ISSN:1057-9230    

DOI:10.1002/hec.4730030302

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThe role played by informal carers in the care of people with chronic disabilities is well known. Given its importance, it is essential to consider the evaluation methodology applied in economic appraisals of different care options. Few studies attempt any evaluation and those that do use varied, inconsistent and controversial methodologies. This paper aims to elicit the major issues and methodological problems related to economic appraisal of informal care.The main concern over the present methods utilized is the lack of explicit exploration of the benefits, as perceived by carers. Carers, through their decision to care it is argued, will consider both costs and benefits. Although concepts encompassed by benefits tend to be less tangible they may considerably outweigh any financial burdens.Various methods have been utilized in the past. Financial outlays are fairly straightforwardly costed, personal effort on the part of carers causes more problems. Methods applied include: the cost of substitute services; state benefits; and travel time values. The most useful is probably the latter, although it is not problem‐free.Assessing benefits relating to concepts of direct and indirect utility and welfare is more complex and difficult to measure. Despite considerable literature on carers' attitudes, often these concepts are not applied (especially to residential care options) or if they are, negative aspects are emphasized (with domiciliary care).A useful application of economic appraisal would elicit optimal solutions to care dilemmas. Producing economic burden information about informal care may not be particularly constructive.Brief assessment of eight scenarios of care, considering cost differences for the public sector and the preferences of patient and carer gives insight to the problem. It emphasizes the complexity of the issue and the essential role likely to be placed on care managers in helping carers to maximize the net benefit of their effort

ISSN:1057-9230    

DOI:10.1002/hec.4730030303

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractIn this paper we examine whether the current method of valuing time within economic appraisals is appropriate. The cost to society of time taken to use health care may differ from the private opportunity cost of such time. However, demand for health care may be affected by the private opportunity time cost and not by the value of time to society. In this paper we show that the private opportunity cost of time is a better predictor of demand for a screening service than the societal approach. It is important, therefore, to use the private opportunity cost of time when assessing the demand for, and impact of, a health care intervention.

ISSN:1057-9230    

DOI:10.1002/hec.4730030304

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThe techniques of cost utility analysis (CUA) were used to evaluate the treatment of gallstone disease by open and laparoscopic cholecystectomy and by extracorporeal shockwave lithotripsy (ESWL). The application of the techniques in this context raised three methodological questions which are not satisfactorily resolved in the literature.The first is whether anex anteorex postperspective is best adopted for the measurement of quality of life (QoL). The second is the method for converting a short term deterioration in QoL followed by full health into QALYs and the reliability of the methods available. The third is the issue of indirect costs which, in the context of a temporary disease state, cannot be easily avoided.The economic evaluation found laparoscopic cholecystectomy to be generally superior than the competitor technologies (entailing lower costs and better outcomes). However, the results were sensitive to assumptions about the perspective for measuring benefits and the inclusion of indirect costs.

ISSN:1057-9230    

DOI:10.1002/hec.4730030305

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThe growth of health services employment in the United States is modelled using ARIMA analysis, and related to the growth in total U.S. employment. It is argued that specific features of the medical care sector (licensed professional manpower, non‐profit firms, third‐party financing) create institutional rigidities which delay adjustment to macroeconomic conditions and other shocks. Tests of Granger causality and the pattern of coefficients in the cross‐correlation function show that health services employment does lag other sectors of the economy by an average of 2 to 4 years. A Box‐Jenkins transfer‐noise function model between total and health employment is constructed and evaluated, and the impact dynamics of adjustment to Medicare and Medicaid are

ISSN:1057-9230    

DOI:10.1002/hec.4730030306

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThis paper uses the results of a household survey conducted in Cairo, Egypt in 1992 to examine the factors that influence the demand for inpatient and outpatient health services. Multi‐stage discrete choice models of the demand for health care, which identify the importance of individual, household, and facility level variables on each treatment decision, are estimated separately for outpatients and inpatients. Consumers are assumed to decide whether to seek any treatment and then choose between three categories of providers: a large public hospital (Embaba Hospital), all other public providers, and private/charitable providers. The results confirm that more affluent consumers prefer the higher cost, higher quality private and charitable hospitals. Age, sex, education, and insurance are also found to strongly impact the use of medical services. The results are suggestive but do not conclusively show that inpatient care is less price responsive than outpatient care. Price responsiveness of inpatient and outpatient demand are imprecisely estimated because price is highly correlated with quality, and the available data on facility quality do not permit us to adequately control for quality variations across facilitie

ISSN:1057-9230    

DOI:10.1002/hec.4730030307

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:1057-9230    

DOI:10.1002/hec.4730030308

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:1057-9230    

DOI:10.1002/hec.4730030309

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:1057-9230    

DOI:10.1002/hec.4730030310

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:1057-9230    

DOI:10.1002/hec.4730030312

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY