| 1. |
- Andrén, Daniela, 1968-, et al.
(author)
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Introducing waiting times for health care in a labor supply model for sickness absence
- 2015
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In: Nordic Journal of Health Economics. - : University of Oslo. - 1892-9729 .- 1892-9710. ; 3:1, s. 34-46
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Journal article (peer-reviewed)abstract
- This paper studies the association between waiting times for different health care services and the duration of sick leave, using a Swedish register database supplemented with information from questionnaires for 3,653 employees. The duration of sick leave is positively associated with waiting two weeks or more for primary care, technical investigations and specialists, compared to waiting one week or less. Except for waiting for a specialist, there is no indication that waiting four weeks or more is associated with longer durations of sick leave than waiting two to three weeks. Long waiting times for surgery is negatively associated with the duration of sick leave, which might be explained by prioritizing where patients with longer waiting times are those with less severe conditions. Including these waiting time variables did not induce substantial changes on the impact of traditional labor supply variables, which suggests that the parameter estimates of traditional variables are relatively robust.
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| 2. |
- Asgeirsdottir, TL, et al.
(author)
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Health behavior in the Nordic countries
- 2016
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In: Nordic Journal of Health Economics. - : University of Oslo Library. - 1892-9729 .- 1892-9710. ; 4:1, s. 28-40
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Journal article (peer-reviewed)abstract
- This paper provides a descriptive analysis of the level of and change in cigarette smoking, excessive alcohol consumption and body weight in Nordic countries and compares them with non-Nordic OECD countries. Our results show that the average prevalence of daily smokers is significantly lower for Nordic countries compared to non-Nordic countries. Four out of five Nordic countries are below the non-Nordic average. However, for alcohol consumption and obesity, it is more difficult to see a clear difference between Nordic countries and non-Nordic countries. Sweden ranks relatively low on all three health behaviors, while alcohol consumption is relatively high in Finland and Denmark. Smoking rates are relatively high in Norway, while the obesity rate is relatively high in Iceland. We conclude that although Nordic populations are often perceived as relatively homogeneous in terms of cultural and political aspects, there are interesting differences in health behaviors within these Nordic countries. These differences need more focus in health-economics research and may have a significant potential in light of the availability of health surveys and administrative register data that can sometimes be linked at the individual level. Such Nordic analyses may, in general, help to move the research front forward and can also be used to predict changes in population health and to study the effectiveness of health economic policies.
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| 3. |
- Gerdtham, Ulf
(author)
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Can health economics help us understand our strange public health care system?
- 2012
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In: Nordic Journal of Health Economics. - : University of Oslo Library. - 1892-9729 .- 1892-9710. ; 1:1
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Journal article (other academic/artistic)abstract
- Figure I depicts a set of inter-sectoral financial flows that represent central features of the organization and financing of health care systems. But It is primarily a set of accounting relationships, a gross anatomical description that provides no “physiology” explaining how the various components interact, or how those interactions might change in response to anatomical changes. What difference does it make, in terms of patterns of service delivery and cost, of distribution of burdens and benefits among the population, or of population health status, if the mixes of financing and funding flows in Figure 1 are re-arranged? These questions, sometimes overt, often covert, are everywhere at the heart of debates over health policy.
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| 4. |
- Glenngård, Anna
(author)
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What matters for patients’ experiences with primary care? A study of variation in patient reported experience measures with regard to structural and organisational characteristics of primary care centres in a Swedish region
- 2024
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In: Nordic Journal of Health Economics. - : University of Oslo Library. - 1892-9729 .- 1892-9710.
