Routledge International Studies in Health Economics – serie

Steep socioeconomic hierarchy in post-industrial Western society threatens public health because of the physiological consequences of material and psychosocial insecurities and deprivations. Following on from their previous books, the authors continue their exploration of the geography of early mortality from age-related chronic conditions, of risk behaviors and their health outcomes, and of infant and child mortality, all due to rigid hierarchy. They divide the 50 states into those that gave their electoral college votes to Trump and those that gave theirs to Clinton in the 2016 presidential election and compare the two sets for socioeconomic and public health profiles. They deliberately apply only simple standard statistical methods in the public health analyses: t-test, Mann-Whitney test, bivariate regression, and backward stepwise multivariate regression. The book assumes familiarity with basic statistics.The authors argue that the unequal power relations that result in eroding public health in the nation and, in particular, in the Trump-voting states, largely cascade from the collapse of American industry, and they analyze the Cold War roots of that collapse. In two largely independent chapters on economics, they explore both the suppression of countervailing forces, such as organized labor, and the diversion of technical resources to the military as essential foundations to the population-level suffering that expressed itself in the 2016 presidential election.This interdisciplinary book has several primary audiences: creators of public policies, such as legislators and governmental staff, public health professionals and social epidemiologists, economists, labor union professionals, civil rights advocates, political scientists, historians, and students of these disciplines from public health through the social sciences.The Open Access version of this book, available at http://www.taylorfrancis.com, has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.

Ensuring equity in healthcare is the main concern of health policymakers in order to provide a sustainable health system. This concern is more prominent in developing countries due to the scarcity of resources. This book provides a comprehensive analysis and discussion on the distributive pattern of out-of-pocket pharmaceutical expenditures under the health reforms in Turkey and makes comparisons with pharmerging countries.Turkey’s health reforms began in 2003 to address shortcomings related to financial protection and to improve health outcomes and the quality of healthcare services. The primary motivation was to ensure equity in the distribution of health resources, and this transformation process led to profound changes in how these resources were used, and in health financing in general. However, there is a lack of knowledge regarding the long-term effect of health reforms on the distribution patterns of health expenditures and health service use. This book offers a thorough equity analysis of the health financing system, affected by this health transformation program. Index and curve approaches are used in the equity analysis of pharmaceutical expenditures. The book examines the long-term effects of health system regulations on the health spending characteristics of households and improves the current understanding of equity in this context. It includes extensive international comparisons of healthcare services across a range of developing countries and highlights the significance of ensuring equity for emerging economies.The author explores the existing evidence as well as future research directions and provides policy and planning advice for health policymakers to contribute to establishing a more equal health system design. Additionally, the book will be of interest to scholars and professionals in the fields of health economics, public health management and health financing.

Ensuring equity in healthcare is the main concern of health policymakers in order to provide a sustainable health system. This concern is more prominent in developing countries due to the scarcity of resources. This book provides a comprehensive analysis and discussion on the distributive pattern of out-of-pocket pharmaceutical expenditures under the health reforms in Turkey and makes comparisons with pharmerging countries.Turkey’s health reforms began in 2003 to address shortcomings related to financial protection and to improve health outcomes and the quality of healthcare services. The primary motivation was to ensure equity in the distribution of health resources, and this transformation process led to profound changes in how these resources were used, and in health financing in general. However, there is a lack of knowledge regarding the long-term effect of health reforms on the distribution patterns of health expenditures and health service use. This book offers a thorough equity analysis of the health financing system, affected by this health transformation program. Index and curve approaches are used in the equity analysis of pharmaceutical expenditures. The book examines the long-term effects of health system regulations on the health spending characteristics of households and improves the current understanding of equity in this context. It includes extensive international comparisons of healthcare services across a range of developing countries and highlights the significance of ensuring equity for emerging economies.The author explores the existing evidence as well as future research directions and provides policy and planning advice for health policymakers to contribute to establishing a more equal health system design. Additionally, the book will be of interest to scholars and professionals in the fields of health economics, public health management and health financing.

