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Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Emotional debates about the reimbursement of cancer drugs, orphan drugs, and end-of-life treatments have revealed fundamental disagreements about what should and should not be considered in reimbursement decisions. Part of this disagreement seems related to the equity-efficiency tradeoff, which reflects fundamental differences in priorities. All in all, it is clear that countries aiming to improve UHC policies will have to go beyond the capacity building needed to utilize the available HTA toolbox. Multi-criteria decision analysis (MCDA) offers a more comprehensive tool for reimbursement decisions where different weights of different factors\u002Fattributes can give policymakers important insights to consider. Sooner or later, every country will have to develop their own way to carefully combine the results of those tools with their own priorities. In the end, all policymaking is based on a mix of facts and values.",{"EN":196},"Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage",{"VOID":198},"[]",{"VOID":200},"Colombo F, Tapay N. Private health insurance in OECD countries: the benefits and costs for individuals and health systems. OECD Health Working Papers. 2004;15:265–319.\nCutler DM. Equality, efficiency, and market fundamentals: the dynamics of international medical-care reform. J Econ Lit. 2002;40(3):881–906.\nHurst J. The reform of health care systems in seven OECD countries. Paper presented at the Second World Congress of Health Economics, Zurich (Switzerland). OECD; 1990 September.\nOECD. Health at a glance 2013: OECD indicators. OECD Publishing; 2013. p. 153–66.\nKotlikoff LJ, Hagist C. Who’s going broke? Comparing growth in healthcare costs in ten OECD countries. NBER Working Paper 2005(w11833)\nKanters TA, Hakkaart L, Rutten-van Mölken MP, Redekop WK. Access to orphan drugs in western Europe: can more systematic policymaking really help to avoid different decisions about the same drug? Expert Rev Pharmacoecon Outcomes Res. 2015;15(4):557–9.\nEUnetHTA Work Package 8. EUnetHTA Handbook on Health Technology Assessment Capacity Building. Barcelona (Spain): Catalan Agency for Health Technology Assessment and Research. Catalan Health Service. Department of Health Autonomous Government of Catalonia; 2008.\nLuce BR, Drummond M, Jönsson B, Neumann PJ, Schwartz JS, Siebert U, Sullivan SD. EBM, HTA, and CER: Clearing the confusion. Milbank Quarter. 2010;88(2):256–76. doi:10.1111\u002Fj.1468-0009.2010.00598.\nShah KK, Cookson R, Culyer AJ, Lettlejohns P. NICE’s social value judgements about equity in health and health care. Health Econ Policy Law. 2013;8(2):145–65.\nBeattie A, Yates R, Noble DJ. Accelerating progress towards universal health coverage in asia and pacific: Improving the future for women and children. BMJ Glob Health. 2016;1(Suppl 2):i12–8.\nPaolucci F. Economic rationales for the design of health care financing schemes. In: Health care financing and insurance: options for design. Berlin: Springer; 2011. p. 13–32.\nStolk E, Busschbach J. Cost effectiveness of sildenafil calls for political discussion. Br Med J. 2000;321:510.\nStolk EA, van Donselaar G, Brouwer WB, Busschbach JJ. Reconciliation of economic concerns and health policy: illustration of an equity adjustment procedure using proportional shortfall. Pharmacoeconomics. 2004;22(17):1097–107.\nAizuddin AN, Sulong S, Aljunid SM. Factors influencing willingness to pay for healthcare. BMC Public Health. 2012;12(Suppl 2):A37.\nPaolucci F, Schut E, van de Ven, WPMM. Economic rationales for the design of health care financing schemes. iHEA 2007 6th World Congress: Explorations in Health Economics Paper; 2007.\nCutler DM, Zeckhauser RJ. The anatomy of health insurance. In: Culyer AJ, Newhouse JP, editors. Handbook of health economics, vol. 1A. Elsevier: Amsterdam; 2000. p. 563–644.\nBaltussen R, Niessen L. Priority setting of health interventions: the need for multi-criteria decision analysis. Cost Eff Resour Alloc. 2006;4:14. doi:10.1186\u002F1478-7547-4-14.\nMarsh K, Lanitis T, Neasham D, Orfanos P, Caro J. Assessing the value of healthcare interventions using multi-criteria decision analysis: A review of the literature. Pharmacoeconomics. 2014;32(4):345–65.\nMühlbacher AC, Kaczynski A. Making good decisions in healthcare with multi-criteria decision analysis: the use, current research and future development of MCDA. Appl Health Econ Health Policy. 2016;14(1):29–40.