energy Data Report, Consumption Estimates, 1960--1989 (SEDR), published in May 1991. Expenditures are calculated by multiplying the price estimates by the consumption estimates, adjusted to remove process fuel and intermediate product consumption. All expenditures are consumer expenditures, that is, they represent estimates of money directly spent by consumers to purchase energy, generally including taxes. 11 figs., 43 tabs.

  9. Uganda Sustainable Land Management : Public Expenditure Review

    OpenAIRE

    World Bank

    2008-01-01

    This report summarizes the findings of the Uganda Sustainable Land Management Public Expenditure Review (SLM PER). The SLM PER was undertaken to achieve six main objectives: (i) establish a robust data base on SLM-related public expenditure that can support credible empirical analysis; (ii) develop a sound methodology for conducting SLM PERs, which could guide similar work in the future; (...

  10. State energy price and expenditure report 1989

    International Nuclear Information System (INIS)

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates for the 50 States, the District of Columbia, and the United States. The estimates are provided by energy source (e.g., petroleum, natural gas, coal, and electricity) and by major consuming or economic sector. This report is an update of the State Energy Price and Expenditure Report 1988 published in September 1990. Changes from the last report are summarized in a section of the documentation. Energy price and expenditure estimates are published for the years 1970, 1975, 1980, and 1985 through 1989. Documentation follows the tables and describes how the price estimates are developed, including sources of data, methods of estimation, and conversion factors applied. Consumption estimates used to calculate expenditures, and the documentation for those estimates, are from the State Energy Data Report, Consumption Estimates, 1960--1989 (SEDR), published in May 1991. Expenditures are calculated by multiplying the price estimates by the consumption estimates, adjusted to remove process fuel and intermediate product consumption. All expenditures are consumer expenditures, that is, they represent estimates of money directly spent by consumers to purchase energy, generally including taxes. 11 figs., 43 tabs

  11. Does the pharmacy expenditure of patients always correspond with their morbidity burden? Exploring new approaches in the interpretation of pharmacy expenditure

    Directory of Open Access Journals (Sweden)

    Abad-Díez José

    2010-05-01

    Full Text Available Abstract Background The computerisation of primary health care (PHC records offers the opportunity to focus on pharmacy expenditure from the perspective of the morbidity of individuals. The objective of the present study was to analyse the behaviour of pharmacy expenditure within different morbidity groups. We paid special attention to the identification of individuals who had higher values of pharmacy expenditure than their morbidity would otherwise suggest (i.e. outliers. Methods Observational study consisting of 75,574 patients seen at PHC centres in Zaragoza, Spain, at least once in 2005. Demographic and disease variables were analysed (ACG® 8.1, together with a response variable that we termed 'total pharmacy expenditure per patient'. Outlier patients were identified based on boxplot methods, adjusted boxplot for asymmetric distributions, and by analysing standardised residuals of tobit regression models. Results The pharmacy expenditure of up to 7% of attendees in the studied PHC centres during one year exceeded expectations given their morbidity burden. This group of patients was responsible for up to 24% of the total annual pharmacy expenditure. There was a significantly higher number of outlier patients within the low-morbidity band which matched up with the higher variation coefficient observed in this group (3.2 vs. 2.0 and 1.3 in the moderate- and high-morbidity bands, respectively. Conclusions With appropriate validation, the methodologies of the present study could be incorporated in the routine monitoring of the prescribing profile of general practitioners. This could not only enable evaluation of their performance, but also target groups of outlier patients and foster analyses of the causes of unusually high pharmacy expenditures among them. This interpretation of pharmacy expenditure gives new clues for the efficiency in utilisation of healthcare resources, and could be complementary to management interventions focused on

  12. 76 FR 36000 - Rulemaking Petition: Independent Expenditure Reporting

    Science.gov (United States)

    2011-06-21

    ... 11 CFR Part 109 Rulemaking Petition: Independent Expenditure Reporting AGENCY: Federal Election... expenditures by persons other than political committees. The Petition is available for inspection in the... committees], including corporations and labor organizations, which make independent expenditures, in order...

  13. Corporate Demand for Insurance: An Empirical Analysis of the U.S. Market for Catastrophe and Non-Catastrophe Risks

    OpenAIRE

    Michel-Kerjan, Erwann; Raschky, Paul A.; Kunreuther, Howard C.

    2009-01-01

    This paper tests some existing theories developed over the past 25 years on corporate demand for insurance. Using a unique dataset of 1,809 large U.S. corporations it provides the first empirical analysis that compares corporate demand for standard property insurance and for catastrophe coverage (here, terrorism). We find that larger companies are more likely to have some catastrophe coverage. Corporate demand for catastrophe insurance is found to be more price inelastic than insurance for no...