This book brings together a collection of empirical case studies featuring a wide spectrum of medical innovation. While there is no unique pathway to successful medical innovation, recurring and distinctive features can be observed across different areas of clinical practice. This book examines why medical practice develops so unevenly across and within areas of disease, and how this relates to the underlying conditions of innovation across areas of practice. The contributions contained in this volume adopt a dynamic perspective on medical innovation based on the notion that scientific understanding, technology and clinical practice co-evolve along the co-ordinated search for solutions to medical problems. The chapters follow an historical approach to emphasise that the advancement of medical know-how is a contested, nuanced process, and that it involves a variety of knowledge bases whose evolutionary paths are rooted in the contexts in which they emerge.This book will be of interest to researchers and practitioners concerned with medical innovation, management studies and the economics of innovation. Chapter 5 of this book is freely available as a downloadable Open Access PDF under a Creative Commons Attribution-Non Commercial-No Derivatives 3.0 license. https://s3-us-west-2.amazonaws.com/tandfbis/rt-files/docs/Open+Access+Chapters/9781138860346_oachapter5.pdf

Health 4.0 is a term that has derived from the Fourth Industrial Revolution (Industry 4.0), as it pertains to the healthcare industry. This book offers a novel, concise, but at the same time, broad picture of the challenges that the technological revolution has created for the healthcare system.It offers a comprehensive view of health sector actors’ interaction with the emerging new technology, which is disrupting the status quo in health service delivery. It explains how these technological developments impact both society and healthcare governance. Further, the book addresses issues related to key healthcare system stakeholders: the state, patients, medical professionals, and non-governmental organizations. It also examines areas of healthcare system adaptiveness and draws its conclusions by analysing recent health policy changes in different countries across the Americas, Europe, and Asia. The authors offer an innovative approach to the subject by identifying the critical determinants of successful implementation of the Fourth Industrial Revolution’s outcomes in practice, on both a macro- and microlevel. The macrolevel analysis is focused on essential factors of healthcare system adaptiveness for Health 4.0, while the microlevel relates to patients’ expectations with a particular emphasis on senior citizens.The book will appeal to academics, researchers, and students, across a wide range of disciplines, such as health economics, health sciences, public policy, public administration, political science, public governance, and sociology. It will also find an audience among healthcare professionals and health and social policymakers due to its recommendations for implementing Industry 4.0 into a healthcare system.

Health 4.0 is a term that has derived from the Fourth Industrial Revolution (Industry 4.0), as it pertains to the healthcare industry. This book offers a novel, concise, but at the same time, broad picture of the challenges that the technological revolution has created for the healthcare system.It offers a comprehensive view of health sector actors’ interaction with the emerging new technology, which is disrupting the status quo in health service delivery. It explains how these technological developments impact both society and healthcare governance. Further, the book addresses issues related to key healthcare system stakeholders: the state, patients, medical professionals, and non-governmental organizations. It also examines areas of healthcare system adaptiveness and draws its conclusions by analysing recent health policy changes in different countries across the Americas, Europe, and Asia. The authors offer an innovative approach to the subject by identifying the critical determinants of successful implementation of the Fourth Industrial Revolution’s outcomes in practice, on both a macro- and microlevel. The macrolevel analysis is focused on essential factors of healthcare system adaptiveness for Health 4.0, while the microlevel relates to patients’ expectations with a particular emphasis on senior citizens.The book will appeal to academics, researchers, and students, across a wide range of disciplines, such as health economics, health sciences, public policy, public administration, political science, public governance, and sociology. It will also find an audience among healthcare professionals and health and social policymakers due to its recommendations for implementing Industry 4.0 into a healthcare system.

Steep socioeconomic hierarchy in post-industrial Western society threatens public health because of the physiological consequences of material and psychosocial insecurities and deprivations. Following on from their previous books, the authors continue their exploration of the geography of early mortality from age-related chronic conditions, of risk behaviors and their health outcomes, and of infant and child mortality, all due to rigid hierarchy. They divide the 50 states into those that gave their electoral college votes to Trump and those that gave theirs to Clinton in the 2016 presidential election and compare the two sets for socioeconomic and public health profiles. They deliberately apply only simple standard statistical methods in the public health analyses: t-test, Mann-Whitney test, bivariate regression, and backward stepwise multivariate regression. The book assumes familiarity with basic statistics.The authors argue that the unequal power relations that result in eroding public health in the nation and, in particular, in the Trump-voting states, largely cascade from the collapse of American industry, and they analyze the Cold War roots of that collapse. In two largely independent chapters on economics, they explore both the suppression of countervailing forces, such as organized labor, and the diversion of technical resources to the military as essential foundations to the population-level suffering that expressed itself in the 2016 presidential election.This interdisciplinary book has several primary audiences: creators of public policies, such as legislators and governmental staff, public health professionals and social epidemiologists, economists, labor union professionals, civil rights advocates, political scientists, historians, and students of these disciplines from public health through the social sciences.

