| 1. |
- Eckerlund, Ingemar, et al.
(författare)
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Econometric analysis of variation in cesarean section rates : a cross-sectional study of 59 obstetrical departments in Sweden
- 1998
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Ingår i: International Journal of Technology Assessment in Health Care. - : Cambridge University Press (CUP): HSS Journals. - 1471-6348 .- 0266-4623. ; 14:4, s. 774-787
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to explain the variation in cesarean section rates among hospitals (obstetrical departments) in Sweden, and to discuss its potential economic consequences. Using data from The Swedish Medical Birth Registry 1991, we made a cross-sectional study of the cesarean section rate at the departmental level. We identified some 20 determinants, demand-related as well as supply-related. A general model including all these regressors was specified, After reducing this model, we were able to explain about one-quarter of the variation, We conclude that the large variation in cesarean section rates indicates inefficiency, due mainly to overutilization, but perhaps also underutilization. It is difficult to calculate the economic consequences or the welfare loss to society, We estimated an additional cost for unnecessary cesarean sections of 13-16 million Swedish crowns (SEK) per year.
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| 2. |
- Eckerlund, Ingemar, et al.
(författare)
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Estimating the effect of cesarean section rate on health outcome : Evidence from Swedish hospital data
- 1999
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Ingår i: International Journal of Technology Assessment in Health Care. - : Cambridge University Press. - 1471-6348 .- 0266-4623. ; 15:1, s. 123-135
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This paper tests the null hypothesis of a zero effect of cesarean section rate on health outcome against the alternative of a positive effect. Using data from 59 hospitals in Sweden from 1988-92, we specify two separate linear regression models for health outcome, one with perinatal mortality, and the other with rate of asphyxia, as dependent variable, We estimate the models by single-year cross-section regressions and as pooled data systems. The null hypothesis cannot be rejected, i.e., we do not find any significant positive effect of cesarean section rate on health outcome. Thus, we conclude that an increase in cesarean section rate does not imply lower perinatal mortality or lower rate of asphyxia. This in turn indicates that the minimum cesarean section rate is optimal.
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| 3. |
- Gerdtham, Ulf-Göran, et al.
(författare)
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A note on the estimation of the equity-efficiency trade-off for QALYs
- 1996
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Ingår i: Journal of health economics. - : Elsevier. - 1879-1646 .- 0167-6296. ; 15:3, s. 359-368
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Tidskriftsartikel (refereegranskat)abstract
- In this note the veil of ignorance approach is tested as a basis for empirically determining the shape of the social welfare function for QALYs. An experiment is carried out where the participants choose between different societies that differ with respect to per capita QALYs and the distribution of QALYs. The answers are analyzed using logistic regression analysis, According to the results the respondents are willing to give up 1 QALY in the group with more QALYs to gain 0.45 QALYs in the group with fewer QALYs,but this trade-off is independent of the size of the difference in QALYs between the groups.
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| 4. |
- Gerdtham, Ulf-Göran, et al.
(författare)
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A note on validating Wagstaff and van Doorslaer's health measure in the analysis of inequalities in health
- 1999
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Ingår i: Journal of health economics. - : Elsevier. - 1879-1646 .- 0167-6296. ; 18:1, s. 117-124
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this note is to validate Wagstaff and van Doorslaer's approach of constructing a continuous health measure to be used in the analysis of inequalities in health. We calculate health concentration indices for Uppsala County in Sweden based on three different health status measures: health measured according to the WvD approach based on a self-assessed categorical health measure, health measured by the rating scale method, and health measured by the time trade-off method. The concentration index does not differ significantly for the three health status measures, and our results thus support the validity of the WvD method.
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| 5. |
- Gerdtham, Ulf-G, et al.