  14. Government expenditure and energy intensity in China

    International Nuclear Information System (INIS)

    The recent economic stimulus package of China has raised growing concern about its potential impact on energy demand and efficiency. To what extent does such expansion of government expenditure influence energy intensity? This question has not been well answered by the previous research. Using provincial panel data, this paper provides some evidence of a link between government expenditure and energy intensity in China. The empirical results demonstrate that the expansion of government expenditure since Asian financial crisis has exerted a significant influence on energy intensity. An increase in government expenditure in China leads to an increase in energy intensity. Further analysis compares such relationships in different economic situations. The comparison shows that such positive effect of government expenditure remains significant after the alteration in economic situation. Therefore, the results suggest introducing some measures to consolidate China's existing gains in energy efficiency. The analysis also explains why the downward trend in energy intensity is reversed in China since 2002. (author)

  15. State energy price and expenditure report, 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 States and the District of Columbia and in aggregate for the US. The estimates developed in the State Energy Price and Expenditure Data System (SEPEDS) are provided by energy source and economic sector and are published for the years 1970 through 1995. Data for all years are available on a CD-ROM and via Internet. Consumption estimates used to calculate expenditures and the documentation for those estimates are taken from the State Energy Data Report 1995, Consumption Estimates (SEDR), published in December 1997. Expenditures are calculated by multiplying the price estimates by the consumption estimates, which are adjusted to remove process fuel; intermediate petroleum products; and other consumption that has no direct fuel costs, i.e., hydroelectric, geothermal, wind, solar, and photovoltaic energy sources.

  16. Government expenditure and energy intensity in China

    Energy Technology Data Exchange (ETDEWEB)

    Yuxiang, Karl [School of Economics and Business Administration, Room 230 of the 11th Dormitory at Campus B, Chongqing University, Chongqing 400044 (China); Chen, Zhongchang [Center for Population, Resources, and Environment Research, Chongqing University, Chongqing 400044 (China)

    2010-02-15

    The recent economic stimulus package of China has raised growing concern about its potential impact on energy demand and efficiency. To what extent does such expansion of government expenditure influence energy intensity? This question has not been well answered by the previous research. Using provincial panel data, this paper provides some evidence of a link between government expenditure and energy intensity in China. The empirical results demonstrate that the expansion of government expenditure since Asian financial crisis has exerted a significant influence on energy intensity. An increase in government expenditure in China leads to an increase in energy intensity. Further analysis compares such relationships in different economic situations. The comparison shows that such positive effect of government expenditure remains significant after the alteration in economic situation. Therefore, the results suggest introducing some measures to consolidate China's existing gains in energy efficiency. The analysis also explains why the downward trend in energy intensity is reversed in China since 2002. (author)

  17. Determinants of Healthcare Expenditure in Economic Cooperation Organization (ECO Countries: Evidence from Panel Cointegration Tests

    Directory of Open Access Journals (Sweden)

    Enayatollah Homaie Rad

    2013-05-01

    Full Text Available Background Over the last decade there has been an increase in healthcare expenditures while at the same time the inequity in distribution of resources has grown. These two issues have urged the researchers to review the determinants of healthcare expenditures. In this study, we surveyed the determinants of health expenditures in Economic Cooperation Organization (ECO countries. Methods We used Panel data econometrics methods for the purpose of this research. For long term analysis, we used Pesaran cross sectional dependency test followed by panel unit root tests to show first whether the variables were stationary or not. Upon confirmation of no stationary variables, we used Westerlund panel cointegration test in order to show whether long term relationships exist between the variables. At the end, we estimated the model with Continuous-Updated Fully Modified (CUP-FM estimator. For short term analysis also, we used Fixed Effects (FE estimator to estimate the model. Results A long term relationship was found between the health expenditures per capita and GDP per capita, the proportion of population below 15 and above 65 years old, number of physicians, and urbanisation. Besides, all the variables had short term relationships with health expenditures, except for the proportion of population above 65 years old. Conclusion The coefficient of GDP was below 1 in the model. Therefore, health is counted as a necessary good in ECO countries and governments must pay due attention to the equal distribution of health services in all regions of the country.

  18. Madame Bovary and Catastrophism: Revolving narratives

    Directory of Open Access Journals (Sweden)

    Ruth Morris

    2011-07-01

    Full Text Available Cet article relie Madame Bovary au contexte scientifique français des années 1850, en lisant le roman de Flaubert à la lumière des théories de Cuvier. Le savant français Georges Cuvier, avec nombre de ses contemporains, explique les origines du monde à l’aide de la théorie des catastrophes. D’après cette théorie, le monde est divisé en périodes très courtes ponctuées de grandes catastrophes ou, en termes cuviériens, de « révolutions » qui ont éradiqué toute vie et ont permis au monde d’être entièrement repeuplé. Une telle conception affecte l’idée même du « temps ». Cuvier pense que la formation de la Terre est relativement récente, l’époque présente n’étant vieille que de cinq mille ans. Cette compression temporelle peut être rapportée à Madame Bovary dont le « tempo » s’accroît au fur et à mesure qu’on se rapproche du dénouement. Dans la théorie des catastrophes comme dans le roman, le temps ne suit pas une ligne chronologique. Les « révolutions » viennent briser le fil continu du temps et Emma est souvent incapable de distinguer entre le passé, le présent et le futur. Les « révolutions » servent aussi à ponctuer et à perturber le cours de la vie sur Terre en produisant des événements majeurs dans l’histoire du globe. Il en est de même dans la vie d’Emma. Son existence est marquée par des événements majeurs, comme le bal, qui créent un éclatement et une fragmentation de la temporalité, comme dans la théorie de Cuvier. Je défendrai aussi l’idée d’un lien entre la soudaineté et la violence des « révolutions » et les crises nerveuses d’Emma, qui surviennent brusquement et relèvent de l’hystérie. La conception cuviérienne de la temporalité doit enfin être envisagée au regard des théories de l’évolution, ce qui implique de réévaluer les notions d’adaptation, d’hérédité et de mort dans le roman de Flaubert.This paper locates Madame