This book provides a concise synthesis of leading edge research in the theory and practise of efficiency measurement in health and health care. Whilst much of the literature in this area is confusing and impregnable, Hollingsworth and Peacock show the logical links between the economic theory underlying efficiency, the methods used in analysis and practical application of measurement techniques including Data Envelopment Analysis and Stochastic Frontiers Analysis. The book outlines which methods are most suitable in which setting, how to specify valid models, and how to undertake a study and effectively disseminate results. The current state of the art is assessed in terms of methods and published applications, and undertakes practical applications of advanced methods, including analysis of economies of scale and scope, variable weightings, specification testing, and estimation of the efficient production of health. Finally, the way forward in efficiency measurement in health is outlined, mapping out an agenda for future research and policy development.

Evidence-based medicine is defined as the conscientious explicit and judicious use of current best evidence in making decisions about the care of individual patients. This superb collection will take a critical view of this concept and examine the economic implications of its imposition.

Accessible and edited by authors based at a top institution, this book provides readers with an excellent summary in an easy-to-read style of this burgeoning field of research.In this volume Bennett, Gilson and Mills have gathered together essays written by academics and experts in the fields of health policy and economic development, each underscoring the need for political commitment to meet the needs of the poor and the development of strategies to build this commitment, covering: evidence regarding the links between health, economic development and household povertyevidence on the extent to which health care systems address the needs of the poor and the near poorinnovative measures to make health care interventions widely available to the poor.Current and topical, this book is of great relevance to policy makers and practitioners in the field of international health and development and researchers engaged with global health and poverty as well as being ideal reading for students of international health and development.

Evidence based medicine is defined as the conscientious explicit and judicious use of current best evidence in making decisions about the care of individual patients. This superb collection takes a critical view of this concept and examines the economic implications of its imposition.

Accessible and edited by authors based at a top institution, this book provides readers with an excellent summary in an easy-to-read style of this burgeoning field of research.In this volume Bennett, Gilson and Mills have gathered together essays written by academics and experts in the fields of health policy and economic development, each underscoring the need for political commitment to meet the needs of the poor and the development of strategies to build this commitment, covering: evidence regarding the links between health, economic development and household povertyevidence on the extent to which health care systems address the needs of the poor and the near poorinnovative measures to make health care interventions widely available to the poor.Current and topical, this book is of great relevance to policy makers and practitioners in the field of international health and development and researchers engaged with global health and poverty as well as being ideal reading for students of international health and development.

This book provides a concise synthesis of leading edge research in the theory and practise of efficiency measurement in health and health care. Whilst much of the literature in this area is confusing and impregnable, Hollingsworth and Peacock show the logical links between the economic theory underlying efficiency, the methods used in analysis and practical application of measurement techniques including Data Envelopment Analysis and Stochastic Frontiers Analysis. The book outlines which methods are most suitable in which setting, how to specify valid models, and how to undertake a study and effectively disseminate results. The current state of the art is assessed in terms of methods and published applications, and undertakes practical applications of advanced methods, including analysis of economies of scale and scope, variable weightings, specification testing, and estimation of the efficient production of health. Finally, the way forward in efficiency measurement in health is outlined, mapping out an agenda for future research and policy development.

Reconfiguring Global Health Innovation presents the findings of multi-year research, contrasting experiences of different latecomer countries in building health innovation systems to cater to local needs. It analyses the emerging industrial structures in health innovation as more and more latecomer countries are foraying into what is a highly difficult and technologically intensive sector, with the aim of finding ways and means to balance these promising developments with public health needs worldwide.The bookpresents empirical findings from six countries across Asia and Africa on health innovation, namely, India, Bangladesh, Vietnam, Kenya, Tanzania and Nigeria. The book concludes that the growth of knowledge and the accumulation of capabilities influence the ability of a country to generate wealth.