\nAngelis A, Kanavos P. Value-Based assessment of new medical technologies: towards a robust methodological framework for the application of multiple criteria decision analysis in the context of health technology assessment. Pharmacoeconomics. 2016;34(5):435–46.\nThokala P, Duenas A. Multiple criteria decision analysis for health technology assessment. Value Health. 2012;15(8):1172–81.\nMirelman A, Mentzakis E, Kinter E, Paolucci F, Fordham R, Ozawa S, Ferraz M, Baltussen R, Niessen L. Decision-making criteria among national policymakers in five countries: a discrete choice experiment eliciting relative preferences for equity and efficiency. Val Health. 2012;15(3):534–9.\nPaolucci F, Mentzakis E, Defechereux T, Niessen LW. Equity and efficiency preferences of health policy makers in China—a stated preference analysis. Health Policy Plan. 2015;30(8):1059–66.\nKeane MP, Wasi N. The structure of consumer taste heterogeneity in revealed vs. stated preference data. Economics Papers 2013-W10. Economics Group, Nuffield College, University of Oxford; 2013.\nSchroeder DA. Discrete choice models. In: Accounting and causal effects: econometric challenges. New York: Springer; 2010. p. 77–95.\nColapinto C, Jayaraman R, Marsiglio S. Multi-criteria decision analysis with goal programming in engineering, management and social sciences: a state-of-the art review. Ann Oper Res. 2017;251(1–2):7–40.\nNeumann PJ, Sanders GD, Russell LB, Siegel JE, Ganiats TG. Cost-effectiveness in health and medicine. 2nd ed. Oxford: Oxford University Press; 2016.\nDakin H, Devlin N, Feng Y, Rice N, ONeill P, Parkin D. The influence of cost-effectiveness and other factors on NICE decisions. HERC research paper 01\u002F13. Health Economics Research Centre, University of Oxford; 2014.\nde Groot S, Rijnsburger AJ, Versteegh MM, Heymans JM, Kleijnen S, Redekop WK, Verstijnen IM. Which factors may determine the necessary and feasible type of effectiveness evidence? A mixed methods approach to develop an instrument to help coverage decision-makers. BMJ Open. 2015;5(7):e007241.\nPiniazhkho O, Németh B. An analysis of the criteria used in existing or proposed MCDA models PRM202. ISPOR 21st Annual International Meeting. May 2016.\nDefechereux T, Paolucci F, Mirelman A, Youngkong S, Botten G, Hagen TP, Niessen LW. Health care priority setting in Norway: a multicriteria decision analysis. BMC Health Serv Res. 2012;12:39.\nRedekop WK. Navigating the waters of economic evaluations of medical devices. ISPOR. 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Seventeen in-depth qualitative interviews were conducted with senior managers and clinicians to gain a user perspective and identify specific areas for process refinement. Data were thematically coded and categorised into relevant themes. Key strengths included a culture shift in thinking about the need to reallocate resources within a fixed funding envelope, whereas a key challenge identified was in putting forth genuine disinvestment options. Areas suggested for improvement included evoking an incentive system for stakeholder engagement and having a mechanism for tracking the effect of resource reallocations. Both an evidence-based approach to priority setting, as well as a way of thinking around managing resource scarcity, can be integrated into organisational processes. Findings reported in this article will influence further application in Calgary and should provide insight for those attempting such activity elsewhere.",{"EN":1126},"Listening to the decision makers",{"VOID":1128},"[\"6221043056974882261\"]",{"VOID":1130},"10.2165\u002F00148365-200403030-00005","2024-04-30T11:50:17.764+00:00","https:\u002F\u002Flink.springer.com\u002Farticle\u002F10.2165\u002F00148365-200403030-00005",[1134,1159,1174],{"id":1135,"sortIndex":21,"researcher":20,"roles":1136,"affiliations":1137,"properties":1154},"53bd418e-5ad1-466e-99bb-6f95895b5b65",[212],[1138,1146],{"id":1139,"sortIndex":21,"affiliation":1140,"properties":20},"a25ba638-c001-46c8-90f0-5014d2e2f80e",{"id":1139,"createTime":20,"updateTime":20,"relativeEntities":1141,"slug":20,"properties":1142,"entityType":20,"verifyStatus":20,"verifyTime":20,"verifyNote":20,"languages":20,"translateLanguages":20,"viewCount":20,"url":20,"parentIds":1145,"statistic":20},[],{"title":1143},{"VI":1144},"Centre for Healthcare Innovation and Improvement, B.C. Research Institute for Children's and Women's