  19. Public expenditure and drug policies in Bulgaria in 2014

    Directory of Open Access Journals (Sweden)

    Toni Yonkov Vekov

    2015-11-01

    National Health Insurance Fund in Bulgaria on the stability of the healthcare insurance model and the implementation of the budget for 2014. Results: The results from the current analysis indicate that the growth of public expenditure is directly proportional to the number of reimbursed medical products and that the pattern of prescriptions including the innovative medical products mainly for the treatment of oncological and rare diseases has a significant impact on it. Conclusion: The reasons for the increase of public expenditure in Bulgaria include the non-transparent decisions in pricing and reimbursement of the products, the lack of guidelines for presenting pharmacological evidence and the lack of legislatively-defined drug policies for the management and control of the patterns of medical prescriptions.

  20. ANALYSIS OF PUBLIC EXPENDITURE IN ROMANIA DURING 1995-2009

    OpenAIRE

    ANA-PETRINA STANCIU

    2011-01-01

    The objective of this paper is to analyze the evolution of Romania’s public expenditure during the period 1995-2009. Expenditure analysis involves tracking their evolution in absolute and relative size, determining the share of public expenditure within the GDP, as well as determining the level of total public expenditure and of each category of expenditure per capita. At the same time there are several econometric models used in optimizing public expenditure for the various economic sectors ...

  1. Copula bivariate probit models: with an application to medical expenditures.

    Science.gov (United States)

    Winkelmann, Rainer

    2012-12-01

    The bivariate probit model is frequently used for estimating the effect of an endogenous binary regressor (the 'treatment') on a binary health outcome variable. This paper discusses simple modifications that maintain the probit assumption for the marginal distributions while introducing non-normal dependence using copulas. In an application of the copula bivariate probit model to the effect of insurance status on the absence of ambulatory health care expenditure, a model based on the Frank copula outperforms the standard bivariate probit model. PMID:22025413

  2. An Analysis of Education Expenditures in the Welfare State in the Post 1980 Period in Turkey

    Directory of Open Access Journals (Sweden)

    Düriye Toprak

    2016-06-01

    Full Text Available  The welfare state that had become stronger gradually in the post-2nd World War has been in the process of restructuring after the 1980 period as a result of globalisation and neo-liberal policies. Social welfare state has had responsibilities in different fields ranging from health to education and from social security to poverty reduction. In Turkey, the education expenditures may be accepted as social expenditures contributing to general social welfare of the society. The goal of this study is to explain the social welfare state briefly, to review the methodological approaches to social expenditures in the context of the social welfare state, and to examine and compare the level of education expenditures in Turkey and some other countries. 

  3. Using administrative data to estimate population displacement and resettlement following a catastrophic U.S. disaster

    OpenAIRE

    Plyer, Allison; Bonaguro, Joy; Hodges, Ken

    2009-01-01

    After a large scale evacuation, authorities need to know the new and frequently changing population distributions in order to meet needs for housing, schools, health care, and other services. This paper reviews literature from the fields of demography and other disciplines to identify available administrative data sets that can form the basis of sound, relevant, and timely county-level population estimates following a catastrophic U.S. event. The most appropriate data to estimate population i...

  4. Catastrophic Incident Recovery: Long-Term Recovery from an Anthrax Event Symposium

    Energy Technology Data Exchange (ETDEWEB)

    Lesperance, Ann M.

    2008-06-30

    On March 19, 2008, policy makers, emergency managers, and medical and Public Health officials convened in Seattle, Washington, for a workshop on Catastrophic Incident Recovery: Long-Term Recovery from an Anthrax Event. The day-long symposium was aimed at generating a dialogue about restoration and recovery through a discussion of the associated challenges that impact entire communities, including people, infrastructure, and critical systems.

  5. Catastrophic Consequences of Kicking the Chameleon

    CERN Document Server

    Erickcek, Adrienne L; Burrage, Clare; Huang, Zhiqi

    2013-01-01

    The physics of the "dark energy" that drives the current cosmological acceleration remains mysterious, and the dark sector may involve new light dynamical fields. If these light scalars couple to matter, a screening mechanism must prevent them from mediating an unacceptably strong fifth force locally. Here we consider a concrete example: the chameleon mechanism. We show that the same coupling between the chameleon field and matter employed by the screening mechanism also has catastrophic consequences for the chameleon during the Universe's first minutes. The chameleon couples to the trace of the stress-energy tensor, which is temporarily non-zero in a radiation-dominated universe whenever a particle species becomes non-relativistic. These "kicks" impart a significant velocity to the chameleon field, causing its effective mass to vary non-adiabatically and resulting in the copious production of quantum fluctuations. Dissipative effects strongly modify the background evolution of the chameleon field, invalidati...