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Journal article (peer-reviewed)abstract
- Previous research on variation in patient reported experience measures (PREMs) suggest that it is important to be cautious when using comparative information about patients’ experiences, collected via patient surveys, to assess provider performance. Not all factors associated with variation in PREMs are related to factors that providers themselves can control. This study explores if structural characteristics of primary care practices (PCCs), that are difficult to control, and the way that providers manage and organise their work matter for patients’ experiences with care. The purpose was to analyse variation in PREMs at the PCC level in Swedish primary care, with regard to structural characteristics of PCCs, including patient mix, and variables representing how providers organise and manage their work. Since the choice reform in 2007-2010, there is a mix of public and private providers, all with public funding and operating under the same overall requirements. The analysis is based on data from a national patient survey in primary care and registry data from a large Swedish region. OLS regression analysis was used to study variation in seven PREM-dimensions in regards to variables representing structural and organisational characteristics and processes of work at PCCs, covering the years 2018-2019 (N=281 PCC year observations). The results imply that variables that can be changed by providers themselves matter more for patients’ experiences with care than factors that providers cannot control. The most significant associations were found between PREMs and proportion and continuity of GP visits and adherence to clinical guidelines regarding treatment of risk groups. However, it is a challenge for providers to offer a high proportion of visits with GPs and good continuity due to a persisting shortage of GPs in Sweden. Recent policy initiatives have been introduced in this area. From a policy perspective, variation in patients’ experiences with regard to socioeconomic conditions is also a concern.
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| 5. |
- Hammarfelt, Björn, et al.
(author)
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Nordic Academic Publishing in Health Economics
- 2023
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In: Nordic Journal of Health Economics. - 1892-9729 .- 1892-9710. ; 6:1, s. 59-78
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Journal article (peer-reviewed)abstract
- We analyse how the Nordic contribution to health economics has evolved over the past three decades – in quantitative and qualitative terms. Using a dataset of publications from five prominent field journals for health economics, we combine different empirical methods to analyse the general trends in terms of number of distinct publications, topics covered, and co-authorship relationships between countries and individuals. We find that the Nordic countries are responsible for a stable share of international publications in health economics. The topics that Nordic health economists publish on are relatively similar to those most prevalent in the international community, even though health insurance is remarkably absent as a research topic in Nordic countries. In terms of links between countries and co-authors, we see that Nordic researchers are well embedded in the international community, and that the Nordic research community has moved toward less hierarchical relationships.
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| 6. |
- Hansen, Fredrik, et al.
(author)
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The future of health economics: the potential of behavioral and experimental econmics
- 2015
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In: Nordic Journal of Health Economics. - : University of Oslo. - 1892-9729 .- 1892-9710. ; 3, s. 68-86
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Journal article (peer-reviewed)abstract
- Health care systems around the globe are facing great challenges. The demand for health care is increasing due to the continuous development of new medical technologies, changing demographics, increasing income levels, and greater expectations from patients. The possibilities and willingness to expand health care resources, however, are limited. Consequently, health care organizations are increasingly required to take economic restrictions into account, and there is an urgent need for improved efficiency. It is reasonable to ask whether the health economics field of today is prepared and equipped to help us meet these challenges. Our aim with this article is twofold: to introduce the fields of behavioral and experimental economics and to then identify and characterize health economics areas where these two fields have a promising potential. We also discuss the advantages of a pluralistic view in health economics research, and we anticipate a dynamic future for health economics.
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| 7. |
- Iversen, Tor, et al.
(author)
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Coordination of care in the Nordic countries
- 2016
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In: Nordic Journal of Health Economics. - : University of Oslo Library. - 1892-9729 .- 1892-9710. ; 4:1, s. 41-55
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Journal article (peer-reviewed)abstract
- Coordination of health care exists at many different levels and in many different forms. We describe the similarities and differences in coordination mechanisms among the Nordic countries. In some respects, the Nordic countries approach coordination problems in similar ways although differences exist. The overall pattern shows that Finland and Sweden have less country-wide coordination compared with the other countries. There are many questions and few answers with regard to which mechanisms work best. Hence, coordination mechanisms in health care seem to be an important area for further research. We outline a few topics for future joint Nordic research in this area.
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| 8. |
- Johannesen, Kasper, 1982-, et al.