Health, Vancouver, Canada",[],{"id":1147,"sortIndex":224,"affiliation":1148,"properties":20},"02e6dfe3-2e0e-40b5-9bb8-cc29222ca339",{"id":1147,"createTime":20,"updateTime":20,"relativeEntities":1149,"slug":20,"properties":1150,"entityType":20,"verifyStatus":20,"verifyTime":20,"verifyNote":20,"languages":20,"translateLanguages":20,"viewCount":20,"url":20,"parentIds":1153,"statistic":20},[],{"title":1151},{"VI":1152},"Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canada",[],{"title":1155,"gsAuthor":1157},{"VI":1156},"Craig 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L, Hussey R, Mooney G, et al. Public health and economics in tandem: programme budgeting, marginal analysis and priority setting in practice. Health Policy 1995; 33: 161–8","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002F016885109593676R",{"doi":1264},"10.1016\u002F0168-8510(95)93676-R",{"id":897,"text":1266,"url":899,"identifiers":1267},"Ham C, Coulter A. Explicit and implicit rationing: taking responsibility and avoiding blame for health care choices. J Health Serv Res Policy 2001; 6(3): 163–9",{"doi":901},{"id":20,"text":1269,"url":20,"identifiers":1270},"Lomas J, Veenstra G, Woods J. Devolving authority for health care in Canada’s provinces: 2. Backgrounds, resources and activities of board members. CMAJ 1997; 156(4): 513–20",{},{"id":897,"text":1272,"url":899,"identifiers":1273},"Miller P, Vale L. Programme approach to managing informed commissioning. Health Serv Manage Res 2001; 14(3): 159–64",{"doi":901},{"id":897,"text":1275,"url":899,"identifiers":1276},"Birch S, Chambers S. To each according to need: a community-based approach to allocating health care resources. CMAJ 1993; 149: 607–12",{"doi":901},{"id":897,"text":1278,"url":899,"identifiers":1279},"Cohen D. Marginal analysis in practice: an alternative to needs assessment for contracting health care. BMJ 1994; 309: 781–5",{"doi":901},{"id":897,"text":1281,"url":899,"identifiers":1282},"Ruta D, Donaldson C, Gilray I. Economics, public health and health care purchasing: the Tayside experience of programme budgeting and marginal analysis. J Health Serv Res Policy 1996; 1(4): 185–93",{"doi":901},{"id":1284,"text":1285,"url":1286,"identifiers":1287},"60846d82-852a-4f1a-b71e-8804010c7635","Haas M, Viney R, Kristensen E, et al. Using program budgeting and marginal analysis to assist population based strategic planning for coronary heart disease. Health Policy 2001; 55: 173–86","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0168851000001196",{"doi":1288},"10.1016\u002Fs0168-8510(00)00119-6",{"id":897,"text":1290,"url":899,"identifiers":1291},"Mitton C, Donaldson C. Twenty-five years of program budgeting and marginal analysis in the health sector, 1974–1999. J Health Serv Res Policy 2001; 6(4): 239–48",{"doi":901},{"id":1293,"text":1294,"url":1295,"identifiers":1296},"d904566a-025c-4f89-892b-a4185766127a","Donaldson C, Farrar S. Needs assessment: developing an economic approach. Health Policy 1993; 25: 95–108","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002F016885109390105X",{"doi":1297},"10.1016\u002F0168-8510(93)90105-x",{"id":897,"text":1299,"url":899,"identifiers":1300},"Mitton C, Donaldson C. Resource allocation in health care: health economics and beyond. Health Care Anal 2003; 11(3): 245–57",{"doi":901},{"id":897,"text":1302,"url":899,"identifiers":1303},"Posnett J, Street A. Programme budgeting and marginal analysis: an approach to priority setting in need of refinement. J Health Serv Res Policy 1996; 1(3): 147–53",{"doi":901},{"id":897,"text":1305,"url":899,"identifiers":1306},"Peacock S. An evaluation of program budgeting and marginal analysis applied in South Australian hospitals. Melbourne: Center for Health Program Evaluation, Monash University, 1998",{"doi":901},{"id":20,"text":1308,"url":20,"identifiers":1309},"Mooney G, Wiseman V. Listening to the bureaucrats to establish principles for priority setting. Sydney: University of Sydney, 1999",{},{"id":1311,"text":1312,"url":1313,"identifiers":1314},"a47fd419-19e8-4225-9d2a-bf11802cbb51","Jan S, Dommers E, Mooney G. A politico-economic analysis of decision making in funding health service organisations. Soc Sci Med 2003; 57(3): 427–35","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0277953602003684",{"doi":1315},"10.1016\u002Fs0277-9536(02)00368-4",{"id":20,"text":1317,"url":20,"identifiers":1318},"Stringer ET. Action research. 2nd ed. Thousand Oaks (CA): Sage Publications Inc, 1999",{},{"id":897,"text":1320,"url":899,"identifiers":1321},"Glaser BG, Strauss AL. The discovery of grounded theory: strategies for qualitative research. Chicago (IL): Aldine, 1967",{"doi":901},{"id":20,"text":1323,"url":20,"identifiers":1324},"Marshall C, Rossman G. Designing qualitative research. 