  6. Application of catastrophe theory to nuclear structure

    International Nuclear Information System (INIS)

    Three two-parameter models, one describing an A-body system (the atomic nucleus) and two describing many-body systems (the van der Waals gas and the ferroelectric (perovskite) system) are compared within the framework of catastrophe theory. It is shown that each has a critical point (second-order phase transition) when the two counteracting forces controlling it are in balance; further, each undergoes a first-order phase transition when one of the forces vanishes (the deforming force for the nucleus, the attractive force for the van der Waals gas, and the dielectric constant for the perovskite). Finally, when both parameters are kept constant, a kind of phase transition may occur at a critical angular momentum, critical pressure, and critical electric field. 3 figures, 1 table

  7. Experiments on Mixotrophic Protists and Catastrophic Darkness

    Science.gov (United States)

    Jones, Harriet; Cockell, Charles S.; Goodson, Claire; Price, Nicola; Simpson, Annika; Thomas, Benjamin

    2009-08-01

    Catastrophically darkened photic zone conditions in water bodies are postulated to be induced by a diversity of mechanisms that are recorded in the geological record, including asteroid and comet impacts and large-scale volcanic eruptions. Giant wildfires, such as those that followed the great fires in Siberia in 1915, have been directly shown to cause large reductions in sunlight penetrating to the ground. Previous studies on the response of phototrophs to s udden prolonged darkness have focused on the survival of axenic strains. In this paper, we describe laboratory experiments to investigate the survival and growth of isolated and mixed cultures of freshwater and marine mixotrophs after 6 months of darkness and in the low light that would follow these events. Mixotrophs could survive 6 months of darkness. Some species used dissolved organic carbon, which can be released from dead biomass after loss of light and was shown to improve feeding rates. Mixotrophs also improved the survival and subsequent growth of obligate phototrophs at low light levels when grown in mixed cultures. The ability of mixotrophs to switch from photosynthesis to heterotrophy following sudden darkening would not only allow them to survive but to grow and contribute to active food chains. The experiments suggest that, following the return of light, resumption of photosynthesis can be rapid. These experiments improve our understanding of the collapse of photosynthesis following catastrophic darkening and emphasize the important role of mixotrophy in the resilience of the photosynthetic biosphere during such periods. We speculate on the implications for the Cretaceous-Tertiary impact event and periods of global freezing.

  8. Grasshopper Population Ecology: Catastrophe, Criticality, and Critique

    Directory of Open Access Journals (Sweden)

    Jeffrey A. Lockwood

    2008-06-01

    Full Text Available Grasshopper population dynamics are an important part of the North American rangeland ecosystem and an important factor in the economies that derive from the rangeland. Outbreak dynamics have plagued management strategies in the rangeland, and attempts to find simple, linear and mechanistic solutions to both understanding and predicting the dynamics have proved fruitless. These efforts to ground theory in a correspondence with the “real” world, including whether the population dynamics are ultimately density dependent or density independent, have generated abundant heat but little light. We suggest that a pragmatic approach, in which theories are taken to be “tools” rather than competing claims of truth, has greater promise to move ecological research in a constructive direction. Two recent non-linear approaches exploiting the tools of complexity science provide insights relevant to explaining and forecasting population dynamics. Observation and data collection were used to structure models derived from catastrophe theory and self-organized criticality. These models indicate that nonlinear processes are important in the dynamics of the outbreaks. And the conceptual structures of these approaches provide clear, albeit constrained or contingent, implications for pest managers. We show that, although these two frameworks, catastrophe theory and self-organized criticality, are very different, the frequency distributions of time series from both systems result in power law relationships. Further, we show that a simple lattice-based model, similar to SOC but structured on the biology of the grasshoppers gives a spatial time series similar to data over a 50-year span and the frequency distribution is also a power law relationship. This demonstration exemplifies how a “both–and” rather than an “either–or” approach to ecological modeling, in which the useful elements of particular theories or conceptual structures are extracted, may

  9. Can a stochastic cusp catastrophe model explain housing market crashes?

    NARCIS (Netherlands)

    C. Diks; J. Wang

    2016-01-01

    Like stock market prices, housing prices often exhibit temporary booms and busts. A possible explanation for the observed abrupt changes is offered by the stochastic catastrophe model. This paper addresses the question whether the catastrophe model can describe and predict the dynamics of housing ma

  10. Universal Health Insurance in India: Ensuring equity, efficiency, and quality

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    2012-01-01

    Full Text Available Indian health system is characterized by a vast public health infrastructure which lies underutilized, and a largely unregulated private market which caters to greater need for curative treatment. High out-of-pocket (OOP health expenditures poses barrier to access for healthcare. Among those who get hospitalized, nearly 25% are pushed below poverty line by catastrophic impact of OOP healthcare expenditure. Moreover, healthcare costs are spiraling due to epidemiologic, demographic, and social transition. Hence, the need for risk pooling is imperative. The present article applies economic theories to various possibilities for providing risk pooling mechanism with the objective of ensuring equity, efficiency, and quality care. Asymmetry of information leads to failure of actuarially administered private health insurance (PHI. Large proportion of informal sector labor in India′s workforce prevents major upscaling of social health insurance (SHI. Community health insurance schemes are difficult to replicate on a large scale. We strongly recommend institutionalization of tax-funded Universal Health Insurance Scheme (UHIS, with complementary role of PHI. The contextual factors for development of UHIS are favorable. SHI schemes should be merged with UHIS. Benefit package of this scheme should include preventive and in-patient curative care to begin with, and gradually include out-patient care. State-specific priorities should be incorporated in benefit package. Application of such an insurance system besides being essential to the goals of an effective health system provides opportunity to regulate private market, negotiate costs, and plan health services efficiently. Purchaser-provider split provides an opportunity to strengthen public sector by allowing providers to compete.

