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- Gerdtham, Ulf, 1960-
(författare)
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Essays on international comparisons of health care expenditure
- 1991
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The five papers of this thesis continue the tradition of international comparisons of aggregate health care expenditure. The studies focus on econometric aspects, such as temporal stability of the estimated relationships, their functional form, and discrimination between different regression models. The effects of aggregate income, institutional and socio-demographic factors on health care expenditure are estimated and evaluated. The first paper uses a cross-sectional sample of 19 OECD countries to test a model including ten explanatory variables on the differences in health care expenditure between countries. The model is also compared, statistically, with earlier regression models. The second paper uses a pooled cross-sectional analysis for 19 OECD countries and three years to re-analyse the ten-variable model. The model is again subjected to various misspecification tests including temporal stability of the estimated equation. The third paper uses a pooled cross-sectional, time-series analysis to experiment with dynamic specifications and various pooling techniques. In the fourth and fifth papers, the significance of absolute and relative price in international comparisons of health care expenditure is investigated.This study concludes that aggregate income is the statistically most important factor in cross-national variation in health care expenditure, and that the aggregate income elasticity exceeds unity. However, the data analyzed in this study also indicate that public financing of health care expenditure is associated with lower expenditure per capita, and that countries with a fee for services as the dominant form of remuneration have higher expenditure. The specified health care expenditure equationseems to be more appropriate than earlier models, and the parameters of the model appear to be stable over time, both in slopes and variance.
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| 2. |
- Gerdtham, Ulf-Göran, et al.
(författare)
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Drug Expenditure and New Drug Introductions : The Swedish Experience
- 1993
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Ingår i: PharmacoEconomics. - : Springer Science and Business Media LLC. - 1179-2027 .- 1170-7690. ; 4:3, s. 215-225
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Tidskriftsartikel (refereegranskat)abstract
- This article measures the impact of the switch to new and more expensive drugs on the aggregate drug expenditure (both prescription and nonprescription) in Sweden during the period 1974 to 1991, and also on the disaggregated expenditure for 3 medical areas: asthma, hypertension and peptic ulcer disease. During the period studied, nominal drug expenditure increased 6-fold. The retail price index of drugs and the number of prescribed drugs accounted for 51.6 and 5.8% of this increase, respectively. The remaining residual amount accounted for 42.6%. Since the price index of drugs increased more slowly than the overall net price index of goods and services, the relative price of drugs decreased dramatically by about 30%. This means that increases in prices of drugs cannot explain the increase in real inflation-adjusted drug expenditure. We also show that the residual increase can be partly explained by the introduction of new and more expensive drugs. It is therefore argued that economic evaluations which compare the extra costs induced by new drugs with the extra benefits should be undertaken to guide decisions about the prescription of new and more expensive drugs.
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| 3. |
- Gerdtham, Ulf G., et al.
(författare)
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Price and quantity in international comparisons of health care expenditure
- 1991
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Ingår i: Applied Economics. - : Informa UK Limited. - 0003-6846 .- 1466-4283. ; 23:9, s. 1519-1528
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Tidskriftsartikel (refereegranskat)abstract
- An important omission from earlier cross-national comparisons of health care expenditure has been the failure to distinguish between price and quantity. Using recent data on purchasing power parities, the purpose of this article is to report some preliminary results regarding health care expenditure and quantity across 22 OECD countries. The article concludes that, contrary to what has been suggested in some recent articles, the relative price of health care is not correlated to the aggregate per capita income. The fraction of the national income that is devoted to health care provision increases with the per capita income regardless of whether health care is measured in terms of expenditure or quantity. The relative price of health care has a rationing effect on the quantity of health care that is offered, with a price elasticity close to minus one. The latter finding means that the health care expenditure is not greater in countries with higher prices. Furthermore, the differences in health care expenditure or quantity between countries persist after correction for the relative price and the income level. Part of these differences can be explained by differences in the definition of health care in the various countries.
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| 4. |
- Johannesson, Magnus, et al.
(författare)
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Willingness to pay for antihypertensive therapy - further results
- 1993
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Ingår i: Journal of health economics. - 1879-1646 .- 0167-6296. ; 12:1, s. 95-108
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Tidskriftsartikel (refereegranskat)abstract
- A measurement experiment regarding willingness to pay for antihypertensive therapy is reported. A new type of binary willingness to pay question is used, that allows for different degrees of certainty with respect to the responses. Mean willingness to pay is derived from a simple expected utility model and estimated using maximum likelihood methods. The estimated parameters are highly significant, with predicted signs, and imply a mean willingness to pay of about SEK 800 ($130) per month. The explanatory power of the equation that only includes 'certain' yes/no responses is, as expected, much higher than that of the equation where only 'uncertain' responses are included.
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