2nd ed. Thousand Oaks (CA): Sage Publications Inc, 1995",{},{"id":897,"text":1326,"url":899,"identifiers":1327},"Lincoln YS, Guba EG. Naturalistic inquiry. Beverly Hills: Sage Publications Inc, 1985",{"doi":901},{"id":897,"text":1329,"url":899,"identifiers":1330},"Mitton C, Peacock S, Donaldson C, et al. Using PBMA in health care priority setting: description, challenges and experience. Appl Health Econ Health Policy 2003; 2(3): 121–7",{"doi":901},{"id":897,"text":1332,"url":899,"identifiers":1333},"Walshe K, Rundall TG. Evidence-based management: from theory to practice in health care. Milbank Q 2001; 79(3): 429–57",{"doi":901},{"id":897,"text":1335,"url":899,"identifiers":1336},"Mitton C, Donaldson C. Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA). Health Policy 2003; 64: 335–48",{"doi":901},{"id":1338,"createTime":1339,"updateTime":1340,"relativeEntities":1341,"slug":1342,"properties":1343,"entityType":203,"verifyStatus":204,"verifyTime":1356,"verifyNote":206,"languages":20,"translateLanguages":1357,"viewCount":21,"primaryUrl":1359,"fullTextUrl":20,"authors":1360,"publicationType":292,"publisherRelationship":1389,"citationCount":1452,"citationInfo":1453,"publishDate":1256,"publishYear":1254,"citationAnalyzeStatus":19,"lastCitationAnalyze":1455,"indexDatabases":1456,"openAccess":20,"references":1457,"isForceReanalyzing":361},"12be4d19-4127-4c5f-8006-3aeb55d74192","2024-01-14T21:49:00.855+00:00","2026-03-28T04:09:00.741+00:00",[],"Key-performance-indicators-for-the-implementation-of-social-health-insurance",{"abstract":1344,"title":1347,"gsPaper":1350,"keywords":1352,"doi":1354},{"EN":1345,"VI":1346},"Several low- and middle-income countries are interested in extending their existing health insurance for specific groups to eventually cover their entire populations. For those countries interested in such an extension, it is important to understand what characterises a well performing social health insurance scheme. This article provides a simple framework to analyse key performance issues related to the functions of health financing within the context of social health insurance. The framework first illustrates how performance in the health financing functions of revenue collection, pooling and purchasing affects the realisation of health financing targets of resource generation, optimal resource use and financial accessibility of health services for all. Then, within each health financing function, key performance issues and associated measurable indicators are developed. The set of performance indicators provided in this article should help policy makers to monitor the development of social health insurance schemes and identify areas for improvement. In doing so, policy makers can come closer to achieving universal coverage — access to appropriate healthcare for all at an affordable cost — the ultimate goal of social health insurance.","Nhiều quốc gia có thu nhập thấp và trung bình đang quan tâm đến việc mở rộng bảo hiểm y tế hiện có cho các nhóm cụ thể nhằm cuối cùng bao phủ toàn bộ dân số của họ. Đối với những quốc gia quan tâm đến việc mở rộng như vậy, điều quan trọng là hiểu những đặc điểm của một chương trình bảo hiểm y tế xã hội hoạt động tốt. Bài viết này cung cấp một khuôn khổ đơn giản để phân tích các vấn đề hiệu suất chính liên quan đến các chức năng tài chính y tế trong bối cảnh bảo hiểm y tế xã hội. Khuôn khổ này trước tiên minh họa cách mà hiệu suất trong các chức năng tài chính y tế của việc thu thập doanh thu, gộp quỹ và mua sắm ảnh hưởng đến việc hiện thực hóa các mục tiêu tài chính y tế như tạo ra nguồn lực, sử dụng nguồn lực tối ưu và tiếp cận tài chính với dịch vụ y tế cho tất cả mọi người. Sau đó, trong mỗi chức năng tài chính y tế, các vấn đề hiệu suất chính và các chỉ số có thể đo lường liên quan được phát triển. Bộ chỉ số hiệu suất được cung cấp trong bài viết này sẽ giúp các nhà hoạch định chính sách theo dõi sự phát triển của các chương trình bảo hiểm y tế xã hội và xác định các lĩnh vực cần cải thiện. Bằng cách đó, các nhà hoạch định chính sách có thể tiến gần hơn đến việc đạt được bao phủ toàn cầu — tiếp cận dịch vụ chăm sóc sức khỏe phù hợp cho tất cả mọi người với chi phí hợp lý — mục tiêu cuối cùng của bảo hiểm y tế xã hội.",{"EN":1348,"VI":1349},"Key performance indicators for the implementation of social health insurance","Các chỉ số hiệu suất chính cho việc triển khai bảo