  11. Grey forewarning and prediction for mine water inflowing catastrophe periods

    Institute of Scientific and Technical Information of China (English)

    MA Qi-hua; CAO Jian-jun

    2007-01-01

    Based on the theory of grey system, established GM (1, 1) grey catastrophe predict model for the first time in order to forecast the catastrophe periods of mine water inflowing (not the volume of water inflowing). After establishing the grey predict system of the catastrophe regularity of 10 month-average volume of water inflowing, the grey forewarning for mine water inflowing catastrophe periods was established which was used to analyze water disaster in -400 meter level of Wennan Colliery. Based on residual analysis,it shows that the result of grey predict system is almost close to the actual value. And the scene actual result also shows the reliability of prediction. Both the theoretical analysis and the scene actual result indicate feasibility and reliability of the method of grey catastrophe predict system.

  12. Household energy consumption and expenditures, 1990

    International Nuclear Information System (INIS)

    This report, Household Energy Consumption and Expenditures 1990, is based upon data from the 1990 Residential Energy Consumption Survey (RECS). Focusing on energy end-use consumption and expenditures of households, the 1990 RECS is the eighth in a series conducted since 1978 by the Energy Information Administration (EIA). Over 5,000 households were surveyed, providing information on their housing units, housing characteristics, energy consumption and expenditures, stock of energy-consuming appliances, and energy-related behavior. The information provided represents the characteristics and energy consumption of 94 million households nationwide

  13. Applications of modelling historical catastrophic events with implications for catastrophe risk management

    Science.gov (United States)

    Sorby, A.; Grossi, P.; Pomonis, A.; Williams, C.; Nyst, M.; Onur, T.; Seneviratna, P.; Baca, A.

    2009-04-01

    The management of catastrophe risk is concerned with the quantification of financial losses, and their associated probabilities, for potential future catastrophes that might impact a region. Modelling of historical catastrophe events and, in particular, the potential consequences if a similar event were to occur at the present day can provide insight to help bridge the gap between what we know can happen from historical experience and what potential losses might be out there in the "universe" of potential catastrophes. The 1908 Messina Earthquake (and accompanying local tsunami) was one of the most destructive earthquakes to have occurred in Europe and by most accounts remains Europe's most fatal with over 70,000 casualties estimated. However, what would the potential consequences be, in terms of financial and human losses, if a similar earthquake were to occur at the present day? Exposures, building stock and populations can change over time and, therefore, the consequences of a similar earthquake at the present day may sensibly differ from those observed in 1908. The city of Messina has been reconstructed several times in its history, including following the 1908 earthquake and again following the Second World War. The 1908 earthquake prompted the introduction of the first seismic design regulations in Italy and since 1909 parts of the Messina and Calabria regions have been in the zones of highest seismic coefficient. Utilizing commercial catastrophe loss modelling technology - which combines the modelling of hazard, vulnerability, and financial losses on a database of property exposures - a modelled earthquake scenario of M7.2 in the Messina Straits region of Southern Italy is considered. This modelled earthquake is used to assess the potential consequences in terms of financial losses that an earthquake similar to the 1908 earthquake might have if it were to occur at the present day. Loss results are discussed in the context of applications for the financial

  14. Northeast Marine Recreational Fishing Expenditure Survey

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — A series of expenditure surveys have been done both regionally and nationally. This data pertains to the Northeast U.S. states that was collected in 1998....

  15. Marine angler expenditures 2006 (NCEI Accession 0145343)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Angler expenditures for their most recent trip in 2006, by fishing mode - for-hire, private boat, shore. Includes categories such as bait, ice, fuel, lodging,...

  16. Mexico : Public Expenditure Review, Volume 2. Main Report

    OpenAIRE

    World Bank

    2004-01-01

    This Public Expenditure Review (PER) concentrates on four main issues: the overall fiscal sustainability and rigidities in expenditure, the distribution of benefits of public spending across households with different income levels, the geographic distribution of the spending, and the institutions for budgeting and expenditure management. Thus, it is not a traditional public expenditure rev...

  17. Mexico : Public Expenditure Review, Volume 1. Core Report

    OpenAIRE

    World Bank

    2004-01-01

    This Public Expenditure Review (PER) concentrates on four main issues: the overall fiscal sustainability and rigidities in expenditure, the distribution of benefits of public spending across households with different income levels, the geographic distribution of the spending, and the institutions for budgeting and expenditure management. Thus, it is not a traditional public expenditure rev...

  18. 10 CFR 603.560 - Estimate of project expenditures.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Estimate of project expenditures. 603.560 Section 603.560... Business Evaluation Fixed-Support Or Expenditure-Based Approach § 603.560 Estimate of project expenditures... have confidence in the estimate of the expenditures required to achieve well-defined...

  19. 11 CFR 9002.12 - Expenditure report period.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Expenditure report period. 9002.12 Section 9002... ELECTION FINANCING DEFINITIONS § 9002.12 Expenditure report period. Expenditure report period means, with... section, as appropriate. (a) In the case of a major party, the expenditure report period begins...

