Search

Health care decisions in many low‐income countries often require a close political agency relationship between healthcare decision makers and constituents. This is especially the case for maternal and child care as well as preventative interventions when resources are scarce. This article examines the effect of the introduction of the National Rural Health Mission in India, introducing Village Health, Sanitation and Nutrition Committees (VHSNC), a self‐governance mechanism to strengthen the political agency in village health care decision making. We study the effect of exposure to VHSNC on both maternal and preventative child health care. We find that exposure to VHSNC's increase the utilization of several maternal health care services, but does not systematically increase the uptake of preventive health care. The effect of VHSNC is more intense in larger villages and areas closer to district headquarters, and is driven by an increase in the utilization of the public healthcare network. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-8586.2008.00285.x Byline: Joan Costa-Font (*), Mireia Jofre-Bonet ([dagger]) Keywords: health insurance; NHS reform; private health care Abstract: ABSTRACT The purchase of private health insurance (PHI) as a means to partially supplement the National Health System (NHS) coverage is often regarded as a potential signal for a declining support for the NHS. Exploiting the fact that PHI is typically purchased by the most affluent, in this paper we test the so called 'secession of the wealthy' hypothesis whereby the likelihood of expressing 'lack of support for the NHS' increases with having supplementary PHI. Using empirical data from Catalonia, we draw upon an empirical strategy that circumvents an obvious simultaneity problem by estimating both a recursive bivariate probit as well as an IV probit. After controlling for insurance premium, household income and other socio-demographic determinants, we find that the purchase of PHI reduces the propensity of individuals to support the NHS. We also find evidence that PHI is a luxury good and sensitive to fiscal incentives. Author Affiliation: (*)London School of Economics, London, UK, and CAEPS, Universitat de Barcelona, Spain ([dagger])Department of Economics and City Health Economics Centre, City University, London, UK Article note: Correspondence: Joan Costa-Font, European Institute, Cowdray House, Houghton Street, London WC2A 2AE, UK. Tel: +44 207 955 6484; Fax: +44 207 955 6803; Email: J.Costa-Font@lse.ac.uk. We thank the comments received from the journal anonymous referees as well as those from Jaume Garcia, David McDaid, Joan Rovira and Guillem Lopez-Casasnovas to previous versions of the paper. All errors are ours and the usual disclaimer applies.

The impact of devolution of responsibilities in healthcare in Spain and regional inequalities in healthcare expenditure is discussed.

This paper reports findings from a European Commission funded study of future long-term care expenditure in Germany, Italy, Spain and the United Kingdom, and presents projections of future long-term care expenditure in the four countries under a number of assumptions about the future. Macro-simulation (or cell-based) models were used to make comparable projections based on a set of common assumptions. A central base-case served as a point of comparison by which to explore the sensitivity of the models to alternative scenarios for the key determinants. The sensitivity of the models to variant assumptions about the future numbers of older people, the prevalence of functional dependency and informal care, patterns of long-term provision, and macroeconomic conditions are examined. It was found that, under the base-case, the proportion of gross domestic product spent on long-term care is projected to more than double between 2000 and 2050 in each country. The projected future demand for long-term care services for older people is sensitive to assumptions about the future number of older people, the prevalence of dependency and the availability of informal care, and projected expenditure is sensitive to assumptions about rises in the real unit-costs of services and the structure of the models. It is important, for planning purposes, to recognise the considerable uncertainty about future levels of long-term care expenditure. KEY WORDS--Long-term care expenditure, demand for long-term care, projections.

Data from Spain and Mexico are used to examine the impact of trade integration arrangements on regional equalities, focusing on the interaction between private and public investment in stimulating economic activity and trade. While Spain's inequalities are driven by private capital formation and previous endowments, Mexico's are driven by variations in export capacity that increase private investment.

We study how the onset of disability affects both sleep satisfaction and sleep time on workdays and weekends. Using longitudinal data from the German Socio-Economic Panel for the period 2008–2017, we run fixed-effects models on sleep satisfaction and duration test whether individuals sleep adapts to disability (i.e. their degree of anticipation and adaptation to its onset). We find that people with disabilities report lower sleep satisfaction scores, and shorter sleep time both on workdays (except for males) and weekends compared to people without disabilities. Although we dont find evidence of anticipation effects, we find that sleep outcomes ambiguously worsen with disability. The adaptation to disability in terms of sleep satisfaction is longer for females than males (5 versus 4 years, respectively). These findings suggest that poor sleep among people with disabilities may explain their worst health outcomes, recovery, rehabilitation, and overall quality of life. [ABSTRACT FROM AUTHOR]

In the last decades, several European health systems have abandoned their vertically integrated health care in favour of some form of managed competition (MC), either in a centralised or decentralised format. However, during a pandemic, MC may put health systems under additional strain as they are designed to follow some form of 'organisational self-interest', and hence face reduced incentives for both provider coordination (e.g. temporary hospital close down, change in the case-mix), and information sharing. We illustrate our argument using evidence for the Covid-19 pandemic outbreak in Italy during March and April 2020, which calls for the development of 'coordination mechanisms' at times of a health emergency. [ABSTRACT FROM AUTHOR]