hiểm y tế xã hội",{"VOID":1351},"[\"11190826821288031815\"]",{"VI":1353},"bảo hiểm y tế xã hội, chỉ số hiệu suất, tài chính y tế, chính sách y tế, bao phủ toàn cầu",{"VOID":1355},"10.2165\u002F00148365-200504010-00004","2024-04-29T21:08:38.917+00:00",[1358],"VI","https:\u002F\u002Flink.springer.com\u002Farticle\u002F10.2165\u002F00148365-200504010-00004",[1361,1376],{"id":1362,"sortIndex":21,"researcher":20,"roles":1363,"affiliations":1364,"properties":1373},"82840283-2233-4acd-91b4-205def68b48f",[212],[1365],{"id":1366,"sortIndex":21,"affiliation":1367,"properties":20},"b67343fd-bc7c-4148-8797-c2f0a591a299",{"id":1366,"createTime":20,"updateTime":20,"relativeEntities":1368,"slug":20,"properties":1369,"entityType":20,"verifyStatus":20,"verifyTime":20,"verifyNote":20,"languages":20,"translateLanguages":20,"viewCount":20,"url":20,"parentIds":1372,"statistic":20},[],{"title":1370},{"EN":1371},"Department of Health Systems Financing, World Health Organization, Geneva, Switzerland",[],{"title":1374},{"VI":1375},"Guy Carrin",{"id":1377,"sortIndex":224,"researcher":20,"roles":1378,"affiliations":1379,"properties":1386},"9eb94658-a47f-4a2e-8d02-3cb314886a09",[212],[1380],{"id":1366,"sortIndex":21,"affiliation":1381,"properties":20},{"id":1366,"createTime":20,"updateTime":20,"relativeEntities":1382,"slug":20,"properties":1383,"entityType":20,"verifyStatus":20,"verifyTime":20,"verifyNote":20,"languages":20,"translateLanguages":20,"viewCount":20,"url":20,"parentIds":1385,"statistic":20},[],{"title":1384},{"EN":1371},[],{"title":1387},{"VI":1388},"Chris James",{"url":1359,"publisher":1390,"properties":1447},{"id":6,"createTime":7,"updateTime":8,"relativeEntities":1391,"slug":10,"properties":1392,"entityType":18,"verifyStatus":19,"verifyTime":20,"verifyNote":20,"languages":20,"translateLanguages":20,"viewCount":21,"subjectFields":1396,"manageAffiliations":1409,"indexDatabases":1420,"url":20,"thumbnailPath":20,"statistic":1442,"gsStatistic":20,"type":20,"analyzePriority":20},[],{"issn":1393,"title":1394,"eissn":1395},{"VOID":13},{"EN":15},{"VOID":17},[1397,1401,1405],{"id":24,"createTime":20,"updateTime":20,"relativeEntities":1398,"label":1399,"description":1400,"parentId":20,"standard":20,"scholarHubFieldId":20},[],{"EN":27},{},{"id":30,"createTime":20,"updateTime":20,"relativeEntities":1402,"label":1403,"description":1404,"parentId":20,"standard":20,"scholarHubFieldId":20},[],{"EN":33},{},{"id":36,"createTime":20,"updateTime":20,"relativeEntities":1406,"label":1407,"description":1408,"parentId":20,"standard":20,"scholarHubFieldId":20},[],{"EN":39},{},[1410,1415],{"id":43,"createTime":20,"updateTime":20,"relativeEntities":1411,"slug":20,"properties":1412,"entityType":20,"verifyStatus":20,"verifyTime":20,"verifyNote":20,"languages":20,"translateLanguages":20,"viewCount":20,"url":20,"parentIds":1414,"statistic":20},[],{"title":1413},{"EN":47},[49],{"id":51,"createTime":20,"updateTime":20,"relativeEntities":1416,"slug":20,"properties":1417,"entityType":20,"verifyStatus":20,"verifyTime":20,"verifyNote":20,"languages":20,"translateLanguages":20,"viewCount":20,"url":20,"parentIds":1419,"statistic":20},[],{"title":1418},{"EN":55},[49],[1421,1428,1435],{"id":76,"indexDatabase":1422,"url":87,"indexYears":88,"academicFieldIds":1427,"indexDatabaseRanking":93},{"id":78,"createTime":20,"updateTime":20,"relativeEntities":1423,"label":1424,"description":1425,"key":84,"publicationTags":1426,"standard":20},[],{"EN":81,"VI":81},{"EN":81,"VI":83},[86],[90,91,92],{"id":59,"indexDatabase":1429,"url":72,"indexYears":20,"academicFieldIds":1434,"indexDatabaseRanking":20},{"id":61,"createTime":20,"updateTime":20,"relativeEntities":1430,"label":1431,"description":1432,"key":68,"publicationTags":1433,"standard":20},[],{"EN":64,"VI":64},{"EN":66,"VI":67},[70,71],[74],{"id":95,"indexDatabase":1436,"url":72,"indexYears":20,"academicFieldIds":1441,"indexDatabaseRanking":20},{"id":97,"createTime":20,"updateTime":20,"relativeEntities":1437,"label":1438,"description":1439,"key":104,"publicationTags":1440,"standard":20},[],{"EN":100,"VI":100},{"EN":102,"VI":103},[106,71],[108,109],{"impactFactor":21,"impactFactorByYear":1443,"i10Index":124,"i10IndexLast5Year":125,"totalPublication":126,"totalPublicationByYear":1444,"totalCitation":142,"totalCitationByYear":1445,"totalCitationPerPublication":161,"totalCitationPerPublicationByYear":1446,"hindexLast5Year":181,"hindex":181},{"2012":112,"2013":113,"2014":114,"2015":115,"2016":116,"2017":117,"2018":118,"2019":119,"2020":120,"2021":121,"2022":122,"2023