  20. 26 CFR 1.528-6 - Expenditure test.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Expenditure test. 1.528-6 Section 1.528-6...) INCOME TAXES (CONTINUED) Homeowners Associations § 1.528-6 Expenditure test. (a) In general. An... or more of its expenditures for such taxable year are qualifying expenditures as defined...

  1. Higher Education: Does Public Expenditure Increase Enrollment?

    OpenAIRE

    Bergh, Andreas; Fink, Günther

    2006-01-01

    This paper evaluates the effects of public education expenditure on student enrollment in tertiary education. We use a cross-section of 132 countries to demonstrate that public expenditure on primary and secondary education positively affects tertiary enrollment rates, while the generosity of tertiary education subsidies themselves do not appear to have any signifcant impact on tertiary enrollment. The results presented are robust to various specifcations, and raise serious concerns regarding...

  2. Corruption, Public Expenditure, and Human Capital Accumulation

    OpenAIRE

    Spyridon Boikos

    2013-01-01

    In this paper we investigate the effect of corruption on human capital accumulation through two channels. The first channel is through the effect of corruption on the public expenditure on education and the second channel is through the effect of corruption on the physical capital investment. Public expenditure on education affects positively human capital, while physical capital can obsolete human capital. Initially, we construct an endogenous two-sector growth model with human capital accum...

  3. Aggregate expenditure ceilings and allocative flexibility

    OpenAIRE

    Marc Robinson

    2012-01-01

    This article shows how to combine top-down budgeting – in the core sense of the establishment of a hard aggregate expenditure ceiling at the start of the budget preparation process – with flexibility in the allocation of the aggregate ceiling between spending ministries during budget preparation. It argues strongly against determining spending ministry shares of the aggregate expenditure ceiling without any prior opportunity for them to present formal new spending proposals. The keys to recon...

  4. Aid, public expenditure, and Dutch disease.

    OpenAIRE

    Christopher S. Adam; Bevan, David L.

    2003-01-01

    Contemporary policy debates on the macroeconomics of aid often concentrate on short-run Dutch disease effects, ignoring the possible supply side impact of aid— financed public expenditure. We develop a simple model of aid and public expenditure in which public infrastructure capital generates an inter-temporal productivity spillover for both tradable and non-tradable sectors, where these productivity effects may display sector-specific biases. The model also allows for non-homo...

  5. State energy price and expenditure report 1993

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The State Energy Price and Expenditure Report (SEPER) presents energy price and expenditure estimates individually for the 50 states and the District of Columbia and in aggregate for the US. The five economic sectors used in SEPER correspond to those used in SEDR and are residential, commercial, industrial, transportation, and electric utility. Documentation in appendices describe how the price estimates are developed, provide conversion factors for measures used in the energy analysis, and include a glossary. 65 tabs.

  6. Orphan Drug Expenditures In The United States: A Historical And Prospective Analysis, 2007-18.

    Science.gov (United States)

    Divino, Victoria; DeKoven, Mitch; Kleinrock, Michael; Wade, Rolin L; Kaura, Satyin

    2016-09-01

    The Orphan Drug Act of 1983 established incentives for the development of drugs that treat rare, or orphan, diseases. We used the IMS Health MIDAS database of audited biopharmaceutical sales to measure US annual spending on orphan drugs in the period 2007-13, and we estimated spending on the drugs for the period 2014-18. We identified 356 brand-name orphan drugs that were approved by the Food and Drug Administration in the period 1983-2013. While we included orphan drugs with both orphan and other indications, we adjusted spending to include only spending for orphan indications. In 2014 dollars, expenditures on orphan drugs totaled $15 billion in 2007 and $30 billion in 2013-representing 4.8 percent and 8.9 percent of total pharmaceutical expenditures, respectively. Our future trend analysis for the period 2014-18 suggests a slowing in the growth of orphan drug expenditures. The overall impact of orphan drugs on payers' drug budgets is relatively small, and spending on orphan drugs as a percentage of total pharmaceutical expenditures has remained fairly stable. Concerns that growth in orphan drug expenditures may lead to unsustainable drug expenditures do not appear to be justified. PMID:27605637

  7. Heterogeneity in the Effect of Common Shocks on Healthcare Expenditure Growth.

    Science.gov (United States)

    Hauck, Katharina; Zhang, Xiaohui

    2016-09-01

    Healthcare expenditure growth is affected by important unobserved common shocks such as technological innovation, changes in sociological factors, shifts in preferences, and the epidemiology of diseases. While common factors impact in principle all countries, their effect is likely to differ across countries. To allow for unobserved heterogeneity in the effects of common shocks, we estimate a panel data model of healthcare expenditure growth in 34 OECD countries over the years 1980 to 2012, where the usual fixed or random effects are replaced by a multifactor error structure. We address model uncertainty with Bayesian model averaging, to identify a small set of robust expenditure drivers from 43 potential candidates. We establish 16 significant drivers of healthcare expenditure growth, including growth in GDP per capita and in insurance premiums, changes in financing arrangements and some institutional characteristics, expenditures on pharmaceuticals, population ageing, costs of health administration, and inpatient care. Our approach allows us to provide robust evidence to policy makers on the drivers that were most strongly associated with the growth in healthcare expenditures over the past 32 years. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26940606