Increasing prescription drug cost-sharing by patients - in the form of increasing copayments - is one of the most striking, and controversial, developments in the health sector over recent years. The exact nature and use of copayments by health care insurers continues to be hot topic of debate. This detailed and meticulously researched study is one of the first of its kind: its results suggest that differences in copayments influence choice, shifting market share for these drugs. Differential copayments for medically equivalent alternatives is one strategy insurers use to affect the choice of one drug over another when faced with differing prices. Relative copayments for therapeutically equivalent drugs, imposed by insurers, are shown to have a significant impact on consumer choice – the implication being that physicians are acting in patients’ financial, as well as medical interest. Unlike much work in this area, Copayments and the Demand for Prescription Drugs is not sponsored by any drug company; and its up-to-date results, established on a firm scientific basis, are entirely unbiased. Its results have applications for the private insurance and pharmaceutical sectors as well as the public sector, and it will be of great interest to professionals and researchers in the fields of health economics, economic and healthcare policy-making, and microeconomics: its primary findings are especially critical to the United States public health sector which is on the cusp of providing a prescription drug benefit to nearly forty million elderly Americans.

In this volume, leading American health economists provide a critical assessment of the current state of knowledge of insurance market reform that is accessible to both policy-makers and researchers.

This book explains how, and why, economics has been applied to a terrible pandemic, using a range of examples mostly drawn from the region most affected, sub-Saharan Africa. Part I shows that microeconomic approaches have found fertile ground in a public health approach that ‘blames’ individual choices for HIV transmission. Despite their attractiveness, however, these approaches fail to explain contemporary patterns of HIV prevalence, illustrating the importance of factors that are excluded from the standard micro-economic approach. Part II of the book looks at our problems in understanding the economic impact of AIDS, and explains why economists cannot agree if epidemic disease is a good or bad thing for economic development. In both sections of the book, the potential for alternative approaches is shown, and the book ends by arguing that a political economy approach can bring meaningful insights to our understanding of the spread and impact of HIV/AIDS.

In this volume, leading American health economists provide a critical assessment of the current state of knowledge of insurance market reform that is accessible to both policy-makers and researchers.

Increasing prescription drug cost-sharing by patients - in the form of increasing copayments - is one of the most striking, and controversial, developments in the health sector over recent years. The exact nature and use of copayments by health care insurers continues to be hot topic of debate. This detailed and meticulously researched study is one of the first of its kind: its results suggest that differences in copayments influence choice, shifting market share for these drugs. Differential copayments for medically equivalent alternatives is one strategy insurers use to affect the choice of one drug over another when faced with differing prices. Relative copayments for therapeutically equivalent drugs, imposed by insurers, are shown to have a significant impact on consumer choice – the implication being that physicians are acting in patients’ financial, as well as medical interest. Unlike much work in this area, Copayments and the Demand for Prescription Drugs is not sponsored by any drug company; and its up-to-date results, established on a firm scientific basis, are entirely unbiased. Its results have applications for the private insurance and pharmaceutical sectors as well as the public sector, and it will be of great interest to professionals and researchers in the fields of health economics, economic and healthcare policy-making, and microeconomics: its primary findings are especially critical to the United States public health sector which is on the cusp of providing a prescription drug benefit to nearly forty million elderly Americans.

Although economics is a relative newcomer to research into the determinants of good health, its significance should not be under-estimated. This book poses the important question of whether economic theory can be developed to explain why people engage in activities that are obviously a danger to their long-term health.In looking first at the individual's own decisions that affect his or her health, and then at the impact of other agent's decisions for the individual's health, the authors provide an exhaustive account of the important issues to be faced to ensure the best future for public health care. Contributors include such experts as Peter Zweifel, Donald S. Kenkel and Mark Pauly. Of great interest to advanced students of health economics, this book will also be extremely useful to students, academics and professionals involved in the sphere of public health.