":123},{"2004":128,"2005":129,"2006":130,"2008":131,"2009":128,"2010":128,"2011":128,"2012":132,"2013":133,"2014":134,"2015":135,"2016":136,"2017":136,"2018":137,"2019":138,"2020":139,"2021":140,"2022":141,"2023":135,"2024":125},{"2004":144,"2005":145,"2006":146,"2008":141,"2009":147,"2010":148,"2011":149,"2012":150,"2013":151,"2014":152,"2015":153,"2016":154,"2017":155,"2018":156,"2019":148,"2020":157,"2021":158,"2022":159,"2023":160},{"2004":163,"2005":164,"2006":165,"2008":166,"2009":167,"2010":168,"2011":169,"2012":170,"2013":171,"2014":172,"2015":173,"2016":174,"2017":175,"2018":176,"2019":177,"2020":178,"2021":179,"2022":123,"2023":180},{"pages":1448,"volume":1450},{"VOID":1449},"15-22",{"VOID":1451},"4",93,{"total":1452,"publishYear":1254,"statisticByYear":1454},{},"2026-03-28T04:09:00.740+00:00",[106,70,93],[1458,1461,1464,1467,1470,1474,1477,1480,1486,1489,1492,1495,1498,1501,1504,1507,1513,1516,1519,1522,1528,1531],{"id":897,"text":1459,"url":899,"identifiers":1460},"Carrin G, Zeramdini R, Musgrove P, et al. Impact of risk sharing on the attainment of health system goals. In: Preker A, Carrin G, editors. Health financing for poor people: resource mobilization and risk sharing. Washington, DC: World Bank, 2004",{"doi":901},{"id":20,"text":1462,"url":20,"identifiers":1463},"Saltman RB, Busse R, Figueras J, editors. Social health insurance systems in western Europe. European Observatory on Health Systems and Policies series. Maidenhead: Open University Press, 2004",{},{"id":20,"text":1465,"url":20,"identifiers":1466},"Carrin G, James C. Experience in the implementation of social health insurance: key factors in the transition period. Int Soc Secur Rev 2005; 58(1): 45–64",{},{"id":897,"text":1468,"url":899,"identifiers":1469},"Normand C, Weber C. Social health insurance: a guidebook for planning. Geneva: WHO\u002FInternational Labour Office, 1994",{"doi":901},{"id":20,"text":1471,"url":1472,"identifiers":1473},"Eichler R, Lewis E. Social insurance assessment tool. LAC Health Sector Reform Initiative. Boston (MA): Management Sciences for Health, 2000 [online]. Available from URL: http:\u002F\u002Fwww.lachsr.org\u002Fen\u002Ftoolsframeworks.cfm [Accessed 2005 Jun]","http:\u002F\u002Fwww.lachsr.org\u002Fen\u002Ftoolsframeworks.cfm",{},{"id":20,"text":1475,"url":20,"identifiers":1476},"Ron A. Planning and implementing health insurance in developing countries: guidelines and studies. Macroeconomic, health and development series, no. 7. Geneva: WHO, 1993",{},{"id":20,"text":1478,"url":20,"identifiers":1479},"World Health Organization. World health report. Health systems: improving performance. Geneva: WHO, 2000",{},{"id":1481,"text":1482,"url":1483,"identifiers":1484},"35b77ce7-7224-4aa2-b53b-c7827e06a667","Kutzin J. A descriptive framework for country-level analysis of health care financing arrangements. Health Policy 2001; 56: 171–204","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0168851000001494",{"doi":1485},"10.1016\u002FS0168-8510(00)00149-4",{"id":20,"text":1487,"url":20,"identifiers":1488},"Zweifel P, Manning WG. Moral hazard and consumer incentives in health care. Chapter 8. In: Culyer AJ, Newhouse JP, editors. Handbook of health economics. Vol. 1A. Amsterdam: Elsevier Science, 2000: 409–59",{},{"id":20,"text":1490,"url":20,"identifiers":1491},"Mossialos E, Le Grand J. Cost containment in the EU: an overview. Chapter 1. In: Mossialos E, Le Grand J, editors. Health care and cost containment in the European Union. Aldershot: Ashgate, 1999",{},{"id":20,"text":1493,"url":20,"identifiers":1494},"World Health Organization. World health report: changing history. Geneva: WHO, 2004",{},{"id":897,"text":1496,"url":899,"identifiers":1497},"Xu KE, Klavus J, Kawabata K, et al. Household health system contributions and capacity to pay: definitional, empirical and technical challenges. In: Murray CJL, Evans DB, editors. Health systems performance assessment: debates, methods and empiricism. Geneva: WHO, 2003: 533–42",{"doi":901},{"id":897,"text":1499,"url":899,"identifiers":1500},"Moens F, Carrin G. Prepayment for hospital care in the Bwamanda Health Zone. Chapter 9. In: Carrin G, Vereecke M, editors. Strategies for health care in developing countries. London: MacMillan Press Ltd, 1992: 157–70",{"doi":901},{"id":897,"text":1502,"url":899,"identifiers":1503},"Kwon S. Healthcare financing reform and the new single payer system in the Republic of Korea: social solidarity or efficiency. Int Soc Secur Rev 2003; 56(1): 