  8. Catastrophic loss risks: An economic and legal analysis, and a model state statute

    International Nuclear Information System (INIS)

    Catastrophic loss risk producing facilities or activities are defined as those human enterprises which are theoretically capable of producing some credible event which entails extremely large losses of human life, health, or property. Two examples of catastrophic loss risk producing facilities are examined, commercial nuclear power plants and LNG terminals. These two types of facilities appear to produce a type of externality in that they impose uncompensated loss risk costs on neighbors. Further, these two types of facilities may be quite dependent upon the subsidies implicit in these externalities for their continued economic operation. A model state statute is proposed which would use insurance premiums as an unbiased source of probability and outcome estimates in order to eliminate this externality and the resulting subsidy, and as a way of improving the present situation within certain economic limits

  9. Risk Measure and Premium Distribution on Catastrophe Reinsurance

    Institute of Scientific and Technical Information of China (English)

    XUN LI; WANG DE-HUI

    2012-01-01

    In this paper,we propose a new risk measure which is based on the Orlicz premium principle to characterize catastrophe risk premium.The intention is to develop a formulation strategy for Catastrophe Fund.The logarithm equivalent form of reinsurance premium is regarded as the retention of reinsurer,and the differential earnings between the reinsurance premium and the reinsurer's retention is accumulated as a part of Catastrophe Fund.We demonstrate that the aforementioned risk measure has some good properties,which are further confirmed by numerical simulations in R environment.

  10. Characteristics of Fluid Milk Expenditure Patterns in the Northeast Region

    OpenAIRE

    Raunikar, Robert; Huang, Chung-Liang

    1984-01-01

    Expenditure patterns for whole milk and lowfat milk in the Northeast region were examined by applying the Tobit maximum likelihood procedure to the 1977-78 USDA NFCSdata. Results suggest that differing expenditure patterns exist between whole milk and lowfat milk. Household income estimates indicate significant positive effects on expenditure for lowfat milk but negative on expenditure for whole milk. Whole milk expenditure was estimated to be strongly related to the family life cycle stages ...

  11. WHEN IS EXPENDITURE "EXOGENOUS" IN SEPARABLE DEMAND MODELS?

    OpenAIRE

    LaFrance, Jeffrey T.

    1991-01-01

    The separability hypothesis and expenditure as an exogenous variable in a system of conditional demands are analyzed. Expenditure cannot be weakly exogenous in a system of conditional demands specified as functions of the prices of the separable goods and total expenditure on those goods. Furthermore, expenditure is uncorrelated with the residuals of the conditional demand equations only when severe restrictions are satisfied. Therefore, expenditure will seldom be strictly exogenous. Economet...

  12. Medicaid's expenditures for newer pharmacotherapies for adults with disabilities.

    Science.gov (United States)

    Shireman, Theresa I; Hall, Jean P; Rigler, Sally K; Moore, Janice M

    2007-01-01

    Medicaid's drug expenditures have grown at double-digit inflation rates since 2000. These prescription drug costs are important contributors to increasing health care costs for disabled persons. In spite of this knowledge, little has been reported about specific patterns of medication use among disabled enrollees. We analyzed Kansas Medicaid data to describe trends in medication use patterns across 3 years among disabled beneficiaries. The marked shifts toward newer medications and disproportionate contributions of newer, more expensive medications to overall prescription costs for antipsychotics, antidepressants, anticonvulsants, antiulcer medications, anti-inflammatory agents, and opioids have implications for both policy and practice. PMID:17722749

  13. Política de Saúde Mental no Brasil: evolução do gasto federal entre 2001 e 2009 Política de Salud Mental en Brasil: evolución del gasto federal entre 2001 y 2009 Mental Health Policy in Brazil: federal expenditure evolution between 2001 and 2009

    Directory of Open Access Journals (Sweden)

    Renata Weber Gonçalves

    2012-02-01

    gastos de 2001 a 2009. Los valores de los gastos fueron actualizados en valores en reales de 2009 por medio de la aplicación del Índice de Precios al Consumidor Amplio. Se calculó el valor per capita/año del gasto federal en salud mental. RESULTADOS: Se observó el crecimiento real de 51,3% del gasto en salud mental en el período. La separación del gasto reveló aumento expresivo del valor extra-hospitalario (404,2% y disminución del hospitalario (-39,5%. El gasto per capita tuvo un crecimiento real menor, aunque expresivo (36,2%. La serie histórica del gasto per capita separado mostró que en 2006, por primera vez, el gasto extra-hospitalario fue mayor que el hospitalario. El valor per capita extra-hospitalario tuvo un crecimiento real de 354,0%; el valor per capita hospitalario disminuyó 45,5%. CONCLUSIONES: hubo crecimiento real de los recursos federales invertidos en salud mental entre 2001 y 2009 e inversión expresiva en las acciones extra-hospitalarias. hubo inversión en el direccionamiento de los recursos, a partir de 2006, en los servicios comunitarios. el componente del financiamiento tuvo papel crucial como inductor del cambio de modelo de atención en salud mental. el desafío para los próximos años es sustentar y aumentar los recursos para la salud mental en el contexto del desfinanciamiento del sistema único de salud.OBJECTIVE: To analyze the evolution of estimates of federal spending in Brazil's Mental Health Program since the promulgation of the national mental health law. METHODS: The total federal outlay of the Mental Health Program and its components of hospital and extra-hospital expenses were estimated based on 21 expenses categories from 2001 to 2009. The expenses amount was updated to values in reais of 2009 by means of the use of the Índice de Preços ao Consumidor Amplo (Broad Consumer Price Index. The per capita/year value of the federal expenditure on mental health was calculated. RESULTS: The outlay on mental health rose 51.3% in