Health systems across the world face multiple pressures. Input costs are soaring, systems are struggling to keep up with increasing demand for their services and areas of the world still lack universal health coverage. All of this whilst health inequalities between the best and worst-off within countries persist and, in some countries, are even widening. There is a need to think of new initiatives in response to these global health challenges. One such response is social finance. Social finance is about creating social returns. This innovative and rapidly growing sector promotes new ways of banking and funding social and public services. However, social finance has an under-recognised, and potentially underexploited, role in responding to specific aspects of global health challenges: funding and facilitating access to health(care) services and acting on health. The objectives of this book are to conceptualise and evidence different forms of social finance - microfinance and impact bonds - acting in these ways and to critically engage with current debates and challenges. With such evidence to hand, we can either avoid adoption of new trends in financing public services or, more hopefully, attract greater policy support and resources for new tools for public health and in supporting more precarious, but potentially essential, parts of the finance sector. This book will be essential reading to students, researchers, policymakers and the general public alike who are interested in, or who work in, and across, health systems and social finance.

Health systems across the world face multiple pressures. Input costs are soaring, systems are struggling to keep up with increasing demand for their services and areas of the world still lack universal health coverage. All of this whilst health inequalities between the best and worst-off within countries persist and, in some countries, are even widening. There is a need to think of new initiatives in response to these global health challenges. One such response is social finance. Social finance is about creating social returns. This innovative and rapidly growing sector promotes new ways of banking and funding social and public services. However, social finance has an under-recognised, and potentially underexploited, role in responding to specific aspects of global health challenges: funding and facilitating access to health(care) services and acting on health. The objectives of this book are to conceptualise and evidence different forms of social finance - microfinance and impact bonds - acting in these ways and to critically engage with current debates and challenges. With such evidence to hand, we can either avoid adoption of new trends in financing public services or, more hopefully, attract greater policy support and resources for new tools for public health and in supporting more precarious, but potentially essential, parts of the finance sector. This book will be essential reading to students, researchers, policymakers and the general public alike who are interested in, or who work in, and across, health systems and social finance.

Human enhancement (HE) is considered one of the most profoundly impactful effects of the Fourth Industrial Revolution. This book presents the definition, theory, scope, and main challenges of HE from a health policy and healthcare systems perspective. It offers a comprehensive view of the consequences of human enhancement disrupting the status quo in health service delivery and social coherence.The book examines the latest achievements of HE, focusing on four forms of enhancement: cognitive, physical, mood and moral. These forms are supported by the list of specific technologies and techniques used for HE. The book identifies the current trends in HE's development and analyses the challenges that HE poses to health policy and healthcare systems. It discusses the legal and financial aspects of HE, including regulation and shows that the financing of HE goes far beyond the scope of universal health coverage, thus opening the door for private, voluntary insurance and/or out-of-pocket payments. This, in turn, leads towards growing inequalities, which may threaten social cohesion. Readers will receive a structured picture of the latest advances in HE and trends in the field, as well as a list of the challenges and problems that HE generates.The book offers a concise picture of HE for students and researchers across the political sciences, public health, public sector management, and sociology. It will also find an audience among healthcare managers, policymakers, and those who are interested in social change.

Human enhancement (HE) is considered one of the most profoundly impactful effects of the Fourth Industrial Revolution. This book presents the definition, theory, scope, and main challenges of HE from a health policy and healthcare systems perspective. It offers a comprehensive view of the consequences of human enhancement disrupting the status quo in health service delivery and social coherence.The book examines the latest achievements of HE, focusing on four forms of enhancement: cognitive, physical, mood and moral. These forms are supported by the list of specific technologies and techniques used for HE. The book identifies the current trends in HE's development and analyses the challenges that HE poses to health policy and healthcare systems. It discusses the legal and financial aspects of HE, including regulation and shows that the financing of HE goes far beyond the scope of universal health coverage, thus opening the door for private, voluntary insurance and/or out-of-pocket payments. This, in turn, leads towards growing inequalities, which may threaten social cohesion. Readers will receive a structured picture of the latest advances in HE and trends in the field, as well as a list of the challenges and problems that HE generates.The book offers a concise picture of HE for students and researchers across the political sciences, public health, public sector management, and sociology. It will also find an audience among healthcare managers, policymakers, and those who are interested in social change.