(author)
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Getting value today and incentivising for the future: Pharmaceutical development and healthcare policies
- 2017
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In: Nordic Journal of Health Economics. - : University of Oslo. - 1892-9729 .- 1892-9710. ; 5:1, s. 77-96
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Research review (peer-reviewed)abstract
- To manage the challenge of limited healthcare resources and unlimited demand for healthcare, decision makers utilise a variety of demand side policies, such as health technology appraisals and international reference pricing to regulate price and utilisation. By controlling price and utilisation demand side policies determine the earnings potential, and hence the incentives to invest in research and development (R&D) of new technologies. However, the impact of demand side policies on R&D incentives is seldom formally assessed. Based on the key assumption that intellectual property rights, i.e. patents, and expected rent are key drivers of pharmaceutical R&D, this work outlines a framework illustrating the link between demand side policies and pharmaceutical R&D incentives. By analysing how policies impact expected rent and consumer surplus, the framework is used to understand how commonly used demand side policies (including timing and length of reimbursement process, international reference pricing, parallel trade, and sequential adoption into clinical practice) may influence R&D incentives. The analysis demonstrates that delayed reimbursement decisions as well as sequential adoption into clinical practise may in fact reduce both expected rent and consumer surplus. It is also demonstrated how international reference pricing is likely to increase consumer surplus at the expense of lower rent and thus lower R&D incentives. Although this work illustrates the importance of considering how demand side policies may impact long-term R&D incentives, it is important to note that the purpose has not been to prescribe which demand side policies should be utilised or how. Rather, the main contribution is to illustrate the need for a structured approach to the analysis of the complex, and at times highly politicised question of how demand side policies ultimately influence population health, both in the short and in the long term.
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| 9. |
- Lyttkens, Carl Hampus, et al.
(author)
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The core of the Nordic health care system is not empty
- 2016
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In: Nordic Journal of Health Economics. - : University of Oslo Library. - 1892-9729 .- 1892-9710. ; 4:1, s. 7-27
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Journal article (peer-reviewed)abstract
- The Nordic countries are well-known for their welfare states. A very important feature of the welfare state is that it aims at easy and equal access to adequate health care for the entire population. For many years, the Nordic systems were automatically viewed as very similar, and they were placed in the same group when the OECD classified health care systems around the world. However, close inspection soon reveals that there are important differences between the health care systems of Denmark, Finland, Iceland, Norway and Sweden. Consequently, it is perhaps no surprise that the Nordic countries fell into three different categories when the OECD revised its classification a few years ago. In this paper, we revisit this issue and argue that the most important similarity across the Nordic countries is the institutional context in which the health care sector is embedded. Nordic health care exists in a high-trust, high-taxation setting of small open economies. With this background, we find a set of important similarities in the manner in which health care is organized and financed in the Nordic countries. To evaluate the performance of the Nordic health care system, we compare a few health quality indicators in the Nordic countries with those of five non-Nordic similarly small open European economies with the same level of income. Overall, the Nordic countries seem to be performing relatively well. Whether they will continue to do so will depend to a large extent on whether the welfare state will continue to reform itself as it has in the past.Published: April 2016.
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| 10. |
- Olsen, Kim Rose, et al.
(author)
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General practice in the Nordic countries
- 2016
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In: Nordic Journal of Health Economics. - : University of Oslo Library. - 1892-9729 .- 1892-9710. ; 4:1, s. 56-67
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Journal article (peer-reviewed)abstract
- Background: General practice systems in the Nordic countries share certain common features. The sector is based on the Nordic model of a tax-financed supply of services with a political objective of equal access for all. The countries also share the challenges of increased political expectations to deliver primary prevention and increased workload as patients from hospital care are discharged earlier. However, within this common framework, primary care is organized differently. This is particularly in relation to the private-public mix, remuneration systems and the use of financial and non-financial incentives.Objective: The objective of this paper is to compare the differences and similarities in primary care among the Nordic countries, to create a mapping of the future plans and reforms linked to remuneration and incentives schemes, and to discuss the pros and cons for these plans with reference to the literature. An additional objective is to identify gaps in the literature and future research opportunities.Results/Conclusions: Despite the many similarities within the Nordic health care systems, the primary care sectors function under highly different arrangements. Most important are the differences in the gate-keeping function, private versus salaried practices, possibilities for corporate ownership, skill-mix and the organisational structure. Current reforms and political agendas appear to focus on the side effects of the individual countries’ specific systems. For example, countries with salaried systems with geographical responsibility are introducing incentives for private practice and more choices for patients. Countries with systems largely based on private practice are introducing more monitoring and public regulation to control budgets. We also see that new governments tends to bring different views on the future organisation of primary care, which provide considerable political tension but few actual changes. Interestingly, Sweden appears to be the most innovative in relation to introducing new incentive schemes, perhaps because decisions are made at a more decentralised level.
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