A new approach to the tradeoff between quality and accessibility of health care

Tanke, Marit A.C.; Ikkersheim, David

doi:10.1016/j.healthpol.2012.02.016

Cited by 17 publications

(15 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Additionally, living in a zip code with a higher percentage of highly-educated adults was associated with higher functional wellbeing, ovarian-specific, and TOI HRQOL scores in the bivariate analyses, but these coefficients lost statistical significance after controlling for other variables. These results confirm previous research demonstrating associations between ovarian cancer outcomes (including HRQOL) and contextual factors [8,[12][13][14][15][16][17][18]. Alternative measures of community characteristics, including better measures of area-level SES, could reveal more robust associations with HRQOL [26].…”

Section: Discussionsupporting

confidence: 88%

“…Availability of transportation, for example, has been investigated as a contributor to cancer disparities [14,15]. Cancer patients with higher travel burdens (in terms of distance and time) to their treatment centers often have poorer HRQOL, lower rates of adherence to treatment regimens, and worse survival outcomes [13,[15][16][17]. Variation in travel burden can pose challenges to cancer patients across the rural-urban continuum, though burdens may be offset by higher quality care at regionalized cancer centers (usually in urban areas) [15,17].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Disparities in health-related quality of life in women undergoing treatment for advanced ovarian cancer: the role of individual-level and contextual social determinants

Moss

Murphy

Filiaci

et al. 2018

Support Care Cancer

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Disparities in health-related quality of life in women undergoing treatment for advanced ovarian cancer: the role of individual-level and contextual social determinants

Moss

Murphy

Filiaci

et al. 2018

Support Care Cancer

View full text Add to dashboard Cite

show abstract

“…This demonstrates that social context must be also considered in the analysis of spatial inequalities in health. • Spatial accessibility to health care: Studies demonstrated a lower health care use in lower medical density areas [20] and for remote patients [21]. Health care access may improve prevention and early diagnosis of diseases but also follow-up and management [22].…”

Section: Combined Effects Of Local Health Care Accessibility Environmentioning

confidence: 99%

Beyond the map: evidencing the spatial dimension of health inequalities

et al. 2020

View full text Add to dashboard Cite

Background Spatial inequalities in health result from different exposures to health risk factors according to the features of geographical contexts, in terms of physical environment, social deprivation, and health care accessibility. Using a common geographical referential, which combines indices measuring these contextual features, could improve the comparability of studies and the understanding of the spatial dimension of health inequalities. Methods We developed the Geographical Classification for Health studies (GeoClasH) to distinguish French municipalities according to their ability to influence health outcomes. Ten contextual scores measuring physical and social environment as well as spatial accessibility of health care have been computed and combined to classify French municipalities through a K-means clustering. Age-standardized mortality rates according to the clusters of this classification have been calculated to assess its effectiveness. Results Significant lower mortality rates compared to the mainland France population were found in the Wealthy Metropolitan Areas (SMR = 0.868, 95% CI 0.863–0.873) and in the Residential Outskirts (SMR = 0.971, 95% CI 0.964–0.978), while significant excess mortality were found for Precarious Population Districts (SMR = 1.037, 95% CI 1.035–1.039), Agricultural and Industrial Plains (SMR = 1.066, 95% CI 1.063–1.070) and Rural Margins (SMR = 1.042, 95% CI 1.037–1.047). Conclusions Our results evidence the comprehensive contribution of the geographical context in the constitution of health inequalities. To our knowledge, GeoClasH is the first nationwide classification that combines social, environmental and health care access scores at the municipality scale. It can therefore be used as a proxy to assess the geographical context of the individuals in public health studies.

show abstract

“…In its informal opinion, the ACM assumed that patients were willing to travel further for better care for complex procedures. This argument is partly supported by the relevant academic literature: it has been shown that some patients are more inclined to travel further for higher quality of care, to a certain extent at least (Tanke and Ikkersheim, 2012;Ikkersheim et al, 2013;Gutacker et al, 2016;Middelveldt et al, 2018;Vallejo-Torres et al, 2018).…”

Section: B Potential Travel Time Effectsmentioning

confidence: 94%

Collaboration and Competition Policy in a Market-Based Hospital System: A Case Study from the Netherlands

Schors¹,

Kemp²,

Varkevisser³

2020

Journal of Competition Law &Amp; Economics

View full text Add to dashboard Cite

In the Dutch healthcare system, provider competition is used as a tool to improve efficiency. From a competition policy perspective, little is known about how collaboration among healthcare providers contributes to overall patient welfare, and how a balance is achieved between scale benefits and preventing anti-competitive collusion. This paper examines the ex-post effects of a Dutch case study in which three competing hospitals have collaborated to provide high-complexity low-volume cancer surgery, an arrangement that tests the limits of permissibility under the Dutch cartel prohibition. Our preliminary empirical research demonstrated only a modest increase in price and travel time for some of the tumour surgeries. Volume analysis showed that the intended centralization of surgical procedures has not been fully realized. Our findings highlight the importance of a comprehensive self-assessment by the collaborating hospitals to ex-ante assess (potential) efficiencies and antitrust risks. Such self-assessments could benefit from research focused on which collaborations are most appropriate to achieve quality gains. For the ex-post assessment by competition authorities following the cartel prohibition, a more thorough insight into the (long-term) changes in hospital prices, profitability, and quality after collaboration is needed.

show abstract

A new approach to the tradeoff between quality and accessibility of health care

Cited by 17 publications

References 26 publications

Disparities in health-related quality of life in women undergoing treatment for advanced ovarian cancer: the role of individual-level and contextual social determinants

Disparities in health-related quality of life in women undergoing treatment for advanced ovarian cancer: the role of individual-level and contextual social determinants

Beyond the map: evidencing the spatial dimension of health inequalities

Collaboration and Competition Policy in a Market-Based Hospital System: A Case Study from the Netherlands

Contact Info

Product

Resources

About