(författare)
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Equity in the delivery of health care in Sweden
- 1998
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Ingår i: SCANDINAVIAN JOURNAL OF SOCIAL MEDICINE. - : SCANDINAVIAN UNIVERSITY PRESS. - 0300-8037. ; 26:4, s. 259-264
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Tidskriftsartikel (refereegranskat)abstract
- There is mutual agreement that health care should be delivered according to need. In this article, although we employ different specifications for need, we conclude that there is inequity in the delivery of health care in Sweden. Higher income groups visi
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| 6. |
- Gerdtham, Ulf-Göran, et al.
(författare)
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New estimates of the demand for health : Results based on a categorical health measure and Swedish micro data
- 1999
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Ingår i: Social science & medicine (1982). - : Elsevier. - 1873-5347 .- 0277-9536. ; 49:10, s. 1325-1332
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Tidskriftsartikel (refereegranskat)abstract
- In this paper we estimate a 'Grossman' model of demand for health based on Swedish micro data. The data set consists of a random sample of over 5000 individuals taken from the Swedish adult population. Health capital is measured by a categorical measure of overall health status, and an ordered probit model is used to econometrically estimate the demand for health equation. The results are consistent with the theoretical predictions and show that the demand for health increases with income and education and decreases with age, male gender, overweight, living in big cities and being single.
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| 7. |
- Gerdtham, Ulf-Göran, et al.
(författare)
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Price indices of drugs and the switching to new drugs two empirical examples
- 1998
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Ingår i: PharmacoEconomics. - : Springer Science and Business Media LLC. - 1179-2027 .- 1170-7690. ; 13:1, s. 71-80
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Tidskriftsartikel (refereegranskat)abstract
- Standard price indices may not account for the price decrease that results when patients switch to pharmaceutical products for which their demand-reservation price exceeds the price of the new product. In a similar way, standard price indices may not account for the price increase that results when patients switch to pharmaceuticals for which the reservation price is below the price of the new drug. This study was designed to assess whether standard pharmaceutical price indices under- or overestimate the real price development resulting from new drug introductions. We illustrate that both situations may occur. In our first example, the switch from a branded to a generic drug, we showed that standard price indices recorded a price increase of about 16%, although the price actually decreased by about 5%. In our second example, the introduction of new formulation of a currently marketed drug, we showed that standard price indices recorded a price increase of about 6%, when the actual price increased by more than 65%.
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| 8. |
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| 9. |
- Gerdtham, Ulf-G, Sundberg, Gun
(författare)
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Sjukvårdens rättvisa fördelning
- 1997
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Ingår i: Ekonomisk Debatt. - : Nationalekonomiska föreningen. ; 25:7, s. 305-306
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 10. |
- Gerdtham, Ulf G., et al.
(författare)
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The effect of changes in treatment patterns on drug expenditure
- 1998
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Ingår i: PharmacoEconomics. - : Springer Nature. - 1179-2027 .- 1170-7690. ; 13:1 PART II, s. 127-134
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Tidskriftsartikel (refereegranskat)abstract
- This paper investigates the effects of changes in drug therapy on drug expenditure in Sweden between 1990 and 1995. Analyses have been carried out for both the aggregate drug expenditure and for drug expenditure according to the main groups of the Anatomical Therapeutic Chemical (ATC) classification system. Changes in expenditure can be divided into 3 components: the price of drugs, the quantity of drugs consumed and a residual. The size of the residual is a measure of the effect of changes in drug treatment patterns on drug expenditure. The aggregate real drug expenditure increased by 50% between 1990 and 1995. The relative retail price index of drugs decreased by 9% and the quantity index measured in terms of defined daily doses increased by 27%. The remaining residual increased by 30%. This implies that, if the residual had been unchanged during the study period, the aggregate expenditure would have increased by only 15%. The results also show that the size of the residual varies substantially across different ATC groups. The increase in the residual was largest for drugs that affect the nervous system (ATC group N); the residual increased by 86%. From the observed changes in residual values, it can be concluded that the underlying factor responsible for the increase in drug expenditure in Sweden is changes in drug therapy from less expensive to more expensive drugs.
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