  14. Demographic and Expenditure Profiles of Zambian Households: Evidence from the June 1991 Zambian Household Expenditure and Income Survey

    OpenAIRE

    Gary Stampley

    1993-01-01

    The HEIS's linkage of household-level demographic and expenditure data for Zambia provides the foundation for an analysis of household expenditure patterns. For this report, total household expenditure was composed of two broad expenditure classifications, food and nonfood. An analytical emphasis was placed on developing the food expenditure patterns of household groups identified by various socioeconomic characteristics. In general, within the various household classifications, there were th...

  15. Large-scale coastal impact induced by a catastrophic storm

    DEFF Research Database (Denmark)

    Fruergaard, Mikkel; Andersen, Thorbjørn Joest; Johannessen, Peter N;

    Catastrophic storms and storm surges induce rapid and substantial changes along sandy barrier coasts, potentially causing severe environmental and economic damage. Coastal impacts of modern storms are associated with washover deposition, dune erosion, barrier breaching, and coastline and shoreface...

  16. Catastrophic Events and Mass Extinctions: Impacts and Beyond

    Science.gov (United States)

    2000-01-01

    This volume contains extended abstracts that have been accepted for presentation at the conference on Catastrophic Events and Mass Extinctions: Impacts and Beyond, July 9-12, 2000, in Vienna, Austria.

  17. Pain frequency moderates the relationship between pain catastrophizing and pain

    Science.gov (United States)

    Kjøgx, Heidi; Zachariae, Robert; Pfeiffer-Jensen, Mogens; Kasch, Helge; Svensson, Peter; Jensen, Troels S.; Vase, Lene

    2014-01-01

    Background: Pain frequency has been shown to influence sensitization, psychological distress, and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method: A non-clinical (247 students) and a clinical (223 pain patients) sample completed the Danish versions of the Pain Catastrophizing Scale (PCS), Beck Depression Inventory, and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency. Results: In both samples, high pain frequency was found to moderate the association between pain catastrophizing and pain intensity, whereas low pain frequency did not. The psychometric properties and the factor structure of the Danish version of the PCS were confirmed. Conclusions: This is the first study to validate the Danish version of the PCS and to show that pain frequency moderates the relationship between pain catastrophizing and reported pain in both non-clinical and clinical populations. PMID:25646089

  18. Pain frequency moderates the relationship between pain catastrophizing and pain

    Directory of Open Access Journals (Sweden)

    Heidi eKjøgx

    2014-12-01

    Full Text Available Background Pain frequency has been shown to influence sensitization, psychological distress and pain modulation. The present study examined if pain frequency moderates the relationship between pain catastrophizing and pain. Method A non-clinical (247 students and a clinical (223 pain patients sample completed the Danish versions of the Pain Catastrophizing Scale, Beck Depression Inventory and the State Trait Anxiety Inventory and rated pain intensity, unpleasantness and frequency Results In both samples, high pain frequency was found to moderate the association between pain catastrophizing and pain intensity, whereas low pain frequency did not. The psychometric properties and the factor structure of the Danish version of the PCS were confirmed.Conclusions This is the first study to validate the Danish version of the PCS and to show that pain frequency moderates the relationship between pain catastrophizing and reported pain in both non-clinical and clinical populations.

  19. Chernobyl: Endless horror. Late effects of the reactor catastrophe

    International Nuclear Information System (INIS)

    Ten years after the accident, the people of Chernobyl are trying to live a normal life, but the problems resulting from the catastrophe have not been solved. Some of them are just starting to emerge. (orig.)

  20. Environment-related expenditures in 2013

    International Nuclear Information System (INIS)

    In 2013, households, private corporations and general government spent Euro 47.2 billion for environmental protection, an increase of 1.8% over 2012. For the 2000-2013 period on the whole, this expenditure has been rising faster than the gross domestic product (GDP): +4% on an annual average for the environmental protection expenditure compared with +2.8% for the GDP. In connection with the growing environmental concerns of society, public policy contributed to this steady increase through economic incentives ('bonus/malus' system, for instance) and regulation. In particular, the latter led to a technical improvement of processes (selective collection of waste, bringing up to standard of water treatment plants) which participated in the growth of expenditure. Wastewater and waste managements are the two main environmental protection expenditure domains. Furthermore, they are connected with topics related to resource management: drinking water supply and materials recovery. However, the expenditure for the materials recovery sector is decreasing in 2013, due to declines in raw materials prices. Expenditure for renewable energies - another topic related to environment - is considerably growing in 2013. Electricity production notably from water power is rising sharply, as a result of a particularly rainy spring. Nevertheless, the growth of environmental expenditures does not impact the corresponding employment in a systematic way. Thus, even if value added of the environmental goods and services sector (EGSS) increased by 1.8% in 2013, employment decreased by 0.3%. And the labor market in the green economy has been in decay since 2011, at a practically similar rate as for the economy as a whole