5–94",{"doi":901},{"id":20,"text":1505,"url":20,"identifiers":1506},"Gonzalez Rossetti A. Social health insurance in Latin America. Background paper for the Department for International Development Health Insurance Workshop; 2002 Apr 9-10; London. London: Department for International Development Health Systems Resource Centre, 2002",{},{"id":1508,"text":1509,"url":1510,"identifiers":1511},"cd54883b-eae7-4f2c-87d4-bd58b9c5e907","Chiang TL. Taiwan’s 1995 health care reform. Health Policy 1997; 39: 225–39","https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0168851096008779",{"doi":1512},"10.1016\u002Fs0168-8510(96)00877-9",{"id":897,"text":1514,"url":899,"identifiers":1515},"Van de Ven WPMM, Beck K, Buchner F, et al. Risk adjustment and risk selection on the sickness fund insurance market in five European countries. Health Policy 2002; 65(1): 75–98",{"doi":901},{"id":20,"text":1517,"url":20,"identifiers":1518},"James C, Carrin G, Savedoff W, et al. Clarifying efficiency-equity tradeoffs through explicit criteria, with a focus on developing countries. Health Financing Policy Issue Paper. Health Care Anal 2005; 13(1): 33–51",{},{"id":897,"text":1520,"url":899,"identifiers":1521},"McGuire A, Henderson J, Mooney G. The economics of health care. London: Routledge, 1988",{"doi":901},{"id":1523,"text":1524,"url":1525,"identifiers":1526},"3e7179f0-39ba-4f0a-bc57-848f4b66db44","Carrin G, Hanvoravongchai P. Provider payments and patient charges as policy tools for cost-containment: how successful are they in high-income countries? Hum Resour Health 2003; 1(6) [online]. Available from URL: http:\u002F\u002Fwww.human-resources-health.com\u002Fcontent\u002F1\u002F1\u002F6 [Accessed 2005 Jun 24]","http:\u002F\u002Fhuman-resources-health.biomedcentral.com\u002Farticles\u002F10.1186\u002F1478-4491-1-6",{"doi":1527},"10.1186\u002F1478-4491-1-6",{"id":20,"text":1529,"url":20,"identifiers":1530},"Organisation for Economic Cooperation and Development (OECD). OECD health data 2001 comparative analysis of 30 countries [CD ROM]. Paris: OECD, 2001",{},{"id":20,"text":1532,"url":20,"identifiers":1533},"Carrin G, Hanvoravongchai P. Monetary incentives in cost-containment policies of high-income countries: how successful are they? Geneva: WHO\u002FHealth Systems Financing, 2002",{},{"id":1535,"createTime":1536,"updateTime":1537,"relativeEntities":1538,"slug":1539,"properties":1540,"entityType":203,"verifyStatus":204,"verifyTime":1551,"verifyNote":206,"languages":20,"translateLanguages":20,"viewCount":21,"primaryUrl":1552,"fullTextUrl":20,"authors":1553,"publicationType":292,"publisherRelationship":1642,"citationCount":20,"citationInfo":20,"publishDate":1705,"publishYear":1706,"citationAnalyzeStatus":19,"lastCitationAnalyze":1707,"indexDatabases":1708,"openAccess":20,"references":20,"isForceReanalyzing":361},"bb9b5a57-37a5-47b7-80eb-80192d52c727","2023-12-28T03:36:26.225+00:00","2026-03-25T12:13:59.862+00:00",[],"Direct-Medical-Costs-of-COPD-in-the-USA-An-Analysis-of-the-Medical-Expenditure-Panel-Survey-2017-2018",{"abstract":1541,"title":1543,"gsPaper":1545,"references":1547,"doi":1549},{"EN":1542},"In this study, we aimed to provide a nationally representative estimate of the economic burden of chronic obstructive pulmonary disease (COPD) by examining direct medical costs among individuals aged 45 years and older in the USA. Medical Expenditure Panel Survey (2017–2018) data were used to estimate the direct medical costs associated with COPD. All-cause (unadjusted) cost and COPD-specific (adjusted) cost were determined for the various service categories using a regression-based approach among patients with COPD. We developed a weighted two-part model and adjusted for various demographic, socioeconomic, and clinical characteristics. The study sample consisted of 23,590 patients, of which 1073 had COPD. Patients with COPD had a mean age of 67.4 years (standard error (SE): 0.41), and the total all-cause mean medical cost per patient per year (PPPY) was 2018 US $19,449 (SE: US $865), of which US $6145 (SE: US $295) was for prescription drugs. Using the regression approach, the mean total COPD-specific cost was US $4322 (SE: US $577) PPPY, with prescription drugs contributing US $1887 (SE: 216) PPPY. These results represented an annual total COPD-specific cost of US $24.0 billion, with prescription drugs contributing US $10.5 billion. The mean annual out-of-pocket spending accounted for 7.5% (mean: US $325) of the total COPD-specific cost; for COPD-specific prescription drug cost, 11.3% (mean: US $212) was out-of-pocket cost. COPD poses a significant economic burden on healthcare payers and patients 45 years of age and older in the USA. While prescription drugs accounted for almost half of the total cost, more than 10% of the prescription drug cost was out-of-pocket.",{"EN":1544},"Direct Medical Costs of COPD in the USA: An Analysis of the Medical Expenditure Panel Survey 2017–2018",{"VOID":1546},"[\"12000916151347440007\"]",{"VOID":1548},"Raherison C, Girodet P-O. Epidemiology of COPD. Eur Respir Rev. 2009;18:213–21.