Economics of Health Care

Book Cover......Page 1
Half-Title......Page 2
Title......Page 3
Copyright......Page 4
Contents......Page 5
Preface......Page 9
1.1 Introduction......Page 11
1.2 Outline of the text......Page 14
1.3 Analytical framework......Page 15
2.1 Introduction......Page 17
2.2 Sources of health improvement......Page 19
2.3 The measurement of health improvements......Page 28
2.4 Conclusions......Page 37
3.1 Introduction......Page 38
3.2 Health and health care as commodities......Page 39
3.3 Basic principles of expected utility theory......Page 41
3.4.1 Health care and information......Page 44
3.4.2 Health care, information and insurance......Page 48
3.4.3 Process utility in health care......Page 50
3.5 Conclusions......Page 54
4.2.1 Introduction......Page 56
4.2.2 Some policies for equity......Page 58
4.2.3 Monitoring equity......Page 59
4.3.1 Introduction......Page 63
4.3.2 Sympathy and commitment......Page 64
4.3.3 Titmuss: the Kantian imperative......Page 65
4.3.4 Sen’s commitment......Page 66
4.3.5 Margolis and participation......Page 67
4.3.6 Rawls’ theory of justice......Page 69
4.4 Conclusions......Page 70
5.1 Introduction......Page 72
5.2.1 Efficiency and equity......Page 73
5.2.2 Measuring efficiency......Page 76
5.2.4 Time preference and discounting......Page 77
5.2.5 Risk and uncertainty......Page 78
5.2.7 Aggregation and equity......Page 79
5.3 The valuation of human life......Page 80
5.4.1 Specifying alternatives for appraisal......Page 84
5.4.2 Specifying the appraisal objective......Page 85
5.4.3 Identifying all effects......Page 86
5.4.4 Measuring all identified effects......Page 87
5.4.5 Valuing all measured effects......Page 88
5.4.6 Discounting future costs and benefits......Page 90
5.4.8 Assessing equity......Page 91
5.4.9 Choosing......Page 92
5.5 Conclusions......Page 93
6.2.1 Specifying alternatives for appraisal......Page 94
6.2.2 Specifying the appraisal objective......Page 96
6.2.3 Identifying all effects......Page 97
6.2.4  Measuring the identified effects......Page 98
6.2.5 Valuing the measured effects......Page 99
6.2.6 Discounting future costs and benefits......Page 101
6.2.7 Allowing for risk and uncertainty......Page 102
6.2.8 Assessing equity......Page 103
6.3.1 Introduction......Page 104
6.3.3 Setting the objective of the appraisal......Page 105
6.3.6 Measuring and valuing costs and benefits......Page 106
Revenue costs......Page 107
Patients, their visitors and society in general......Page 108
6.3.7 Sensitivity analysis......Page 109
6.3.8 Assessing equity......Page 110
Equity......Page 111
6.3.9 Choosing......Page 112
6.4.1 Ten questions to ask of any published study......Page 113
7.1 Introduction......Page 115
7.2 The household production model: a simple exposition......Page 116
7.3 The Grossman model: the algebra......Page 119
7.4 Summing-up the Grossman case......Page 124
7.5 Postscript......Page 129
8.1 Introduction......Page 131
8.2 Need......Page 132
8.3 The agency relationship......Page 134
8.4 Supplier-induced demand......Page 138
8.5 Empirical evidence on supplier-induced demand......Page 141
8.6 Conclusions......Page 143
9.1 Introduction......Page 145
9.2 Utilisation and welfare......Page 147
9.3 Utilisation: the empirical results......Page 149
9.4 Conclusions......Page 156
10.2 Markets and failures......Page 158
10.3 Further complications and additional failures......Page 163
10.4 Acceptance and response: structural considerations......Page 166
10.5 The importance of ethical conduct4......Page 169
10.6 Conclusions: the performance effects......Page 172
11.1 Introduction......Page 175
11.2.1 The theory of the firm......Page 176
11.2.2 The hospital as a firm......Page 177
11.3 Hospital cost functions......Page 182
11.4 Hospital cost inflation......Page 188
11.5 Conclusions......Page 190
12.2 Recent trends in health care expenditure......Page 192
12.3.1 The United States......Page 197
12.3.3 The United Kingdom......Page 198
12.3.4 Australia......Page 199
12.4.1 Cost-sharing......Page 200
12.4.2 Payment systems......Page 205
12.4.3 Competition......Page 210
12.5 Which system?......Page 213
12.6 Conclusions......Page 216
Notes......Page 218
Bibliography......Page 221
Index......Page 236