The application of Artificial Intelligence (AI) in the healthcare sector is certain to boost levels of automation and productivity but, paradoxically, it will also increase the availability of “first line competence.” At the same time as demographic trends are affecting demand for health and social care, the technological developments we are seeing make it highly likely that AI will play a decisive role in tackling the challenges our healthcare systems will encounter. This book reveals systemic connections to tackle questions about the potential impact of AI on future challenges in the healthcare sector.Specifically, it develops practical proposals for ways in which AI can be applied to solve these forthcoming issues. It emphasizes the importance of AI in what is known in the literature as human augmentation. The book’s innovative perspective is apparent in the way it challenges conventional wisdom in the context of several pressing questions, such as:• What opportunities and challenges could arise from the application of AI in the healthcare sector?• How can the philosophy of medicine, viewed from a systemic perspective, help us to understand, explain, and resolve some of the future challenges in the healthcare sector?• How could AI affect inclusive employment opportunities for people with disabilities?The book also contains an underlying argument to the effect that the rational approach adopted by economists is perhaps less rational when applied to a healthcare sector that is crying out for more “first line competence.”The primary readership will be academic, but the book will also appeal to policymakers, consultants, HR departments, healthcare stakeholders, and related practitioners.

The application of Artificial Intelligence (AI) in the healthcare sector is certain to boost levels of automation and productivity but, paradoxically, it will also increase the availability of “first line competence.” At the same time as demographic trends are affecting demand for health and social care, the technological developments we are seeing make it highly likely that AI will play a decisive role in tackling the challenges our healthcare systems will encounter. This book reveals systemic connections to tackle questions about the potential impact of AI on future challenges in the healthcare sector.Specifically, it develops practical proposals for ways in which AI can be applied to solve these forthcoming issues. It emphasizes the importance of AI in what is known in the literature as human augmentation. The book’s innovative perspective is apparent in the way it challenges conventional wisdom in the context of several pressing questions, such as:• What opportunities and challenges could arise from the application of AI in the healthcare sector?• How can the philosophy of medicine, viewed from a systemic perspective, help us to understand, explain, and resolve some of the future challenges in the healthcare sector?• How could AI affect inclusive employment opportunities for people with disabilities?The book also contains an underlying argument to the effect that the rational approach adopted by economists is perhaps less rational when applied to a healthcare sector that is crying out for more “first line competence.”The primary readership will be academic, but the book will also appeal to policymakers, consultants, HR departments, healthcare stakeholders, and related practitioners.

This book brings together a collection of empirical case studies featuring a wide spectrum of medical innovation. While there is no unique pathway to successful medical innovation, recurring and distinctive features can be observed across different areas of clinical practice. This book examines why medical practice develops so unevenly across and within areas of disease, and how this relates to the underlying conditions of innovation across areas of practice.The contributions contained in this volume adopt a dynamic perspective on medical innovation based on the notion that scientific understanding, technology and clinical practice co-evolve along the co-ordinated search for solutions to medical problems. The chapters follow an historical approach to emphasise that the advancement of medical know-how is a contested, nuanced process, and that it involves a variety of knowledge bases whose evolutionary paths are rooted in the contexts in which they emerge.This book will be of interest to researchers and practitioners concerned with medical innovation, management studies and the economics of innovation.Chapter 5 of this book is freely available as a downloadable Open Access PDF at http://www.taylorfrancis.com under a Creative Commons Attribution-Non Commercial-No Derivatives (CC-BY-NC-ND) 3.0 license.

Reconfiguring Global Health Innovation presents the findings of multi-year research, contrasting experiences of different latecomer countries in building health innovation systems to cater to local needs. It analyses the emerging industrial structures in health innovation as more and more latecomer countries are foraying into what is a highly difficult and technologically intensive sector, with the aim of finding ways and means to balance these promising developments with public health needs worldwide.The bookpresents empirical findings from six countries across Asia and Africa on health innovation, namely, India, Bangladesh, Vietnam, Kenya, Tanzania and Nigeria. The book concludes that the growth of knowledge and the accumulation of capabilities influence the ability of a country to generate wealth.