\nVestbo J, Hurd SS, Agustí AG, Jones PW, Vogelmeier C, Anzueto A, et al. 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KFF. 2020. https:\u002F\u002Fwww.kff.org\u002Fmedicare\u002Fissue-brief\u002Fcomparing-private-payer-and-medicare-payment-rates-for-select-inpatient-hospital-services\u002F.\nComparing Commercial and Medicare Professional Service Prices. HCCI. https:\u002F\u002Fhealthcostinstitute.org\u002Fhcci-research\u002Fcomparing-commercial-and-medicare-professional-service-prices.\nBureau UC. Health Insurance Coverage in the United States: 2020. Census.gov. https:\u002F\u002Fwww.census.gov\u002Flibrary\u002Fpublications\u002F2021\u002Fdemo\u002Fp60-274.html.\nCenters for Medicare and Medicaid Services. Hospital Readmissions Reduction Program (HRRP). 2019. https:\u002F\u002Fwww.cms.gov\u002FMedicare\u002FMedicare-Fee-for-Service-Payment\u002FAcuteInpatientPPS\u002FReadmissions-Reduction-Program.html.\nStrassels SA, Smith DH, Sullivan SD, Mahajan PS. The costs of treating COPD in the United States. Chest. 2001;119:344–52.\nMiller JD, Foster T, Boulanger L, Chace M, Russell MW, Marton JP, et al. 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CMS bundled payments for care improvement initiative models 24: year 3 evaluation & monitoring annual report. Lewin Group, Falls Church, VA. Oct 2017. Available from: https:\u002F\u002Fdownloads.cms.gov\u002Ffiles\u002Fcmmi\u002Fbpci-models2-4yr3evalrpt.pdf. [Accessed 26 Jun 2022].\nHaas D, Zhang X, Kaplan R, Song Z. Evaluation of economic and clinical outcomes under Centers for Medicare & Medicaid Services mandatory bundled payments for joint replacements. JAMA Intern Med. 2019;179(7):924–31. https:\u002F\u002Fdoi.org\u002F10.1001\u002Fjamainternmed.2019.0480.\nBarnett M, Wilcock A, McWilliams J, et al. Two-year evaluation of mandatory bundled payments for joint replacement. N Engl J Med. 2019;380:252–62. https:\u002F\u002Fdoi.org\u002F10.1056\u002FNEJMsa1809010.\nNavathe A, Troxel A, Liao J, et al. Cost of joint replacement using bundled payment models. 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Medicare program; End-Stage Renal Disease Prospective Payment System, and Quality Incentive Program. Final rule, 80(215). Nov 2015. Available from: https:\u002F\u002Fwww.govinfo.gov\u002Fcontent\u002Fpkg\u002FFR-2015-11-06\u002Fpdf\u002F2015-27928.pdf. [Accessed 26 Jun 2022].\nMedicare Payment Advisory Commission. Report to the Congress: Medicare payment policy. Mar 2014. Available from: http:\u002F\u002Fwww.medpac.gov\u002Fdocs\u002Fdefault-source\u002Freports\u002Fmar14_entirereport.pdf. [Accessed 26 Jun 2022].\nAcumen, LLC. Evaluation of patient satisfaction and experience of care for Medicare beneficiaries with end-stage renal disease (ESRD): impact of the ESRD Prospective Payment System (PPS) and ESRD Quality Incentive Program (QIP) final report. Jul 2014. Available from: https:\u002F\u002Finnovation.cms.gov\u002Ffiles\u002Freports\u002Fesrd-eval-ptsat.pdf. [Accessed 26 Jun 2022].\nCubanski J, Damico A, Neuman T. 10 Things to know about Medicare Part D coverage and costs in 2019. Kaiser Family Foundation. Jun 4 2019. Available from: https:\u002F\u002Fwww.kff.org\u002Fmedicare\u002Fissue-brief\u002F10-things-to-know-about-medicare-part-d-coverage-and-costs-in-2019\u002F. [Accessed 26 Jun 2022].\nEvaluation of the oncology care model: performance periods 1–5. Jan 2021. Available from: https:\u002F\u002Finnovation.cms.gov\u002Fdata-and-reports\u002F2021\u002Focm-evaluation-pp1-5. [Accessed 26 Jun 2022].\nCenters for Medicare and Medicaid Services. MS-DRG classifications and software. Available from: https:\u002F\u002Fwww.cms.gov\u002FMedicare\u002FMedicare-Fee-for-Service-Payment\u002FAcuteInpatientPPS\u002FMS-DRG-Classifications-and-Software. [Accessed 26 Jun 2022].\nWerble C. Medicare Part B. Health Aff. 2017. https:\u002F\u002Fdoi.org\u002F10.1377\u002Fhpb20171008.000171.\nButcher L. ASP+6 should go, but what’s next? 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